Coronavirus Responses and Patterns in Africa: Southern and West Africa

Inter-ethnic relations, International Relations, National politics, Public health,, Society & Culture

1836333B-64AF-49C9-B21B-7F66F21411A6Three months ago when the COVID-19 outbreak started to move around the globe, the World Health Organisation issued a warning to the continent of Africa whose nations were just starting to feel its impact [‘Coronavirus: WHO tells African countries to ‘prepare for the worst’, Eye on Africa, 18-Mar-2020, www.france24.com]. The pandemic was late in reaching Africa and initially slow to make inroads, taking 98 days to register its first 100,000 confirmed cases but is now accelerating – only taking 18 more days to hit the 200,000 mark of cases [‘COVID-19: WHO warns of virus acceleration in Africa’, Vanguard, 14-Jun-2020, www.vanguardngr.com]. Overall African fatalities sit at 6,793 (16-Jun-2020) with just five countries (Algeria, Egypt, Nigeria, South Africa and Nigeria) accounting for 70% of the deaths.

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Southern Africa:
To date South Africa has been the nation most heavily affected by the public health emergency – over 73,000 confirmed cases and 1,568 deaths (16-Apr-2020). The Western Cape province has become the epicentre of the RSA pandemic, recording so far around 75% of the country’s fatalities. The province’s high incidence of cases has been attributed to the presence of poor, densely populated townships like Khayelitsha, a shantytown of 500,000 people. Cape Town’s thriving tourism (before the closedown) has also been advanced as contributing to the outbreak’s toll. South Africa, with a more developed economy and better health care system, has conducted more a million virus tests, while many other African countries have racked up only a few thousands. The clear implication of this is that ”the disease is spreading undetected elsewhere on the continent”  [‘Cape Town becomes South Africa’s coronavirus hotspot’, (Jevans Nyabiage), South China Morning Post, 12-Jun-2020, www.amp.scmp.com].

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Bulawayo, Zim.  (Photo: Philimon Bulawayo/Reuters)

South Africa’s smaller, northern neighbour Zimbabwe has done surprisingly well on paper in the crisis (four deaths recorded only), but with the rider that testing for the disease—hampered by a critical shortage of health equipment and infrastructure—has been very limited…by 10th April it had tested a mere 392 people [‘In Zimbabwe, lack of tests sparks fear COVID-19 goes undetected’, (Chris Muronzi), Aljazeera, 10-Apr-2020, www.aljazeera.com].

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(Image: SABC News)

West Africa:
Results of the fight against the pandemic in West Africa have been mixed. Senegal began its counter-measures early in January, closing the borders, implementing contact-tracing, etc. The country was able to produce a test kit for COVID-19 costing only $1 per patient and has managed to accommodate every coronavirus patient either in hospital or in a community health facility. African countries who experienced the 2013/14 Ebola virus outbreak like Senegal put that experience to good use, prohibiting large gatherings, strict night-time curfews, banning intercity travel, etc. Côte d’Ivoire (the Ivory Coast) followed Senegal’s approach, declaring a state of emergency and trying to impose curfews in it’s main city Abidjan, but the country’s buoyant economy has taken quite a hit from the coronavirus crisis. Ghana has utilised an extensive system of contact-tracing and a “pool-testing” mechanism which follows up only on positive results [‘Why are Africa’s coronavirus successes being overlooked?’, (Afua Hirsch), The Guardian, 21-May-2020, www.theguardian.com; ‘Women unite against COVID-19 in Senegal’, Relief web, 10-Jun-2020, www.reliefweb.int].

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The speeding up of coronavirus cases in a small African country like Guinea-Bissau has occurred notwithstanding it’s small population and limited testing, reflecting a reality stretching across the whole continent, the sheer incapacity of weak and under-resourced national health infrastructures to cope with the pandemic [‘West Africa facing food crisis as coronavirus spreads’, (Emmanuel Akinwotu),  The Guardian, 16-May-2020, www.theguardian.com].

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Kano   (Photo: Reuters/Luc Gnago)

B2ADCEDB-748F-4BBD-926C-6B2115F8760EIn Nigeria, Africa’s most populous country, the most worrying hotspot has been the north in Kano state and metropolis. The pandemic has gotten out of hand here because of a confluence of factors, including the state government’s early failure to admit the presence of coronavirus (which it initially tried to pass off as an upsurge in other illnesses), costing it vital lost time in the fight against the disease; the closure of Kano’s only testing centre for a week in April; acute shortages of PPE; and the pre-existing displacement of 1.8m people in the region [‘Covid-19 Outbreak in Nigeria Is Just One of Africa’s Alarming Hot Spots’, (Ruth Maclean), New York Times, 17-May-2020, www.nytimes.com].

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Dakar, Senegal   (Photo: John Wessels/AFP via Getty Images)

PostScript: A young and rural population
Africa’s avoidance of the worse excesses of COVID-19 thus far has prompted the theory that the continent’s demographics is working in it’s favour. A study in the journal BMJ Global Health attributes this to Africa’s young, rural-based population …60% of the population is under 25, cf. Europe (95% of its deaths from the virus have been people over 60). BMJ hypothesises that Africa will likely suffer “more infections but most will be asymptomatic or mild, and probably (go) undetected” [‘Africa’s young and rural population may limit spread and severity of coronavirus, study says’, (Jevans Nyabiage), South China Morning Post, 28-May-2020, www.amp.scmp.com].

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Egypt and South Africa alone account for nearly 48% of the entire continent’s corona-related deaths
the study focused on Kenya, Senegal and Ghana

Behind the Coronavirus Counts, How well do the Numbers Stack up?

International Relations, Media & Communications, Medical history, Natural Environment, Politics, Public health,

Every day we are reminded of the global reach of the novel coronavirus crisis. We know it’s a pandemic because WHO and other health agencies publish data showing that 211 countries and territories have been affected by the disease. The international media coverage tends to focus largely on the unenviable “big five” chart-toppers who have been most affected – the US, Italy, Spain, France and the UK. A number of sites publish constantly updated lists of the growing toll of Covid-19 casualties, a sort of sombre “score card” listing all the countries who have recorded instances of the disease.

Confirmed Coronavirus Cases: Globally tracked, country-by-country – as @ 23-Apr-2020

Country Total casesTotal deaths Region
USA850,00047,700Americas
Italy 188,00025,500Western Europe
Spain 208,50021,750Western Europe
France 160,00021,500Western Europe
UK134,00018,300Western Europe
Sources: WHO http://covid19.who.int/;
http://worldometers.info/

When we scroll through the world tables of where the pandemic has landed, it’s instructive to look at the comparative totals by continent – Europe has a bit over 1.28 million confirmed cases recorded, and the Americas, 995,510 (predominantly from the US), compare these to South-East Asia, a bit more than 38,572 and Africa, a mere 18,234 cases✺✺.

(Source: www.vietnamcredit.com.vn)

From a statistical standpoint we might wonder if the published data gives a true impression of the extent of of the pandemic? It needs to be kept in mind that the numbers we have are those that have been reported to the World Health Organisation. Population differences aside, it is clear that the low numbers in South-East Asia and Africa (examples: Cambodia 122 cases, zero fatalities✺✺, Myanmar 139 cases, five fatalities✺✺, Ghana 1,279 cases, 10 fatalities✺✺, Ethiopia 117 cases, three fatalities✺✺) mask the full impact of the catastrophe. They are a product of limited testing by countries in these regions … widespread poverty, surplus populations, lack of resources and infrastructure mitigate against the capacity to take corrective, safety monitoring measures.

(Photo: www.theborneopost.com)

Limited testing capacity and weak surveillance
The small numbers of recorded cases and handful of reported deaths in Africa and S.E. Asia (the Caribbean is another such case in point) can engender a false security and justify a lack of action by such already economically and health-challenged countries, thus the risk of infections spreading is magnified. In the early phases of the outbreak some S.E. Asian states were slow to acknowledge the risks…even as late as mid-March, Myanmar’s government was still attributing it’s low number of cases to the superior “lifestyle and diet” of the locals. The fight against Covid-19 by Third World countries is further retarded by a failure to test widely and in the numbers necessitated by the crisis. It shouldn’t be overlooked that some of these countries have quite repressive regimes that don’t rank the goal of a universal healthcare system as their highest priority [‘Experts Doubt Low Coronavirus Counts of Some Southeast Asian Countries’, (Zsombor Peter), VOA, 29-Mar-2020, www.voanews.com].

(Photo: www.upnews.info.com)

For the bulk of African countries the story is similar. A by-product of their lack of development is that their health systems are fragile before the onset of coronavirus hits them. Awareness of the inability to cope with a full-blown health crisis, had led some leaders to advocate so-called “miracle cures” for the virus (eg, Madagascar’s president’s championing of untested traditional plant remedies). Nigeria (Africa’s largest nation by population)  shows only 981 confirmed cases and 31 deaths✺✺ to date but is looking as vulnerable as anyone in Africa. Oil exports are the hub of Nigeria’s economy and the fall of the world’s crude oil price to a record low will hamstrung the country’s efforts to contain any future eruptions of the disease [‘Coronavirus: How drop in oil price affects Nigeria’s economy’, (Michael Eboh), Vanguard, 17-Mar-2020, www.vanguardngr.com]. The outbreak of pandemic hotspots in Nigeria could be devastating, especially in the north, given the country’s population of nearly 200 million people and it’s inadequate healthcare capacity.

(Photo: www.newswirenow.com)

Too good to be …
Some countries have reported being lightly or relatively lightly touched by the onslaught of the coronavirus, these results have surprised outside observers. One such country that raises eyebrows in this respect is Russia. The republic has 146 million people and shares long borders with China, yet it fesses up to having had only 68,622 cases✺✺ (well under half of that of the UK) and suffered only a comparatively low 615 deaths✺✺ from the epidemic (most of those since the start of April). If you cast aside the anomalies, on paper it’s an excellent result! But whether Soviet or post-Soviet, there’s always an air of suspicious doubt about Russian information. The Russian Bear has had form in the past with cover-ups…a prime example—the Soviet Union throwing a tarpaulin over the Chernobyl nuclear disaster in the 1980s —indicative of a less than honest response to major disasters [‘The Very Low Number of Russia’s Reported COVID-19 Cases Raises Questions of a Cover-Up’, (Rick Moran), PJ Media, 22-Mar-2020, www.pjmedia.com].

Image: www.asianews.it

Russia, if it so erred, is not “Robinson Crusoe” in deliberately underreporting the pandemic’s effect. China for nearly three months from the initial outbreak didn’t include asymptomatic patients in the official stats, and only rectified this oversight on April Fools Day [‘China acknowledges underreporting coronavirus cases in official count’, (Mark Moore), New York Post, 01-Apr-2001, www.nypost.com]. For six weeks after WHO declared a global health emergency Indonesia did not report a single Covid-19 case (unlike most of it’s S.E. Asian neighbours). Considering the republic’s population size (more than 270 million) and it’s close links with China, this aroused widespread suspicion of underreporting and criticism in a Harvard University study which seemed to belatedly jolt Indonesia into disclosure. The first notification by Djakarta of coronavirus cases occurred on 2nd March, and from then on Indonesia’s curve has been on an upward trajectory – currently 8,211 cases, 689 deaths✺✺ [‘Why are there no reported cases of coronavirus in Indonesia?’, (Randy Mulyanto & Febriana Firdaus), Aljazeera, 18-Feb-2020, www.aljazeera.com].


Doubting a hermetically-sealed “Hermit Kingdom”
North-East Asia’s renegade, secretive state, North Korea, can be added to the list of countries purporting to be Covid-19–free. Pyongyang‘s official line has been met with disbelief from several external sources such as South Korea and Radio Free Europe which asserts that disclosures from within North Korean military circles confirm the occurrence of coronavirus cases in the border areas [‘What Is the Coronavirus Doing to North Korea’, (Nicholas Eberstadt), New York Times, 22-Apr-2020, www.nytimes.com]

Addendum: (Coronavirus as at 0130 hrs EAT time, 25-April-2020)
USA 890,200 cases | 50,403 deaths
Italy 189,973 cases | 25,549 deaths
Spain 219,764 cases  | 22,524 deaths
France 158,183 cases | 21,856 deaths
UK 143,464 cases | 19,506 deaths

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✺✺ figures as at 0130 hrs EAT time, 25-Apr-2020
just over the last week the African continent experienced a sudden surge in infections, ‘Africa’s 43% jump in virus cases in 1 week worries experts’, (Gerard Zim Rae), ABC News, 23-Apr-2020, www.abcnews.go.com
although Russia did close its eastern border with China after the virus breakout