Scientists are mystified and cautious as Africa avoids the COVID-19 disaster

In a busy market in a poor township outside Harare, Nyasha Ndou kept her mask in her pocket while hundreds of other people, mostly dewormed, needed to buy and sell fruit and vegetables displayed on wooden tables and plastic sheets. In the capital, as in large parts of Zimbabwe, coronavirus is quickly relegated to the past as political rallies, concerts and home gatherings have returned.

“COVID-19 is gone. When was the last time you heard of someone who died of COVID-19?” said Ndou. “The mask is to protect my pocket,” he added. “The police demand bribes, so I lose money if I do not move around with a mask.”

Days earlier, Zimbabwe registered only 33 new COVID-19 cases and zero deaths, in line with a decline in the disease across the continent, with data from the World Health Organization showing that infections have fallen since July.

When the coronavirus first appeared last year, health authorities feared the pandemic would sweep across Africa and kill millions. The catastrophic scenario has yet to become a reality in Zimbabwe or large parts of the continent.

Researchers stress that it is difficult to obtain accurate COVID-19 data, especially in African countries with irregular surveillance, and warn that declining coronavirus trends can easily change.

But there is something “mysterious” going on in Africa that amazes scientists, said Wafaa El-Sadr, president of global health at Columbia University. “Africa does not have the vaccines and resources to fight COVID-19 that they have in Europe and the United States, but somehow they seem to be doing better,” she said.

Less than 6% of Africa’s population is vaccinated. For several months, the WHO has described the continent as “one of the least affected regions in the world” in its weekly pandemic reports.

Some researchers say that the continent’s young population – the average age is 20, against around 43 in Western Europe – as well as its slower urbanization rate and the population’s tendency to spend time outdoors, may have spared it the more deadly effects of the virus, so far. Several studies are investigating whether there may be other explanations, including genetic causes or previous infection with parasitic diseases.

On Friday, researchers working in Uganda said they found that COVID-19 patients with high incidence of malaria were less likely to suffer serious illness or death than people with a small history of the mosquito-borne disease.

“We went into this project and thought we would see a higher rate of negative outcomes in people with a history of malaria infections because that’s what was seen in patients who were simultaneously infected with malaria and Ebola,” Jane said. Achan, a senior research consultant at the Malaria Consortium and a co-author of the study. “We were actually quite surprised to see the opposite – that malaria can have a protective effect.”

Achan said this may indicate that previous malaria infection could “blunt” the tendency of the immune system to go into overdrive when infected with COVID-19. The research was presented Friday at a meeting of the American Society of Tropical Medicine and Hygiene.

Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases at Redeemer’s University in Nigeria, said African authorities are accustomed to curbing outbreaks even without vaccines and credited the extensive network of community health professionals.

“It’s not always about how much money you have or how sophisticated your hospitals are,” he said.

Devi Sridhar, President of Global Public Health at the University of Edinburgh, said African leaders have not been given the honor they deserve for acting quickly; she cited Mali’s decision to close its borders before the coronavirus arrived.

“I think there is another cultural approach in Africa where these countries have approached COVID with a sense of humility because they have experienced things like Ebola, polio and malaria,” Sridhar said.

In recent months, coronavirus has hit South Africa and is estimated to have killed more than 89,000 people there, the vast majority of deaths on the continent. But so far, African authorities, although acknowledging that there may be gaps, do not report a large number of unexpected deaths that may be coronavirus-related. WHO data show that COVID-19 deaths in Africa account for only 3% of the global total, while deaths in America and Europe account for 46% and 29%, respectively.

In Nigeria, Africa’s most populous country, the government has registered nearly 3,000 deaths among its population of 200 million. The United States records that many deaths every two or three days.

The low numbers have made Nigerians like Opemipo Are, a 23-year-old in Abuja, feel relieved. “They said there would be dead bodies on the street and all that, but nothing similar happened,” she said.

On Friday, the Nigerian authorities launched a campaign to significantly expand the West African nation’s COVID-19 vaccinations. Officials aim to inoculate half the population by February, a goal they believe will help them achieve herd immunity.

Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups, suggested that Africa may not need as many vaccines as the West. It is a controversial idea that he says is being seriously discussed among African scientists – and is reminiscent of the proposal made by British officials in March last year to allow COVID-19 to freely infect the population in order to build immunity.

However, this does not mean that vaccines are not needed in Africa.

“We need to vaccinate completely to prepare for the next wave,” said Salim Abdool Karim, an epidemiologist at the University of South Africa’s KwaZulu-Natal who has advised the South African government on COVID-19. “When you look at what’s happening in Europe, the likelihood of more cases spreading here is very high.”

The impact of coronavirus has also been relatively subdued outside Africa in poor countries such as Afghanistan, where experts predicted that outbreaks in the midst of an ongoing conflict would prove disastrous.

Hashmat Arifi, a 23-year-old student in Kabul, said he had not seen anyone wearing a mask for several months, including at a wedding he attended with hundreds of guests. During his university hours, more than 20 students are routinely exposed close to each other.

“I have not seen any case of corona lately,” Arifi said. Afghanistan has recorded about 7,200 deaths among its 39 million people, although few tests were conducted in the middle of the conflict, and the actual number of cases and deaths is unknown.

Back in Zimbabwe, doctors were grateful for COVID-19’s breath – but feared it was only temporary.

“People should remain very vigilant,” warned Dr. Johannes Marisa, President of Physicians and Dentists of Zimbabwe Assn. He fears another coronavirus wave could hit Zimbabwe next month. “Satisfaction is what will destroy us because we can be caught unaware.”

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