Early restrictions of mass gatherings and enforcement of social distancing, handwashing and sanitising measures helped Africa to avoid exponential spread of the Covid-19 three months since the first case was reported on the continent, but rising infection numbers mean that another difficult phase of the deadly disease is unfolding.
Health research experts say timely interventions by African governments helped to buy the continent time to slow Covid-19 infections and change the course of early projection models that showed the continent would have nearly half a million infections by mid-April.
Africa has reported some 50,000 despite infections and about 2,000 deaths since the first case, an Italian national in Algeria, was reported 11 weeks ago.
More than 3.8 million have contracted the disease and over 270,000 died globally since the disease was first reported in December in the China city of Wuhan.
CONTINENTWIDE AWARENESS
“We knew Covid-19 was a significant threat to Africa, so we addressed it early. We convened an emergency meeting of Africa Health ministers, which endorsed the Africa Joint Continental Strategy for Covid-19. Because of the early political engagement there was a continentwide awareness and alert to prepare countries,” said Africa Centres for Disease Control and Prevention (Africa CDC) director, Dr John Nkengasong.
Public health hygiene and social distancing measures including curfews and lockdowns enforced in African countries including Rwanda, Uganda, Kenya, Nigeria, South Africa and many others helped to prevent an overrun on the continent’s fragile health system as has happened in Europe and the US, researchers at London School of Hygiene and Tropical Medicine (LSHTM) opine.
“Our early projections were explicitly about what happens when people don’t react. Those projections haven’t changed. Clearly people in Africa have reacted — both individuals taking more precautions as they learn about the dangers of Covid-19, businesses changing practices, and policymakers imposing restrictions intended to slow spread.”
“The alarm system is still there, it is just not beeping as loudly at the moment (because people stopped setting the alarms off),” Carl Pearson, a lead scientist at LSHTM, which projected 450,000 coronavirus infections in Africa by mid-May, told The EastAfrican.
The LSHTM had projected that most African countries would hit 10,000 infections this month if no measures were in place to contain spread of the virus.
But those restrictions are hard to maintain and populations are getting tired of staying home without adequate food and other basic supplies.
Striking mobs have violated curfew restrictions in Nigeria and South Africa, while in Kenya thousands who had taken to working from home are back on the streets and traffic jams are building in the capital, Nairobi.
Countries such as Burundi and Tanzania have only announced lax restrictions on movement and public gathering, while others such as Somalia have weak administrative systems that have failed to facilitate a co-ordinated response to the pandemic.
The World Health Organisation has warned that between 83,000 and 190,000 people in Africa could die of Covid-19 and 29 million to 44 million infected in the first year of the pandemic if containment measures fail.
The projection is based on prediction modelling that studied 47 African countries collectively with a population of one billion people.
LOWER TRANSMISSION RATE
The WHO predicts there will be a slower rate of Covid-19 transmission, lower age of people with severe disease and lower mortality rates compared with other parts of the world due to social and environmental factors such as a younger population that has benefited from the control of communicable diseases including HIV and tuberculosis to reduce possible vulnerabilities.
The lower rate, however, suggests a more prolonged outbreak over a few years, if containment is not prioritised.
“While Covid-19 likely won’t spread as exponentially in Africa as it has elsewhere, it likely will smoulder in transmission hotspots,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.
“Covid-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat.”
The London School of Hygiene and Tropical Medicine predicts that people and institutions are going to have to adapt to living with the virus by taking measures such as better data collection to enable more targeted public health responses and switching to jobs that need less person-to-person interaction.
Africa CDC reckons that countries must balance between reducing transmission while preventing social and economic disruption.
Research by the WHO shows that many Africans believe Covid-19 will have a major impact on their country (62 per cent), but only 44 per cent believe it is a threat to them personally.
The large information gap is a threat to the efficiency of response efforts.
Further, more than two thirds (69 per cent) say food and water would be a problem if they were required to remain at home for 14 days — and 51 per cent would run out of money. The WHO report includes first-of-its-kind data to adapt the Covid-19 pandemic response to local needs and capacities in Africa.
It also includes recommendations for governments to rapidly prioritise enhancing public health capacity to test, trace, isolate and treat people infected with the virus, making the most of the time early intervention with public health and social measures provided.
APPROPRIATE DYNAMICS
Research data is seen as a key component in helping African governments to find the right balance and adapt life-saving policies to their local context.
The LSHTM scientists have been updating their prediction models as data has become available about the appropriate dynamics in African countries, and the impact of various interventions.
There is also concerns of under-testing on the continent.
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