On the pandemic world map, Africa continues to stand out. While Europe appears once again submerged, the number of known contaminations is comparable to that of France. If many hypotheses are put forward to explain this African exception, “We must also insist on the fact that the countries of the continent took measures very early. As soon as the first cases appeared, very radical decisions were adopted, such as the closing of borders ”, highlighted Laurence Caramel, journalist at World Africa. She answered your questions on Wednesday, November 18.
Find the entire chat: Few infections, no excess mortality … is there an African exception?
JoeChip: Isn’t the number of contaminations and sick people greatly underestimated in Africa?
The question was asked from the start of the epidemic, because the number of contaminations indeed appears “abnormally” low compared to other continents and Africa lacks health infrastructure and testing capacities. Nine months later, we can only note that few patients have developed serious forms. There was no unexplained excess mortality that could suggest that the epidemic has remained under the radar.
Cathange: Does the fact that the population live more outdoors, and of course the average youth of the population, play a role?
Several hypotheses are put forward to explain that Africa, which accounts for 17% of the world population, has only 4% of cases of contamination:
- the youth of its population: Africa is the youngest region on the planet, with a median age (19.7 years) more than twice that of Europe (42.5 years);
- living more outdoors on a continent where the majority of the population is still rural;
- its weak integration into the world economy initially limited the circulation of the virus. The countries most affected, especially South Africa, are the most “connected” countries;
- a form of immunity linked to the fact that regular exposure to epidemics could also have physiological effects reinforcing resistance to viruses;
- know-how in the management of epidemics that European countries no longer have, for example.
But it should also be emphasized that African countries took action very early on. From the appearance of the first cases, very radical decisions were adopted, such as the closing of borders.
Asylum: Are there differences between the countries of the continent? Morocco, for example, has long been confined.
There are indeed very large differences within the continent. More than 80% of cases are concentrated in a handful of countries. South Africa alone has reported half of the cases. But, over the months, the geography of the epidemic has changed. After the peak of the first wave reached at the end of July, the number of reported cases has gradually fallen to stabilize around 7,000 per day. Since the end of September, the number of contaminations has started to increase again and it is especially in the Maghreb states that a new outbreak of the virus has been observed. Some countries, which had not experienced a first wave thanks to the containment measures, are now affected, such as Angola.
Dori: The epidemic seems to be spreading less quickly where the weather is hot. Could the climate or seasonality have an impact?
The outbreak of the epidemic in South Africa indeed took place during the southern winter. Currently, the spread of Covid-19 is faster in North Africa, which in turn enters the winter. Temperatures therefore seem to play an important role, but difficult at this stage to say in what proportion.
Roberto: Could you enlighten us on the situation in West Africa, and more particularly in Côte d’Ivoire?
According to our correspondent Yassin Ciyow, “Côte d’Ivoire has officially recorded 128 deaths and around 21,000 cases since the spring. As elsewhere on the continent, these figures arouse some suspicion, but, overall, the epidemic appears to be under control. The hospitals are not full, the intensive care units are empty. Ivorians wear the mask less and less, apart from politicians in representation, or in shopping centers. The Covid is no longer a daily concern. “
YD: Do African megalopolises like Lagos also stand out?
The epidemic was imported to Africa by African or foreign travelers who circulate between the big cities of the world, it is therefore initially rather an evil which affects the elites in the most urbanized countries. But we can see, especially in South Africa and Kenya, that the epidemic has spread to densely populated informal settlements.
Masai: Tanzania does not seem to list the cases, the figure has not changed for months, is it a choice of denial of the virus?
Tanzanian President John Magufuli is indeed one of the few heads of state on the continent to have shown total denial of the new coronavirus. With each health ministry reporting the number of cases to the World Health Organization, Tanzania’s statistics are therefore not surprising.
Albert: In Cameroon, between malaria, cholera, Ebola, dengue fever and others, the population knows what an epidemic is, and that the Covid one is not necessarily the worst. The screening system works, the tests are free. And above all, no one thinks that the apocalypse has arrived. In the end, I find that the attitude there is much healthier than in Europe.
Your testimony confirms what Dr Elisabeth Carniel, director of the Pasteur Institute in Yaoundé, told us a few days ago:
“In Cameroon, very few people had to be hospitalized. Few have died. The occupancy rate of the Covid beds is 1%. Containment was little respected and, today, everyone goes to mass or participates in sporting gatherings without wearing masks. “
DB: What is the current situation in South Africa? And especially in Cape Town?
According to our correspondent in Johannesburg, Mathilde Boussion, “The situation has been stable since the end of August with 1,000 to 2,000 new cases per day. The number of deaths most often fluctuates around fifty daily deaths. Officially, the country has around 20,000 deaths from Covid but the South African Medical Research Council, which tracks mortality in the country, mentions 50,000 more natural deaths than in 2019.
Contrary to Europe, the country is completing its reopening. Cyril Ramaphosa announced the full reopening of the borders on November 11. Among the few restrictions still in force, a curfew between midnight and 4 a.m. and reduced gauges in establishments such as bars or gyms. On the other hand, the situation deteriorated in the Cape region and the president warned that local reconfinement measures could be taken. “
Basbous: As the first vaccines showing high efficiencies will soon be deployed in rich countries, what is the position of African governments on vaccination?
In the race for the vaccine, it is indeed legitimate to wonder whether African governments will have the financial means to purchase the doses necessary to protect their populations. Several initiatives have already been taken to ensure some form of equity in access to vaccines for the poorest countries. The main one, led by the WHO, is called Covax. Most African governments have adhered to it. The African Union has estimated that $ 12 billion would be needed to immunize 60% of the continent’s population.
genetics: Genes inherited from Neanderthals protect us from certain diseases. Africans do not have it. Could it be that the absence of Neanderthal genes is protecting them from Covid-19?
This is a question that interests many readers. I modestly refer you to the article written by our specialist Hervé Morin:
Curlyrise : Personally, I find it particularly disturbing that very often only arguments of the physiological type (gene, form of immunity) or climatic (the virus does not resist heat) are put forward. The articles and contributions very rarely make the assumption of good crisis management and very high reactivity from the start of the epidemic. African countries deserve to be taken seriously, in my opinion, just like Sweden or South Korea, for which we never say that the reduced number of cases is due to a “Korean gene”.
On the contrary, it seems to me that the responsiveness of African governments in managing the health crisis was very quickly hailed. Starting with the World Health Organization. This is what Dr Ngoy Nsenga, responsible for crisis response in Africa at the WHO, told us a few days ago: “The early reaction of governments in the management of the new coronavirus, the mastery of screening and tracing methods in a region used to managing recurrent contagions constitute the decisive element to explain the singular evolution of the continent. ” However, he himself does not rule out the other hypotheses you mention to explain the situation on the continent.
Maxence L .: What about the protective influence of chloroquine on organisms, because it is widely consumed on the continent for its virtues of antimalarial?
Many wonder about the effectiveness of hydroxychloroquine and make the link between the low prevalence of Covid-19 in Africa and the massive use of this antimalarial drug in the continent. Promoted in France by Doctor Didier Raoult (IHU-Méditerranée Infection de Marseille) in combination with an antibiotic, azithromycin, this molecule has still not demonstrated its effectiveness in “Phase 3, controlled, randomized studies”, the most reliable according to the French High Authority of Health.