5 Common sense reasons why the Africa continent is escaping the worst of the pandemic.

Amid a slew of negative news stories relating to Africa, here’s a glimmer of hope for the continent. While community transmission of Covid-19 is proven to be taking place with no country on the continent escaping infection, African countries are not being as hammered by the virus as other countries.

To date, from the 54 countries that make up the continent combined, there have been over 99,977 cases reported, 3,095 deaths and 39,336 recoveries (Africanews.com)

While it can be argued that testing has been low and tallies less reliable in developing African countries, there is also no evidence that hospitals have been overwhelmed and over the past three months, death rates in Africa have remained low. As a long term resident of Nairobi, Kenya, I have been interested by the lack of explosion of cases that was predicted in the country. Here are 5 possible reasons as to why:

1. People live outside.  ‘You are less likely to catch Corona Virus outdoors’. inews.co.uk

In Africa, the majority of people still live outside. A temperate climate across the continent means that populations use housing mainly for shelter and sleep, the rest of the day is spent outside. Cooking and washing happens outside. There are offices and modern malls in urban centres but for most, life is lived almost entirely in the fresh air, either on city streets or in rural settings. Shopping takes place in outdoor markets or from street booths. Subsistence farming is the norm.

Dr Chris Smith, clinical lecturer in virology at the University of Cambridge, previously told the BBC the chances of Covid-19 transmission outside were “vanishingly small” because “the amount of dilution from fresh air is so high”. (link to full article above)

2. Better levels of Vitamin D. ‘Recent studies confirm the pivotal role of vitamin D in viral infections’. Scitech Daily.

The BAME (Black, Asian, Minority Ethnic) community in the Northern hemisphere have been hard hit by Coronavirus and some scientists have linked this to a possible lack of vitamin D, stating that those with darker skin living in the Northern hemisphere find it harder to absorb vitamin D. Although any relationship between Vitamin D deficiency and the severity of Covid 19 has not been proved, it is worth noting that populations in Africa’s 54 countries, specifically those close to the equator, are not prone to seasonal flu outbreaks. While vitamin D deficiencies have been noted on the continent, but they are less severe than those suffered by BAME communities living in the northern hemisphere. (British Medical Journal )

3. Young population. ‘The World’s 10 youngest populations are all in Africa’ World Economic Forum

As at 2020, in Kenya the median age is 18 years. Of all the world’s populations, Niger has the youngest median age at 15 years. The average age in Italy is 45.4, UK is 40 years and USA is 38.3. Put another way, the percentage of the population over 65 in Italy is 23%, whereas in Kenya the figure is less than 3%. It goes without saying that the youth segment of the population are experiencing less severe symptoms of Covid 19, with many presenting as asymptomatic. While Coronavirus is now present throughout Africa, it is not causing anywhere near the numbers of deaths seen in the Northern hemisphere. On 30th March, the Kenya Ministry of Health had predicted 10,000 cases by April 30th (link), presumably extrapolating the global rate of case growth, yet the figure currently stands at 1,109 confirmed cases on 21st May, with 375 recoveries and 50 deaths.

4. Lower obesity levels. ‘Obesity-related diseases are now among the top three killers across the globe, except in Sub-Saharan Africa.’ Worldbank.org, Feb 2020.

The mortality risk factor for those with obesity and diabetes suffering from Covid-19 has been proved. A quarter of UK Covid-19 patients who died in hospitals in the UK, had diabetes NHS England has confirmed. While figures for obesity and levels of diabetes are reported to have increased in Africa, particularly amongst the middle class populations of Africa’s largest cities, the problem is still markedly lower on the continent than elsewhere in the world.

According to the World Bank, 85% of Africans currently live on less than $5.50 per day. Youth unemployment is a huge problem for countries like Kenya where over a third of the population under 34 years, do not have jobs. Many of the youth who are employed, work in the poorly paid informal sector. With much of the population of African countries living on a hand-to-mouth basis, with no means of storing food, the obesity problem is far lower.

5. Draconian lockdowns. ‘How overreaction made Vietnam a virus success’ BBC News, 15th May 2020

Introducing Draconian measures fast has proved to be effective in preventing the spread of Covid-19, as seen in countries like Thailand and South Korea alongside effective systems of track and trace. In Africa, local infections were first recorded while the crisis was already playing out in China and northern Europe, giving African countries time to close borders and restrict movement fast. With weaker health systems, prevention was always going to be a more effective measure than cure.

Kenya recorded its first case of Covid-19 on March 6th. By March 15th the Kenya government suspended travel into the country for all but residents and imposed a system of quarantine for those arriving. Schools were closed with immediate effect, gatherings banned (including at places of worship), people were urged to work from home and use mobile money rather than cash transactions. Hand washing stations were to be provided at the entrance to malls and hospitals and numbers of passengers in vehicles restricted to 60% occupancy. Later a curfew was imposed along with ‘containment’ measures restricting travel between counties to all but freight carriers. Concerted efforts at ‘track and trace’ have also been in place from the beginning, with particular attention paid to containing potential hot-spots and extensive testing at border crossings.

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While African countries have so far escaped Covid-19 wreaking havoc on their health services, the wider economic impact and repercussions on health are far reaching. The UN has warned that 500,000 in Sub-Saharan Africa could die of AIDS related illnesses if access to treatment for HIV continues to be disrupted by the coronavirus crisis for more than 6 months. With no furlough schemes and little fiscal support from local governments, businesses and individuals are left alone to sink or swim. Help from the developed world will be thin on the ground while Western economies address their own deficits. Diaspora remittances will fall and local industries, such as tourism, are stalled for the foreseeable future.

While there are predictions that the peak has yet to arrive in Sub-Saharan Africa, having been effectively stalled by early implementation of lockdowns, do we dare hope that Africa’s outcome could be better? Having ridden the wave of Covid-19 with few deaths so far, perhaps African countries have the capacity to bounce back faster than elsewhere? A good outcome from the pandemic could inspire much needed investor confidence and improve the profile of the continent on the World stage.