BY DAWIT GIORGIS
May 4, 2020
Why does Africa’s coronavirus outbreak appears slower than anticipated?
Africa’s low coronavirus rate should puzzle health experts. Health experts warned of the devastation by deadly virus in Africa, where most hospitals are desperately short of equipment and trained staff. But what people see on the ground is no different from any day in Africa. France 24, states on March 1, “Whether it’s a matter of faulty detection, climatic factors or simple fluke, the remarkably low rate of coronavirus infection in African countries, with their fragile health systems, continues to puzzle – and worry – experts”
Paul Hunter, a UK-based specialist in infectious diseases and epidemics, largely puts the absence of COVID-19 on the continent down to luck. “If you look at how COVID-19 has spread to non-Chinese countries, most of the spread has been pretty much due to the general intensity of travel around the world,” he told DW. “There is nothing special about Africa not having seen a case other than pure chance at the moment.” This is a stupid answer. In the same logic what happened in Europe and America could be ‘pure chance.’
Too Warm for COVID-19?
Another theory is that the continent is too warm for the COVID-19 virus to thrive. Coronaviruses, which include some of the viruses responsible for the common cold and flu, can show something called seasonality — that is, they peak and wane depending on the season. But the virus has been detected first in Egypt, one of the hottest places in Africa. It has further moved to Algeria, Nigeria and Cameroon where it is very warm and where we have the largest number of people infected in the continent. This argument does not hold water.
The Lack of Testing Capacity
The most prevalent question in the understanding and prevention of coronavirus in Africa is the lack of testing capacity. Yes it is but testing would not be necessary to find out if people have already been infected. Society would have noticed that without testing. In densely populated places like Addis Ababa, Lagos, Cairo, Nairobi, Johannesburg it would be extremely difficult not to notice several people under severe pain and dying in numbers. One would not need testing to notice the arrival of the pandemics. Testing would be useful for the
asymptomatic. Africa has not yet seen the mass infection and death predicted by the experts since the epidemics started in China in November of last year, and WHO declared Pandemics on March 11, 2020 and since the first infection was detected in Egypt on Feb 14. As of May 4, 44,483 confirmed cases in Africa with 1801 deaths. (Al Jazeera)
And in Ethiopia as of this week there were 140 confirmed cases with two deaths and two infections out of 1560 tests. There are no patients in the intensive care unit with only 55 patients in the isolation/ treatment center. As of this week only a handful of African states have more than a thousand cases of infections: Algeria 4474, Cameroon 2077*, Ivory Coast, 1398, Djibouti 1112, Egypt 6465, Ghana, 2169, Guinea 1586, Morocco 4903, Nigeria 2558, South Africa, 6783. Only the Comoros archipelago and the tiny kingdom of Lesotho have not yet detected any cases. This data raises another question as well. (Why do African countries along the Mediterranean coast have more cases than all others?) My question
Health care professionals agree that if there was any community infection in cities across Africa and the same spread pattern was seen as in other countries, one would have had by now thousands of cases and hundreds of hospitalizations in cities. However, there is no evidence that has happened yet. In fact, there is a lot of circumstantial evidence coming from many countries like Ethiopia that suggests the contrary, including not many hospitals reporting real or suspected cases, as well as house-to-house surveys in many parts of the country not indicating a pandemic outbreak.
The puzzle goes beyond the African continent because people also talk about the “Indian exception as infections and death rates in India are lower than was expected. Two months after its first recorded case, Covid-19 infections in the world’s second-most populous country, India , has crossed the 40,000 mark this week on May 4 as the country prepares for an extended lockdown. (Economic Times)
An Indian-American physician and oncologist Siddhartha Mukherjee answered the question of: “ Is India an outlier when it comes to novel coronavirus fatalities? “To be totally frank, I don’t know and the world doesn’t know the answer. “It’s a mystery, I’d say and part of the mystery is we are not doing enough testing. If we tested more then we’d know the answer.” He is alluding to both diagnostic tests, which determine those who are currently infected, and antibody tests to find out whether someone was previously infected and recovered. There may be different answers for the Indian case than the one being theorized for Africa. (BBC)
When Africa’s first case of coronavirus was detected in Egypt on February 14, the rest of the continent prepared for the brunt of a pandemic that has engulfed Europe and spread to the United States, infecting more than 1.6 million worldwide. More than two months after Egypt became the first country in Africa to confirm a coronavirus case, the outbreak appears to have reached almost every nation on the continent of 1.2 billion people but not as widespread as expected, while the entire Europe and America continues to experience massive infections and deaths.
Do European and Africans have Genetically different levels of Immune Systems?
Cell Press ( A journal that provide a platform for the communication of strong, engaging life and physical science to the research community and beyond.) published on October 20, 2016 about two studies; “that show that those differences in disease susceptibility can be traced in large part to differences at the genetic level directing the way the immune systems of people with European and African ancestry are put together.”
The ScienceDaily of 2016/10/ states that: it’s long been clear that people from different parts of the world differ in their susceptibility to developing infections as well as chronic inflammatory and autoimmune diseases. Now, two studies reported in Cell on October 20 show that those differences in disease susceptibility can be traced in large part to differences at the genetic level directing the way the immune systems of people with European and African ancestry are put together.
The two new studies show these immune systems are genetic “and can be traced back all the way to the Neanderthals, who died out some 40,000 years ago. It’s long been clear that people from different parts of the world differ in their susceptibility to developing infections as well as chronic inflammatory and autoimmune diseases. Now, two studies reported in Cell on October 20 show that those differences in disease susceptibility can be traced in large part to differences at the genetic level directing the way the immune systems of people with European and African ancestry are put together. The study titled “ Africans and Europeans have genetically different immune systems “ was conducted by Institut Pasteur in France and published in 2016. It states:
“The immune systems of any two individuals can respond differently to an infection or therapeutic treatment. To understand the genetic and evolutionary basis of these differences, the team led by Lluis Quintana-Murci, CNRS research director, Scientific Director at the Institute Pasteur and Head of the Human Evolutionary Genetics Unit (Institut Pasteur/CNRS), launched a large-scale study four years ago. The findings are now published in Cell. In collaboration with teams from the French National Genotyping Center (CEA), the Leipzig- based Max Planck Institute and Ghent University, the scientists analyzed the genome-wide expression of genes involved in the immune response of 200 individuals, 100 of European ancestry and 100 of African ancestry. More specifically, they sequenced the entire RNA of these individuals to characterize the way in which immune cells known as monocytes – a key part of the innate immune response – respond when attacked by bacterial or viral ligands, including the influenza virus.
Their first observation was that the amplitude of the immune response in Africans and Europeans differed, especially in the case of genes involved in inflammatory and antiviral responses. These differences can largely be attributed to genetic variants, distributed differently among Africans and Europeans, which modulate the expression of immunity genes. This finding offers insights that can help shed light on why some populations are particularly susceptible to diseases such as lupus, which is more common in Africa than in Europe.”
The scientists also showed that the population frequency of some of these mutations has been shaped by natural selection, helping each population to adapt more effectively to its environment. They made the striking discovery that natural selection had independently led to a reduced inflammatory response in populations in both Europe and Africa, via entirely separate processes involving different genes. This example of convergent evolution confirms that while the immune response offers effective protection against infection, an excessively strong response, as seen in allergies or autoimmune diseases, can be harmful.
By identifying the genetic variants responsible for the modulation of genes involved in the immune response, this study will provide scientists with new tools for understanding the mechanisms underpinning the immune reaction to infection and predisposition to disease, in both individuals and human populations, so state the document I read. I don’t completely understand what it exactly means but the main essence is that our immune systems are different and this may explain why the corona pandemics have not been as severe as it has been in people living in Europe. We have to take into consideration that the population that has been disproportionately affected by the pandemics in America, is the African American community. I have not yet read any connection between the above findings and the reality on the ground. We deserve more explanations from tour African scientists.
The Million Dollar Question
Health experts still say that Africa will experience huge devastation where most hospitals are desperately short of equipment and trained staff. The World Health Organization continues to warn Africa that the spread is inevitable. But there are no indications that what took place in Europe and America will happen in Africa.
Let us take as an example the largest slum in Africa, Kenya , Nairobi: The Kibera Slum has, according to kibera.uk.org, 250,000 of the world’s poorest people living in 2.5 sq. km of land, there is no way at all to practice two meter social distancing. Around 60% of the Kenyan capital’s 4.4 million inhabitants live in 200 high-density informal settlements like Kibera, which account for around 6% of the city’s total land area.
The average size of shacks in this area is 12ft by 12ft built with mud walls corrugated iron sheet as roof with dirt of concrete floor. Only about 20% of Kibera has electricity. There is hardly any water, which has to be collected from the Nairobi dam. The dam water is not clean and is known for causing typhoid and cholera. In most of Kibera there are no toilet facilities. Kenya reported its first case on the 12th March 2020, since the beginning of the outbreak in China in December 2019. And yet we have only over 360 infections and 14 deaths in Kenya.
We see more or less the same situation in all the big urban centers in Africa. Are the majority of Africans living in Africa immune to Coved 19 infections or is it just a matter of time for Africa? Let the African scientists speak out.
Dawit W Giorgis Visiting scholar, Boston University, African Studies Center
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