Covid-19: Africa’s case numbers are rising rapidly, WHO warns

Ten African countries account for nearly 80% of all cases of covid-19 in the continent, and numbers are accelerating, the World Health Organization has said.

Since the virus was first detected on the continent in Egypt on 14 February,1 it took 98 days to reach 100 000 cases and only 18 days to move to 200 000 cases.2

More than 5600 people have died from the illness, 70% of whom were in just five countries: Algeria, Egypt, Nigeria, South Africa, and Sudan.

More than half of Africa’s 54 countries are experiencing transmission of covid-19 in the community. This is largely concentrated in capital cities, but cases are spreading into the provinces.

South Africa is the most affected, accounting for 25% of Africa’s total cases and 1210 deaths,3 with the Western Cape and Eastern Cape provinces especially affected.

When population is taken into account, Djibouti (433), São Tomé and Príncipe (235), Gabon (146), Cabo Verde (102), and Equatorial Guinea (93) are reporting the most cumulative covid-19 cases per 100 000 population within the continent.4

Matshidiso Moeti, WHO’s regional director for Africa, said, “For now Africa still only accounts for a small fraction of cases worldwide. But the pace of the spread is quickening. Swift and early action by African countries has helped to keep numbers low, but constant vigilance is needed to stop covid-19 from overwhelming health facilities.”

An earlier report showed that health workers have been significantly affected by covid-19, with 4962 infected in 36 African countries since the beginning of the outbreak.5

In the WHO Africa region of 47 countries, there were 150 102 cases and 3593 deaths by 11 June.6

In WHO’s Eastern Mediterranean region Yemen is particularly affected by covid-19. While 565 cases and 130 deaths have been recorded officially, eyewitness accounts say gravediggers are working overtime, and death rates are far higher than usual, with patients being turned away from hospitals.78 Only half of health facilities are operating after five years of war, limiting the testing and reporting of covid-19.9 United Nations aid agencies voiced alarm on 12 June at the deteriorating humanitarian situation in Yemen as covid-19 spreads and a lack of funding jeopardises lifesaving programmes.10

WHO said many African countries had been quick to make difficult decisions and put in place lockdowns and key public health measures, such as promoting physical distancing, good hand hygiene, and testing and tracing of contacts of people with covid-19, with isolation of cases.

However, Moeti acknowledged that shutdowns had come at considerable socioeconomic cost to populations already suffering hardship and poverty.

“Stay-at-home orders and closing of markets and businesses have taken a heavy toll, particularly on the most vulnerable and marginalised communities,” she said. “So, the need to balance between saving lives and protecting livelihoods is a key consideration in this response, particularly in Africa.”

Easing restrictions should be a controlled process and needs to be coupled with ensuring that widespread testing capacities and mechanisms are in place.

National governments have started to scale up health workforce and laboratory capacities and to set up points of entry screening at airports and border crossings, which WHO said had been effective in slowing the spread of the virus.