When the coronavirus first began spreading around the world, there was near-universal concern among experts that countries in Africa could be hit particularly hard, with high rates of transmission that could quickly overwhelm health care systems.
But roughly nine months into the pandemic, which has sickened over 31 million people and caused more than 950,000 deaths around the world, most African countries have fared significantly better than other parts of the world.
The reasons are still something of a mystery — more research is needed, and some studies that aim to answer the questions are only just beginning — but scientists said the success of many African countries so far offers crucial lessons for the rest of the world and shine a light on how inherent biases can distort scientific research.
“The initial disease prediction models painted a very bleak picture of severe devastation of lives and economies in Africa,” Dr. Sam Agatre Okuonzi, who works at Arua Regional Referral Hospital in northern Uganda, said Thursday in a World Health Organization news briefing. “In Uganda, it was predicted that by September, there would be 600,000 cases of Covid-19 and 30,000 deaths. But the reality is starkly different.”
Uganda has 7,064 reported coronavirus cases and 70 deaths, according to a Johns Hopkins University tally. South Africa, the hardest-hit country on the continent, has recorded more than 665,000 cases and 16,206 deaths. That represents about 28 deaths per 100,000 people, compared to more than 61 deaths per 100,000 in the U.S.
Yet even though other countries, such as Ethiopia, Algeria and Nigeria, have struggled with bigger outbreaks, most countries on the continent have succeeded so far in containing the virus’s spread.
Part of that success owes to aggressive measures enacted early in the pandemic to restrict people’s movements and slow transmissions within communities, said Dr. Matshidiso Moeti, the WHO’s regional director for Africa.
“Governments took early, quite drastic action through the lockdowns at great cost to their economies,” Moeti said in the briefing. “This has bought us some time.”
She said there are concerns that numbers of new infections could spike in the coming weeks as restrictions are eased and many African countries slowly return to normal. Moeti said upticks are already being observed in South Africa, Algeria, Mauritania and Ghana, likely as a direct result of the reopening of cities in May and June.
The WHO has stressed that the next few months — in Africa but also elsewhere — will be very important to stave off an anticipated second wave of infections.
Moeti said African countries should emphasize preparedness and must “put in place the public health capacities to contain the spread, so we don’t have wide spread repeating itself in cycles.”
As efforts to prepare for a possible second wave get underway, scientists are also trying to learn what African countries did right in the first phase of the pandemic.
More research is needed, but some early theories have emerged, Okuonzi said.
He said it’s possible that some African countries are better equipped to respond to infectious disease outbreaks “because we have a lot of experience from Ebola and other diseases.”
Shaun Truelove, an assistant scientist and modeling expert at the Johns Hopkins Bloomberg School of Public Health, said it’s also possible that some populations in Africa could have “cross-reactive immunities” from having been exposed to other circulating coronaviruses.