Apr 1
Thinking Citizen Blog — The West and Central African Covid Anomaly — Why So Relatively Few Deaths?
Thinking Citizen Blog — Thursday is Health, Health Care, and Global Health Policy Day
Today’s Topic: The West and Central African Covid Anomaly — Why So Relatively Few Deaths?
Covid was expected to devastate Africa. It didn’t. Why? Or are the deaths just not being counted? Is the South African Covid death rate higher than in Western and Central Africa because of better reporting or is something else going on? Is there an “African paradox” or is it an illusion? Today a few excerpts from a recent article in New York Times on the subject. Experts — please chime in. Correct, elaborate, elucidate.
THE COMBINATION OF WEAK HEALTH CARE SYSTEMS AND COMPROMISED IMMUNE SYSTEMS LED TO APOCALYPTIC EXPECTATIONS
1.“In the first months of the pandemic, there was fear that Covid might eviscerate Africa, tearing through countries with health systems as weak as Sierra Leone’s, where there are just three doctors for every 100,000 people, according to the World Health Organization.”
2. “The high prevalence of malaria, H.I.V., tuberculosis and malnutrition was seen as kindling for disaster.”
3. But it never happened. “The low rate of coronavirus infections, hospitalizations and deaths in West and Central Africa is the focus of a debate that has divided scientists on the continent and beyond. Have the sick or dead simply not been counted? If Covid has in fact done less damage here, why is that? If it has been just as vicious, how have we missed it?”
NB: Reporting from Kamakwie, Sierra Leone, on March 23, 2022, (See photo above) Stephanie Noten of the New York Times writes: “There are no Covid fears here. The district’s Covid-19 response center has registered just 11 cases since the start of the pandemic, and no deaths. At the regional hospital, the wards are packed — with malaria patients. The door to the Covid isolation ward is bolted shut and overgrown with weeds. People cram together for weddings, soccer matches, concerts, with no masks in sight. Sierra Leone, a nation of eight million on the coast of Western Africa, feels like a land inexplicably spared as a plague passed overhead.”
TWO THIRDS OF THE POPULATION HAVE ANTIBODIES, ONLY 14% VACCINATED WHY SO FEW DEATHS? SIMPLEST EXPLANATION — THE AGE THING
1. Age: the median age is 19 years in Africa, 43 in Europe, 38 in the United States.
2. “Nearly two-thirds of the population in sub-Saharan Africa is under 25, and only 3 percent is 65 or older.”
3. “Young people infected by the coronavirus are often asymptomatic, which could account for the low number of reported cases.”
OTHER EXPLANATIONS: high temperatures, the outdoors thing, exposure to other pathogens
1. “High temperatures and the fact that much of life is spent outdoors could be preventing spread.”
2. “Or the low population density in many areas, or limited public transportation infrastructure.
3. “Perhaps exposure to other pathogens, including coronaviruses and deadly infections such as Lassa fever and Ebola, has somehow offered protection.
NB: But in India the fatality rate is high despite a young population and plenty of other pathogens. So are the Covid deaths in Africa just not being counted? “Most people die in their homes, not in hospitals, either because they can’t reach a medical facility or because their families take them home to die. Many deaths are never registered with civil authorities. This pattern is common across sub-Saharan Africa. A recent survey by the United Nations Economic Commission for Africa found that official registration systems captured only one in three deaths.”
Trying to Solve a Covid Mystery: Africa’s Low Death Rates
Opinion | Africa’s Low Vaccination Rates Should Concern Everyone
https://www.nytimes.com/2022/03/15/health/covid-vaccines-africa.html
Africa marks its ‘worst pandemic week’ yet, with cases surging and vaccine scarce, the W.H.O. says.
https://www.nature.com/articles/d41586-022-00842-9
Coronavirus in Africa: Five reasons why Covid-19 has been less deadly than elsewhere
For the last four years of posts organized by theme:
PDF with headlines — Google Drive
ATTACHMENTS BELOW -
#1 A graphic guide to justice (9 metaphors on one page).
#2 “39 Songs, Prayers, and Poems: the Keys to the Hearts of Seven Billion People” — Adams House Senior Common Room Presentation, 11/17/20
YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.
