# Africa and COVID-19 **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [April 1, 2020, 4:05am UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785 "2020-04-01T04:05:19Z")\ **Posts on this page:** 7\ **Page:** 2
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [April 1, 2020, 5:19pm UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/21 "2020-04-01T17:19:26Z")
> [@CarnalK](#): > > Right, it’s just even this last quote just said “yes they can” - he would be crazy to say that it’s impossible. But the person DSeid quoted was talking about findings from the extensive case tracking done in South Korea. I get that, and am not saying that DSeid’s quote is wrong. But it seems like as we go on, they are finding things that contradict those earlier findings, so there might be things that were missed, even if it was an ‘extensive case tracking’ study. I doubt that South Korean (or Chinese who found similar things) physiology is that different from European (though my take is ‘humans are humans’ after all, as, again, I’m not expert, so maybe there is some fundamental difference that I’m clueless about), yet there seems to be some large differences in things as we move forward. South Korea is one of the really hard hit countries that also seems to have done a remarkable job of dealing with the virus very early on, though they maybe starting to see their second wave. At any rate, that’s the best I gots. I can only relate what I’ve been told and what I’ve read, I don’t really know this stuff that well…it’s not even tangentially related to my own areas of expertise. Sadly, I’ve had to try and learn a lot of this stuff on the fly recently. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [April 1, 2020, 5:31pm UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/22 "2020-04-01T17:31:34Z")
Well, if you find something that actually contradicts Dseid’s cite, from the head of the World Health Organization’s emerging diseases and zoonoses unit, I’d like to see it. Because what you quoted wasn’t a finding of anything, it was a pediatrician’s opinion. ---
**Author:** ![DinoR](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dinor/32/2821_2.png) [@DinoR](https://boards.straightdope.com/u/DinoR)\ **Post date:** [April 1, 2020, 8:36pm UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/23 "2020-04-01T20:36:29Z")
There are some real reasons to worry even if the disease has not spread as far to date. Africa has the majority of worldwide cases of HIV. That is a lot of people at higher risk of death. Lagos, Nigeria is the largest city on the continent. A [look](https://www.usnews.com/news/world/articles/2020-03-30/africas-megacity-lagos-braces-for-two-week-coronavirus-lockdown) at their situation as they transitioned into a 14 day lockdown highlights some red flags. When you have a decent chunk of your population living in poverty, with zero social safety net, and in many cases not having access to drinking/washing water in their home, mitigation measures can be difficult. Libya is in the midst of a civil war and shares a border with Egypt. Fighting was expected to ramp back up again this year. The leaders of the warring parties probably face higher personal risks of death if they lose that fight than from the pandemic. Dying from pneumonia sucks. Being beaten, sodomized with a bayonet and then shot multiple times like Gadaffi also sucks. Controlling the pandemic may not be priority number one. It may not even be on the priority list. Maybe the various nations that were supporting the warring parties are so distracted the risk of fighting drops enough to let priorities shift to the virus..maybe. Libya is at the northern tip of the land route taken by refugees, especially those fleeing fighting in the Sahel, on their way to Europe during what has been a large refugee crisis. The refugee numbers might drop but I would be surprised if they stop. The risks of dying on the trip or being sold in Libyan slave markets didn’t stop the flow. That produces what has been mostly a one way flow that can reasonably be expected to simply ignore things like legal declarations against travel. To the extent that nations on the route get better at enforcement and turning people back it can turn the flow into mixing function to spread the disease. Refugees from multiple nations mix as they travel with limited opportunity for hygiene and lots of physical stress weakening their immune systems. Then they deal with security forces that they might infect. If turned around they can carry the virus back along the route as far as they make it. That refuge route to Libya is also a smuggling route. It, along with routes towards the middle east, is an important part of the logistics for the insurgent groups in the Sahel. Those are two way routes traveled by people that already ignore and avoid government attempts to stop their travel. There is a whole lot of transmission across international borders that is possible because of the instability in the Sahel. > [@DSeid](#): > > That would under report confirmed cases for sure. But a spike in deaths due to pneumonia, even if attributed to influenza or other clinically, would still be noticeable if it was taking off. If the deaths themselves are being reported in the first place, let alone classified as pneumonia. Many of the countries in Africa have relatively weak governance. Despite recent high urbanization rates in Africa in the last few decades, the majority of people on the continent still lives in rural areas. Many are far from routine government intervention. Mix the two and reporting, especially of rural deaths, may not be very accurate. Then there the failed states of Libya and Somalia. We should not expect the competing claimants to power to be very good about reporting anything. They have bigger problems and limited spans of control. There are also a number of functioning states in Africa that have their reach limited by currently active insurgencies. Parts of those countries function under government control. In some parts the mere existence of the government officials responsible for the area can be in question. Just an example from the [March](https://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/S_2020_223.pdf) report by the UN Secretary General on the mission in Mali > [@](#): > > During the reporting period, the percentage of civil administrators present at > their duty stations in northern Mali remained stable, at 23 per cent, with 60 per cent > of governors, 42 per cent of prefects and 16 per cent of sub-prefects deployed. In > Mopti Region, central Mali, as at 31 January, the number of civil administrators > present at their duty stations had decreased to 27 per cent, from 30 per cent in > November 2019. Officials present included the governor, 75 per cent of prefects and > 19 per cent of sub-prefects. For some of the parts of Africa where the official government data is suspect the estimate is also likely suspect. The estimate you propose is probably fine if you just want to check to see if Egypt is trying to cover things up. For the countries of the Sahel region, Libya, and Somalia it risks being an exercise in GIGO (Garbage In, Garbage Out.) ---
**Author:** ![DummyGladHands](https://avatars.discourse-cdn.com/v4/letter/d/49beb7/32.png) [@DummyGladHands](https://boards.straightdope.com/u/DummyGladHands)\ **Post date:** [April 1, 2020, 9:05pm UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/24 "2020-04-01T21:05:57Z")
I don’t have the link but the decrease in tourism thru Covid has lead to an increase in poaching for horns, killing Pangolins etc. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [August 9, 2020, 2:40am UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/25 "2020-08-09T02:40:35Z")
Bumping to add this. [https://science.sciencemag.org/content/369/6504/624](https://science.sciencemag.org/content/369/6504/624) Summarized [here](https://science.sciencemag.org/content/369/6504/twis) > [@](#): > > With the spread of the coronavirus disease 2019 (COVID-19) pandemic across the globe, experts predicted that Africa would suffer an overwhelming number of cases and deaths, but this seems not to be the case. Despite potential issues with reporting, there may be distinct factors in the African nations that are contributing to reduced mortality from COVID-19. In a Perspective, Mbow _et al._ discuss how the younger age of the population of Africa could limit severe disease. Other factors might also be involved, particularly exposure to other infectious diseases and parasites that could train the immune systems of Africans to better cope with infection ---
**Author:** ![SayTwo](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@SayTwo](https://boards.straightdope.com/u/SayTwo)\ **Post date:** [August 9, 2020, 7:56am UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/26 "2020-08-09T07:56:50Z")
Also from the article: > There are differences in opinion about whether the pattern of SARS-CoV-2 spread is different in Africa compared with that in the United States and Europe. So far, **despite a paucity of data** , it appears that the virus is spreading differently and potentially with an attenuated outcome in Africa. There has been limited testing of asymptomatic cases or of antibody titers. Therefore, it is unknown whether early interventions were successful in preventing transmission or whether there are differences in susceptibility between populations of different regions. Perhaps the COVID-19 pandemic can emphasize the need for widespread implementation of public health tools, such as high-quality data, accurate diagnostics for track and trace, good communication, and an effective vaccine. This seems really important, in terms of understanding this disease fully, so one wonders why there hasn’t been more study done along these lines. I may be wrong, but I’m under the impression that we are devoting tremendous resources to the study of this virus, so that we could send some teams to places in Africa to collect data if we wanted to. Again, I may be wrong, but to a naive outsider it seems, on the surface, easy enough to do? ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 13, 2020, 1:54pm UTC](https://boards.straightdope.com/t/africa-and-covid-19/850785/27 "2020-11-13T13:54:06Z")
Bump for another update. [https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1) Consistent with the virus being as wide-spread in African population as in places like the United States after initial surge, but with identified cases, let alone symptomatic cases and identified deaths from covid-19, being relatively extremely low - to degrees that the authors feel is not explainable by poor reporting (or poor testing or misclassification) or even the population pyramid skew to younger age groups. > [@](#): > > Voluntary non-remunerated donors (VNRDs), who donate blood at community-based ‘blood drives’ comprised only 7.6% (236/3098) of our sample of donors; the remainder were family replacement donors (FRDs) who provide a unit of blood in compensation for a transfusion received by a sick relative. The two groups did not differ significantly by age ( _P_ = 0.15) or sex ( _P_ = 0.51, table S5). Crude seroprevalence was 8.5% (20/236) for VNRDs and 5.4% (154/2862) for FRDs. The median sample date for VNRDs (June 14, 2020) was two weeks later than that for FRDs (May 29, 2020). > > Population exposure across Kenya, with a population-weighted test-adjusted seroprevalence of 4.3%, is considerably higher than was previously thought, based on the cases and deaths reported to date. Seroprevalence was particularly high in the three urban counties; Mombasa (8.0%), Nairobi (7.3%) and Kisumu (5.5%). Consistent with other studies, seroprevalence did not vary significantly by sex; ([_9_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-9), [_10_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-10), [_16_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-16)) however, it peaked in 35-44-year-olds and was lowest for those ≥45 years, which is also consistent with existing reports where seroprevalence was found to be lower in older adults ([_9_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-9), [_10_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-10)). > > SARS-CoV-2 seroprevalence in our study is comparable to estimates from large population-based serosurveys in China, Switzerland, Spain and the USA after the initial epidemic peak and following many tens of thousands of deaths ([_9_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-9), [_10_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-10), [_17_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-17), [_18_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-18)). Our results are also comparable to other surveys of blood donors in Brazil ([_13_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-13)), Italy ([_12_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-12)), and many parts of England ([_19_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-19)). Kenya has an estimated population of 53 million in 2020 and 57% of the population is aged 15-64 years. If the transfusion donor seroprevalence of 4.3% was applied to all 15-64-year-olds it would suggest approximately 1.3 million infections. However, by the median sample date, May 30, 2020, only 2093 cases had been detected (of which approximately 90% were asymptomatic) and 71 deaths among all ages ([_6_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-6)). Although it is difficult to extrapolate our data directly to the whole population, they do strongly suggest that the infection is more widespread in Kenya than the current PCR test results suggest … > > … What are the potential explanations for the divergence in the ratio of observed cases or deaths to serologically defined infections inferred from transfusion donors in Kenya, compared to many high-income countries? (i) The seroprevalence could be over-estimated because of bias in the selection or behavior of blood transfusion donors. (ii) Cases could be under-ascertained by national public health surveillance though it seems unlikely that reporting of deaths and severe cases could be reduced by several orders of magnitude, and hospitals in Kenya were not overwhelmed by admissions with respiratory illness. (iii) The steep demographic age-pyramid results in a smaller vulnerable age group. In Kenya, only 3.9% of the population is aged 65 years or greater which is substantially less than, for example, 23.3% found in Italy; again, this would only explain a several-fold reduction in severe cases or deaths ([_4_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-4)). (iv) There may be alternative mechanisms of immunity to SARS-CoV-2 including cell-mediated immunity ([_20_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-20), [_21_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-21)) perhaps as a result of HCoV-elicited immunity ([_22_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-22), [_23_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-23)). Despite our prior work showing HCoVs circulate in Kenya ([_24_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-24)), we did not identify evidence of cross-reactive antibodies to endemic coronaviruses in our validation study. > > Although blood donors are not representative of the Kenyan population as a whole, we adjusted for demographic bias in the sample structure by standardization against the age, sex, and regional distribution of the Kenyan population. A substantial proportion (43%) of the population of Kenya is outside the age-range (15-64 years) sampled in this study and the seroprevalence in children \<15 years and adults \>65 years is often lower ([_9_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-9), [_10_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-10)); our estimate for blood donors may be higher than the estimate for the population as a whole. Blood donors also differ from the general population in their risk of exposure to SARS-CoV-2. For instance, potential donors are excluded from giving blood if they have been ill during the last six months so the sample may underestimate the population prevalence of SARS-CoV-2 antibodies; on the other hand, people who are shielding at home are unlikely to be captured in our sample leading to an overestimate of seroprevalence. Our exploration of the two distinct populations of blood donors, FRDs and VNRDs, suggests variation in the seroprevalence by donor group but, of note, 92% (2862/3098) of our sample came from the group with lower seroprevalence and exclusion of VNRDs reduced the crude seroprevalence in our study little, from 5.6% to 5.4%. Against these considerations, other countries have relied on blood transfusion donors for an early estimate of seroprevalence but later estimates from random population samples have not been substantially different ([_25_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-25), [_26_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-26)). … > > … Our study provides a national and regional estimate of population exposure to SARS-CoV-2 in an African country. The 4.3% prevalence in blood transfusion donors is in sharp contrast with the reported COVID-19 cases and deaths and supports the impression that disease may be attenuated in Africa ([_7_](https://science.sciencemag.org/content/early/2020/11/11/science.abe1916?rss=1#ref-7)). [Previous page](https://boards.straightdope.com/t/africa-and-covid-19/850785.md?page=1)