COVID-19 Overview in Africa from our Regional Coordinator in Nigeria, Dr Azukaego Nnaji

COVID-19 Overview in Africa

By: Dr Azukaego Nnaji

Corona virus disease discovered in Wuhan china in 2019 commonly called COVID-19 is the current pandemic that has brought the entire world to a standstill at the moment. In world history, various pandemics have occurred, such as the Black plague in the 14th century; the 1918 Influenza (Spanish flu); and the 2009 Flu pandemic (H1N1), to mention a few, but none was as wide spread, as the current COVID-19. While these plagues were more localised, COVID-19 has traversed borders, countries, races, languages, religions, cultures, territories and regions.  As at 5th April 2020, the world has confirmed 1,133,758 cases of COVID -19 infection with 62,784 deaths and a CFR of 5% spanning across more than 203 countries of the world (NCDC, 2020).­

Table 1:  Global confirmed cases, and deaths in different regions of the world as at 5th April, 2020 (WHO, 2020a).

African Overview

The African region which houses many developing nations surprisingly has recorded low cases of COVID-19, compared to their developed counterparts in other parts of the world. While 54 countries have been affected in Africa, countries like Comoros, Lesotho, and Sao-Tome and Principe, are yet to record any case. Interestingly, the more developed countries of the African region like Algeria, Egypt, Morocco and South Africa have recorded more cases (more than 1000 confirmed cases) than those in sub-Saharan Africa, (African arguments, 2020).

Table 2: African countries and confirmed cases as at 5th April, 2020 (Africanargument, 2020).

Impacts of COVID-19 on Africa

No doubt the COVID-19 pandemic has devastated the world’s economy, and the world is currently in limbo but the countries with fragile economies like most African countries will feel the impact more than the more buoyant ones. Most countries in Sub-Saharan Africa, have frail economies with poor health facilities and social amenities. The impacts of the pandemic are being felt in two ways:

1] Exogenous effects which are effects that come from direct trade links between affected partner continents such as Asia, Europe and the United States; tourism; the decline in remittances from African Diaspora; Foreign Direct Investment and Official Development Assistance;  illicit financing flows and domestic financial market tightening, etc.

2] Endogenous effects, which occur as a result of the rapid spread of the virus in many African countries which is linked to morbidity and mortality. On the other hand, they lead to a disruption of economic activities. This has caused a decrease in domestic demand in tax revenue due to the loss of oil and commodity prices coupled with an increase in public expenditure to safeguard human health and support economic activities (African Union, 2020).

The oil producing countries such as Nigeria, Angola, Algeria, Congo, Gabon and Chad will have darker economic prospects than the whole continent. Oil prices lost about 50% of their value dropping from US$ 67 a barrel to below US$ 30 a barrel from Dec 2019 to March 2020 (African Union, 2020). In response to support crude oil prices hit by the pandemic COVID-19, major oil producers proposed to reduce production, as people consume less with decline in travel. Most other Sub-Saharan African countries which are agricultural based economies are equally hit due to lockdown.

Using Nigeria, the most populous country in Africa as a prototype, all industries have been affected by COVID-19, mostly negatively, especially the oil sector. More so, as the country is struggling out of recession. The agricultural sector, which the country has been struggling to resuscitate, is equally crippled due to lockdown. While Nigeria joins other nations to observe the international measures in controlling transmission of infection such as lock down, hand washing, social distancing, crowd regulation, one wonders how practicable these measures can be in this region of the world?  

According to Nigerian demographic health survey (NDHS), though 65.3% of Nigerians have access to improved water supply, only 29.2% have water available. Secondly, only 32.6% of households have basic hand washing facility. A good number of households are crowded with an average of 4.7 persons per household, with 21.6% of households having more than 6 persons in a house (NDHS, 2018).

Due to the fact that 36.85% fall below the middle wealth quantile, a good number depend on menial jobs for survival, making lock down a big challenge. Little wonder the lockdown is not as effective as it should be as people have taken to the streets to look for daily bread, within the second week of the exercise. It is commendable that many countries in Africa are putting together palliative measures for their citizens, but is there an adequate database to ensure effectiveness?  In the absence of strong data base, where these measures exist at all, like in Nigeria, they are insufficient, uncoordinated, and ineffective. For instance, distribution of relief materials has consistently pulled crowds as people jostle to get a share which negates the purpose of containing the virus through social distancing.

As the epicenter of covid-19 moves from region to region, (from western Pacific to Europe to America), speculations are that it will soon move to Africa.  How prepared is Africa? The questions at the back of so many minds are ‘The low number of cases recorded in Africa, is it real? Or ‘Could it be a problem of under diagnosis? Could there be other factors responsible for the low number of cases in Africa? Take for instance, accessibility to testing, many African countries are still unable to test for COVID-19. Though a lot of progress has been made by WHO in this regard to increase the number to forty-seven countries (47), as opposed to two (2), at the start of the outbreak (WHO, 2020b), there is still room for much work. In Nigeria for instance, despite having nine (9) activated laboratories, samples have to be transported to distances of more than 8 hours (in some cases), to get tested. This simply means, that not enough people will get tested.

There is also the issue of proper quarantine facilities, as there were no preexisting ones, so governments have converted preexisting unused government buildings, parts of stadiums, abandoned houses, and warehouses to serve as quarantine facilities. With crowded facilities, and overstretched medical personnel, people who may be infected, stay at home mistaking their symptoms as that of malaria with/without common cold. This poses a problem due to the incubation period of 14 days (2 weeks) of the virus, which will make it difficult for people to link their symptoms to COVID-19.

Contact tracing is equally a challenge. Nigeria recorded her first case on 27 February, 2020, through an Italian citizen who came into the country from Milan, Italy on 25 February, 2020. He was detected two days after he came into the country instead of at the point of entry. The contacts that must have occurred within those two (2) days, is left to imagination. Of the 232 confirmed cases in Nigeria, as at 5th April, 2020; 101 (44%) have travel history to high risk countries, 35 (15%) are contacts of known confirmed cases and 96 (41%) of cases have incomplete epidemiological information (NCDC, 2020).

In the face of frail economies, poor infrastructures, and poor health facilities, worries are that Africa is a time bomb ticking away, as the low cases recorded gives a sense of security, which may not be real. Nigeria, as the most populous country in Africa is again, the center of concern. Could that be the reason Nations are lifting their citizens out of Nigeria?

References

Africanarguments (2020) ‘Coronavirus in Africa Tracker: How many covid-19 cases and where?’ [Latest]; available at   https://africanarguments.org/2020/04/06/coronavirus-in-africa-tracker-how-many-cases-and-where-latest/; accessed 5 April, 2020.

African Union (2020) The Impact of Corona virus disease on African Economy; available at https://au.int/sites/default/files/documents/38326-doc-covid-19_impact_on_african_economy.pdf; accessed 7 April 2020.

NCDC (2020) ‘COVID-19 Outbreak in Nigeria: Situation Report-037; available at file:///C:/Users/NNAJI%20AZUKAEGO/Downloads/An%20update%20of%20COVID-19%20outbreak%20in%20Nigeria_050420_15.pdf; accessed 5 April, 2020.

Nigerian Demographic Health Study, NDHS (2018): pages 11-32; available at https://www.dhsprogram.com/pubs/pdf/FR359/FR359.pdf; accessed 5 April, 2020.

WHO (2020a) ‘Coronavirus disease 2019 (COVID-19), Situation report-76’; available at file:///C:/Users/NNAJI%20AZUKAEGO/Desktop/COVID%2019.pdf;   accessed 5 April, 2020.

WHO (2020b) ‘African countries move from COVID-19 readiness to response as many confirm cases’; available at    https://www.afro.who.int/health-topics/coronavirus-covid-19; accessed 6 April, 2020.

Leave a Reply

Your email address will not be published.