Africa Hosts Just 1.5% Of Global COVID-19 Tally
COVID-19 responders learn how to properly don and doff protective gowns in Kenya

In contrast to Europe and the Americas, Africa has just 1.5 percent of the world’s reported cases of COVID-19, and less than 0.1 percent of the world’s deaths, World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus noted on Africa Day 2020.

“Africa appears to have so far been spared the scale of outbreaks we have seen in other regions,” said Dr Tedros. “Of course, these numbers don’t paint the full picture. Testing capacity in Africa is still being ramped up, and there is a likelihood that some cases may be missed.”

Still, African countries’ histories of facing outbreaks of infectious disease have played in their favor, said the WHO Director-General.

“Africa’s knowledge and experience of suppressing infectious diseases has been critical to rapidly scaling up an agile response to COVID-19,” he said.

For example, a coalition of African leaders, organized through the African Union chaired by South African President Cyril Ramaphosa, was set up early in the global pandemic to coordinate cross-country preparedness efforts. Infrastructure and knowledge from battling previous outbreaks was used to rapidly scale COVID-19 interventions, as seen in South Africa’s rapid deployment of mobile diagnostic teams, and the Democratic Republic of the Congo’s use of Ebola screening infrastructure for COVID-19 temperature screening.

Additionally, citizens across the continent have largely understood the need for strong lockdown measures, taken early by many African nations. WHO Regional Director for Africa Dr Matshidiso Moeti on Monday thanked citizens for abiding by stay-at-home orders where possible, acknowledging the hardships that many were facing.

“I’d like to very much commend and thank [the citizens]… because we think that it’s thanks to these measures that we have not started to see the kind of evolution of the pandemic in Africa that we were projecting,” said Moeti. “They accepted the need for some of these measures, although many of them recognize that it would be very tough on them in the households, particularly if you take into account the proportion of African people that are in a sector where you need to be out, earning your money in order to be able to put food food on the table.”

Japan Lifts State Of Emergency As Other Asian Countries Seesaw On COVID-19 Control

On Monday, Japan officially lifted its state of emergency in all its provinces ahead of the May 31st deadline, regarding the emergency situation as “no longer necessary” according to the Ministry of Health. The country has been largely praised for its efficient coronavirus response, relying almost solely on quick contact tracing, testing, and isolation of cases.

India also lifted its restriction on domestic air travel effective Monday, although there were mixed opinions on the move. Meanwhile, Philippines President Rodrigo Roa Duterte commanded its government agencies to expedite the repatriation of more than 24,000 overseas Filipino workers (OFW) within the week.

In China, clusters of cases in Jilin province in the northeast have led to officials to lockdown cities only a couple weeks after the original pandemic epicentre Wuhan began relaxing lockdown measures.

Tensions between China and the US remain high. China’s Foreign Minister Wang Yi remarked that a “political virus is spreading in the US, with some politicians ignoring facts and promoting conspiracy” at a video press conference on Sunday. Still, Wang expressed hope that there could be future collaboration between China and the U.S. for addressing global challenges. 

Park rules in Paterson, New Jersey, USA.
New Death Projections in US Cast Somber Outlook If States Are Too Eager To Reopen

In stark contrast to the Chinese approach, states across the US have begun relaxing social distancing guidance even as new cases continue to appear.

And health experts warn that relaxing COVID-19 measures early could lead to a fresh wave of coronavirus deaths. Some 23,000 more people could die if states failed to reimplement social distancing measures, according to a new analysis by epidemiologists at the Columbia Mailman School of Public Health. 

And enacting federal social distancing measures just two weeks earlier could have prevented 83% of the US’ nearly 100,000 coronavirus deaths, according to the same study. 

But experts fear that social fatigue from complying with the stringent measures mean that citizens will be loathe to comply with any renewed measures. As such, the importance of scaling up public health measures to rapidly detect and contain the virus, as well as improve health education, is even more important in the next phase of the fight.

“Our results also indicate that without sufficient broader testing and contact tracing capacity, the long lag between infection acquisition and case confirmation will mask the rebound and exponential growth of COVID-19 until it is well underway,” says lead researcher Jeffrey Shaman, professor of environmental health sciences at the Columbia Mailman School of Public Health in a press release. “Efforts raising public awareness of the ongoing high transmissibility and explosive growth potential of COVID-19 are still needed at this critical time.”

A COVID-19 triage tent in Italy
High COVID-19 Death Rates in Italy & Sweden  

Sweden had a seven-day rolling average of  6.08 deaths per million between 13 May and 20 May, overtaking the UK, Italy and Belgium to have the highest coronavirus per capita death rate in the world regardless of its low population densities and limits in international travel.

In contrast to countries like France and Germany, social distancing implemented in Sweden depending largely on the discretion of individual Swedes, without harsh controls, fines, or policemen.

However,  the high mortality rate has thrown the government’s decision to avoid strict lockdown into further doubt- especially as its neighboring countries such as Norway, Denmark and Finland, where much tighter restrictions are put in place, have seen dramatically lower numbers of deaths over the past month.

Sweden’s decision to keep open schools, bars and restaurants and to continue to allow gatherings of up to 50 people has been praised by many who believe that the country will be better equipped for a “second wave” with certain degree of herd immunity through the relatively relaxed measures. However, WHO experts have repeatedly warned that early antibody surveys are showing that a far higher proportion of the population will remain susceptible to a second wave, casting strong doubt on the ‘herd immunity’ approach.

Meanwhile, a recent analysis of death registry data by two Italian economists shows that Italy had a 40% higher death rate from February to March 2020, as compared to the same time the previous year.

The economists estimated that the virus may have killed 0.1% of the local population in less than 40 days and that its mortality is vastly underreported in official statistics.

But on the bright side, the analysis shows that stringent containment measures were significantly lower in the Veneto region, which has “embraced mass testing, contact tracing and at-home care provision.” Neighboring Emilia-Romagna and Lombardia did not fare as well.

The economists also found that closure of service activities is effective in reducing COVID-19 mortality – a 10% increase in proportion of the service industry closed correlated with a 15% lower death rate in municipalities. In this second paper, the economists draw from daily death registry data on 4,000 Italian municipalities to investigate two policies, namely the shutdown of non-essential businesses and the management of the emergency care system. However, shutting down factories is much less effective. In addition, results also show that morality strongly increases with distance from the intensive care unit (ICU).

Svet Lustig Vijay contributed to this story

Image Credits: Twitter: WHOAFRO, Paterson Great Falls, Servizio Nazionale della Protezione Civile.