When COVID-19 initially blazed through Asia, Europe and then the United States, global public health experts worried that it could be catastrophic for Africa, with its crowded cities, poorly funded health sector and lack of testing facilities. The U.N. Economic Commission for Africa in April predicted up to 300,000 deaths this year if the virus couldn’t be contained on the continent. Yet it was the U.S, with its superior health system, that hit that grim milestone first, and so far, Africa has been largely spared the worst of the devastation experienced by the rest of the world. As of Dec. 29, the Africa Centres for Disease Control and Prevention was reporting total 2.6 million cases and 63,300 deaths for a population of 1.2 billion. That’s roughly one case for every 500 people, compared to one in 20 in the U.S.
However, those numbers might not actually reflect the reality on the ground. Overall, testing for COVID-19 cases has been comparatively limited on the continent, which could be contributing to lower case numbers. South Africa, which has the highest testing rate in the region, was only performing 0.68 tests a day per 1,000 people in mid-December, compared to 4.3 in the U.S., according to Our World in Data (Denmark, which has the highest test rate, is currently performing 15.1 tests per 1,000). That might explain why the continent has lower-than-expected reported case rates.
As for COVID-19-related deaths, one way to estimate the true impact of the virus is to look at total excess deaths this year, calculated by comparing the overall mortality figures in 2020 to previous annual averages. Those figures in South Africa point to the possibility of a higher number of deaths from COVID-19 than the official records show. A report by the South African Medical Research Council noted that South Africa saw some 17,000 extra deaths from natural causes between early May and mid-July, a 59% increase in excess deaths compared to what was expected over the same period. However, the Africa CDC says there has been no indication that a large number of COVID-19 deaths have been missed.
If official numbers are to be believed, the African continent trails much of the rest of the world when it comes to case fatality rates, and there have been fewer scenes of overwhelmed hospitals and funeral parlors coming from the continent compared to other parts of the globe. Nevertheless, some countries across the continent are currently seeing increases in COVID-19 cases amid concerns of a second wave. South Africa has seen a sharp increase recently, amid evidence that a new variant has been detected; President Cyril Ramaphosa announced new restrictions on Monday, citing the daily record of 14,790 infections recorded on Christmas Day, which he described as “a cause for alarm.” Over the weekend, the country’s total recorded cases since the start of the pandemic reached one million at the weekend.