Since the coronavirus pandemic began spreading across the world, experts have been fairly united in the belief that it’s an extremely serious threat.
But there’s one part of the world that’s dividing opinion in the public health community: Africa.
Other continents, from North America to Europe and Asia, have struggled to contain the pandemic, with cases continuing to rise everywhere outside China – yet Africa has registered a tiny number of confirmed cases by comparison.
France 24 reported that on 1 March Africa only had three confirmed cases. According to the most up-to-date figures from the World Health Organisation, this number is currently 101 across 11 African nations (Algeria, Burkina Faso, Cameroon, Democratic Republic of Congo, Egypt, Nigeria, Senegal, South Africa, Tunisia and Togo). This is a tiny figure in such a populous continent, given that there's over 500 in the UK alone and 10,000 in Italy.
There have been no recorded deaths of coronavirus in the entire continent of Africa so far. But why?
There could be numerous factors influencing Africa’s low tally. It could be faulty detection, climatic factors or simple fluke. But the low rate in a continent with infamously fragile health systems continues to perplex (and worry) some experts.
Shortly after the coronavirus appeared, there were warnings of the virus spreading quickly in Africa because of the continent’s close commercial links with Beijing and its fragile and inconsistent medical services. On 22 February Tedros Adhanom Ghebreyesus, the head of WHO, told African Union health ministers gathered in Ethiopia:
Our biggest concern continues to be the potential for Covid-19 to spread in countries with weaker health systems.
In a study published in The Lancet medical journal, a team of scientists identified Algeria, Egypt and South Africa as the most likely to import new coronavirus cases into Africa. Thankfully, though, the study also noted that these countries have the best prepared health systems in the continent.
But other experts admit that “nobody knows” why coronavirus hasn’t become more widespread in Africa.
Professor Thumbi Ndung’u, from the African Institute for Health Research in Durban, said:
Perhaps there is simply not that much travel between Africa and China.
But Ethiopan Airlines – Africa’s largest airline – never even suspended flights to China. Chinese airlines even resumed flying to Kenya, and no spike in cases was detected.
Africa’s hot climate could be a factor.
Professor Yazdan Yazdanpanah, head of the infectious diseases department at Bichat hospital in Paris, said:
Perhaps the virus doesn’t spread in the African ecosystem, we don’t know.
But Professor Rodney Adam, of the infection control task force at the Aga Khan University Hospital in Nairobi, doesn’t agree.
There is no current evidence to indicate that climate affects transmission.
While it is true that for certain infections there may be genetic differences in susceptibility...there is no current evidence to that effect for Covid-19.
Africa's history might have made it well-equipped to respond to viruses and diseases.
The Lancet study found that Nigeria is one of the best prepared in the continent to handle an epidemic like coronavirus.
Mathias Altmann, an epidemiologist at the University of Bordeaux, told France 24 that Africa’s history of responding to epidemics might have made them more adept at how to stop viruses from spreading.
Neighbouring countries are less able to respond than Nigeria. But Altmann says that also an advantage: that people are often outdoors. He said:
Viruses like this one prefer closed spaces and are less likely to spread in a rural setting.
Whatever the reason, it's a hugely positive thing that, so far, Africa seems to be responding effectively to the pandemic. And it's fascinating that sometimes even experts can't agree on exactly why something is happening.