COVID-19 Less Deadly in Africa

Thus far, COVID-19 has been far less devastating in Africa than observers had feared, including this blogger. It is true that there has been much less testing for the disease in Africa than elsewhere (perhaps one percent of the population, while the United States has conducted over one hundred million tests), and African statistics tend to be weak. But there have been only a few reports of mass deaths anywhere on the continent, such as were seen in Ebola outbreaks. Africa has a population of 1.2 billion people. There have been 1.4 million cases of COVID-19, with less than 35,000 deaths. The United States has a population of an estimated 331 million. There have been 7.1 million cases of COVID-19 and about 205,000 deaths. Despite its obvious shortcomings, the public health and medical infrastructure in the United States is far superior to that of Africa. How to account for the apparent lesser severity of COVID-19 in Africa than in the United States? 

Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa, advances a credible explanation. Summarizing, its most important elements are:

• Africa's population is youthful; only 3 percent is over sixty-five years of age, while in the United States it is 15.2 percent, almost 50 million. In Africa, 90 percent of cases have been among people under sixty years of age; in the United States, in August, it was about 80 percent.
• Even though the continent is urbanizing fast, its population density is lower, and even in urban areas people live and work outdoors to a greater extent than in the developed world. It seems clear that COVID-19 spreads more rapidly in enclosed spaces. 
• Poorly developed infrastructure, especially roads and airports, results in fewer people traveling, reducing the spread of the disease.
• Some African states, notably South Africa (then ground zero for the disease), locked down early. There are estimates that the South Africa lockdown will save some 16,000 lives by the new year.

The bottom line: Africa would appear to confirm that COVID-19 is most dangerous among elderly people living closely together.