Vulnerable informal workers risk arrest and sickness to try eke out a living and feed their families.
Africa’s reported COVID-19 death toll has surpassed 100,000, a fraction of those reported on other continents but rising fast as the second wave of infections overwhelms hospitals.
The continent’s reported deaths, at 100,354 on Friday, are less than North America’s – at more than half a million – and Europe’s which is approaching 900,000, a Reuters tally shows.
But deaths are rising sharply across Africa, driven by its southern region, especially in the economic powerhouse of South Africa, which accounts for nearly half of the total. South Africa was ravaged by a second wave caused by a more contagious variant that has jammed up casualty wards.
“The increased number (of infections) has led to many severe cases and some of the countries really found it quite difficult to cope,” Dr Richard Mihigo, the coordinator of the immunisation programme at the World Health Organization’s Africa office, told the Reuters news agency.
“We have seen some countries getting to their limit in terms of oxygen supply, which has got a really negative impact in terms of case management for severe cases.”
Mihigo said the rise in deaths was pronounced in countries near South Africa such as Zimbabwe, Mozambique and Malawi, raising the possibility that the 501Y V2 variant identified in South Africa late last year had spread through the southern Africa region – although more genomic sequencing needs to be carried out.
International aid group Doctors Without Borders (Medecins Sans Frontieres, or MSF) this month called for urgent vaccine distributions in southern Africa to counter the spread of the new variant, as most African countries have lagged behind richer Western nations in launching mass vaccination programmes.
Reuters’ data show Africa’s case fatality rate is now at about 2.6 percent, higher than the global average of 2.3 percent and marginally up on the 2.4 percent rate after the first wave of infections. At that time, Africa compared favourably with other continents.
Experts caution against reading too much into the data as the real toll could be much higher or lower. For instance, South Africa’s excess deaths – deaths considered over-and-above the normal rate during the pandemic have reached more than 137,000, almost three times its official COVID-19 death toll.
Then again, in some cases Africa’s low testing rates could inflate its true case fatality rate (CFR), said Francisca Mutapi, an infectious disease expert at the University of Edinburgh.
“If deaths being registered as COVID-19 deaths are not necessarily contingent on a positive test … as is the case in South Africa, then this can drive up CFR,” she said.
Even with these caveats, African countries appear to be struggling with COVID-19 more this year than it did previously.
“Are we counting all the deaths on the continent? No … but most people on the continent do know somebody who has died of COVID during this second wave,” Africa CDC Director John Nkengasong told reporters last week.
“Hospitals are being overwhelmed due to health systems that are fragile.”