Monrovia, Liberia – Driving past warehouses and overgrown walls, an ambulance pulls up at a side entrance of a former medical centre at a disused United Nations military base in Liberia’s capital, Monrovia.
The site has been rehabilitated and spruced up to serve as the principal COVID-19 treatment unit in the country, which has seen infections surge by more than 300 percent in the past two weeks.
As the ambulance drops off a new patient, workers at another truck offload oxygen cylinders before taking away a pile of empty ones.
“Since the beginning of June, we’ve had 21 deaths,” the unit’s clinical coordinator, general practitioner Dr Richard Doe, told Al Jazeera. “Just to put that into perspective, it’s more than we had from March to December last year,” he said.
“Our facilities here are struggling,” Doe warned, noting that ventilators are not being used due to a lack of human resources.
“We need the public to help us in this fight against COVID. As long as the people out there do not practice those basic things – wearing masks, hand hygiene, social distancing, and getting vaccinated where available, it will be like a rat race we can’t keep up with.”
The government has responded to the surge by banning gatherings of more than 20 people and ordering the closure of bars and nightclubs from 9pm, with warnings of a possible lockdown to follow.
Liberia is just one of many countries across the African continent to experience rapidly increasing COVID-19 cases and hospitalisations – just as much of the world is witnessing a decline in infection rates as vaccination campaigns take effect.
More than a dozen countries have reported their worst figures since the start of the pandemic, with more than 650,000 new cases recorded on the continent between May 3, when the so-called third wave began, and June 27.
At a press briefing on Thursday, the World Health Organization’s Africa director Dr Matshidiso Moeti warned that “the speed and scale of Africa’s third wave is like nothing we’ve seen before.”
“COVID-19 cases are doubling every three weeks, compared to every four weeks at the start of the second wave. Almost 202,000 cases were reported in the past week and the continent is on the verge of exceeding its worst week ever in this pandemic,” she added.
Moeti said that, among the 14 African countries now in resurgence, 12 have detected coronavirus variants of concern, including nine with the highly contagious Delta variant.
“With the rampant spread of more contagious variants, the threat to Africa rises to a whole new level.”
A recent situational report published by the Johns Hopkins Center for Health Security stated that Africa “has exhibited a substantial increase in daily incidence since mid-May”, with daily case numbers rising threefold.
The report cites “weak adherence to public health measures, including an increase in social gatherings and movement” as contributing to the recent spike in infections.
“The COVID-19 situation in Africa is worrisome,” Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), tweeted last week. “Both the number of cases and deaths [between June 14-20] are almost 40 percent higher than in the week before.”
A week later, hospitalisations due to COVID-19 have increased by a further 42 percent.
First identified in India, Delta – said to be up to 60 percent more transmissible than other variants – has overall been detected in 16 African countries, according to the WHO.
These include South Africa, where President Cyril Ramaphosa announced a return to level-four measures on Sunday evening as the country recorded nearly 160,000 active cases, including a nationwide curfew between 9pm and 4am and a ban on gatherings.
The new rules, which took effect on Monday, will be reviewed after two weeks.
Meanwhile, Uganda has been under a strict 42-day lockdown since June 18 in response to a resurgence in infections, with the Delta variant predominating. Some 45 percent of Uganda’s 75,000 reported cases have occurred just in the past two months.
Schools have been closed and most travel banned, while a night-time curfew is in place between 7pm and 5:30am.
In the Democratic Republic of the Congo (DRC), Jean-Jacques Muyembe, head of the National Institute of Biomedical Research, warned that the “evolution of the Delta variant is very worrying”.
“The contamination is rapid and if it continues, it will be a catastrophe in the DRC,” he told the same briefing. “Our hospitals are overwhelmed, the morgues are overflowing, many politicians and university professors have been infected with the virus, and many have died.”
Meanwhile, there is a lag in vaccination figures across Africa as health officials appeal for access to more doses.
A little more than 1 percent of the African population has been fully vaccinated against COVID-19, according to the WHO, with Africa constituting just 1.5 percent of the 2.7 billion doses administered globally.
The WHO has warned that nearly 90 percent of African countries are expected to miss a target of vaccinating one-tenth of their population by September unless a further 225 million doses are received.
Some countries, including Liberia, initially experienced high levels of vaccine hesitancy amid concerns surrounding reports of rare blood clots in recipients of the Oxford-AstraZeneca offering in Europe.
But since early June, queues at vaccination sites in Monrovia have lengthened significantly as the toll of the virus becomes more visible among the population. To date, the country has officially recorded 4,093 cases, including 128 deaths, according to Johns Hopkins.
But the supply of vaccines to the continent remains far lower than what is needed.
Tedros, the head of the WHO, said at a news conference on Friday that vaccine hesitancy in Africa is not the problem: “There is no vaccine so why do we talk about vaccine hesitancy? The problem is vaccine supply … and we need vaccines now.”
"We are seeing globally that vaccination offers a clear path towards ending devastating surges of severe cases. Yet just over 1% of Africans are now fully vaccinated, compared to 11% of people globally, and over 46% of people in 🇬🇧 & 🇺🇸." – Dr @MoetiTshidi
— WHO African Region (@WHOAFRO) July 1, 2021
Separately, the European Medicines Agency (EMA) has not included the Covishield vaccine, the Indian-made version of AstraZeneca’s jab which comprises more than 90 percent of doses distributed so far to African countries under COVAX, a scheme designed to boost the distribution of vaccines to low-income nations, on its list of approved vaccines.
This means Covishield recipients will be unable to acquire an EU Digital COVID Certificate to facilitate travel to the European Union and several non-EU European states from July 1.
Also on Thursday, Strive Masiyiwa, the African Union special envoy leading efforts to obtain vaccines for the bloc, sharply criticised Europe, saying “not one dose, not one vial, has left a European factory for Africa”.
Masiyiwa further said COVAX had pledged to deliver 700 million vaccine doses to the continent by December. But by June, Africa has received just 65 million doses overall, with fewer than 50 million doses arriving via COVAX.
“Pay up your money,” he told donors. “We will no longer measure pledges, we will measure vaccines arriving at our airports.”
Only four of the eight vaccines listed for emergency use by the WHO have so far received marketing authorisation by the EMA and are recognised for the bloc’s travel pass.
“Africans must not face more restrictions because they are unable to access vaccines that are only available elsewhere,” said the WHO’s Moeti.
“I urge all regional and national regulatory agencies to recognise all the vaccines Emergency Use listed by WHO.”
Adar Poonawalla, the CEO of the Serum Institute of India, tweeted on Monday that he had “taken this up at the highest level and hope to resolve this matter soon, both with regulators and at a diplomatic level”.