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Managing the Covid Crisis Beyond Vaccines: Africa’s Battle Against the Third Wave


Commentary22nd July 2021

Africa’s third-wave surge has been the steepest so far, with 31 daily new cases being recorded per million – much higher than the first-wave (13 daily cases per million) and second-wave (23 daily cases per million) surges.

While the overall rate of infection could now be on the decline, there is significant variability in the trends between countries. African countries are at different stages of battling the third wave and, to assess needs and respond accordingly, a closer look at countries is required.

There are at least four tiers that can be observed from the figures:

  1. In crisis – pre-peak surge

In countries such as Rwanda, Senegal, Gambia, Morocco, Botswana and Malawi, daily new cases are rising exponentially and are not showing any indication that they have reached the peak. The rise in cases is already much higher than these countries have experienced in previous waves.

Figure 1

  1. In crisis – post-peak decline

Countries such as Uganda, Zambia, Namibia, South Africa, DRC and Sierra Leone are exhibiting a decline in daily new cases, but mortality is still on the rise. These countries accounted for more than 80 per cent of new deaths recorded in the continent in the past week.

Figure 2

  1. Resurging cases

Nigeria, Guinea, Ghana and Togo have not reached peak levels, yet cases are on the rise with 156 per cent, 150 per cent, 78 per cent and 70 per cent biweekly growth rates respectively.

Figure 3

  1. Overwhelmed health sector

Countries such as Tunisia and Zimbabwe have reached a peak in cases, which is overwhelming health systems and driving a health-care crisis.

Tunisia appears to be past the peak stage and the country’s health-care system cannot cope. Hospitals in Tunis are in crisis mode, with medical personnel saying they are unable to treat patients because of the massive surge in numbers, and shortages of staff as well as oxygen and other materials. Similarly, in Zimbabwe the surge in cases has led to an increase in demand for beds in public hospitals. The government is expediting the preparation of isolation and treatment centres throughout the country.

This phenomenon can be witnessed elsewhere in Africa. Hospital admissions in around ten countries have increased rapidly and at least six countries are facing shortages of intensive-care unit beds. Demand for medical oxygen has spiked, with the WHO estimating it to be 50 per cent higher than at the same time in 2020, yet supply has not kept up due to an insufficient quantity of oxygen production plants, with many in a state of disrepair or poor maintenance. Other barriers to adequate medical-oxygen supply in Africa include challenges in distribution, scarcity of cylinders and a lack of personnel or technical skills among staff. 

It is clear that in many countries infections are still rising or are volatile, driven by public fatigue with non-pharmaceutical public-health measures and an increased spread of variants. The longer the virus is not contained, the more likely new variants that are more transmissible are to emerge.

While vaccine shortages and suboptimal absorption are significant challenges that need to be addressed, it is important to ensure that overwhelmed health-care systems do not cost more lives. In addition to national efforts, the global community needs to provide flexible responsive assistance to manage the rising number of Covid-19 cases. Accelerating ongoing support in terms of oxygen, surge hospital capacity, medical supplies and testing supplies can stop the collapse of vital health facilities, which would prevent not only the treatment of patients with Covid-19 but also the provision of other essential health services.

Lead Image: Getty Images

Charts created with Highcharts unless otherwise credited.

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