What was the conclusion about levels of Covid in African countries - much lower because of the heat, or just younger population or something else?

[loveyouradvice]

Just that really... anyone know?

Lower population density means it takes longer for any illness to become endemic.

important to remember that "lower levels of COVID in Africa" =/= actual lower prevalence of SARS-COV-2 infections

As summarised in a recent systematic review:

"Precisely estimating COVID-19 cumulative incidence in Africa remains problematic due to challenges in contact tracing, routine surveillance systems and laboratory testing capacities and strategies in many countries. Furthermore, Africa is a large, complex and heterogeneous continent with a range of different economies, countries impacted by humanitarian crises, vulnerable population groups and unique public health challenges."

I've copied a summary of the paper below:

gh.bmj.com/content/7/8/e008793

WHAT IS ALREADY KNOWN ON THIS TOPIC
There is limited published evidence on the seroprevalence of SARS-CoV-2 in Africa, including one previous systematic review and meta-analysis in the general population for the continent and global systematic reviews that under-represent studies in Africa due to sparse data.
Recently, in part via WHO’s Unity studies, the quantity and quality of available seroprevalence data has increased, providing the opportunity to understand the true extent of exposure to SARS-CoV-2 in Africa, disaggregated by demographic groups, place (eg, subregion, country) and time.

WHAT THIS STUDY ADDS
Our results indicate a high seroprevalence in Africa (65.1%) in July–September 2021, which had increased from 3.0% in April–June 2020, and large, persistent under-ascertainment of infection based on confirmed case-based data.
Our results also indicate considerable heterogeneity in seroprevalence within countries and between countries and African subregions.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
High, heterogeneous seroprevalence in Africa highlights the need for targeted serosurveillance, public health and social measures and vaccination strategies tailored to the local context, particularly to address geographic and demographic vulnerabilities.

Also:

"The pooled seroprevalence in Africa estimated in this study (65.1% in Q3 2021) is among the highest in the world (comparable to the Southeast Asia region).10 With vaccination coverage in Africa being low during the study period (6.8% as of September 2021),7 this was mostly driven by infections"

Well you did ask OP

This is a topic I’m interested in, as someone I’m close to travelled to a developing country during the height of UK lockdowns and general covid hysteria.

There was no distancing there, no masking, and certainly no lockdowns- it was business as usual with crowded markets operating etc. Covid was definitely around, but it was like a bad flu season and it did not overwhelm the (okay-ish) healthcare system. I found it troubling to get a glimpse into another place where life was continuing much as normal when at the same time we were basically under house arrest in the UK. At that point I began questioning the covid response and frankly — became anti-lockdown.

I’ve never been satisfied with the explanations as to why developing countries which did not implement strict lockdown policies did not experience the healthcare and mortality apocalypse we were told was going to happen if we didn’t lockdown in the UK.

I don’t think population density can sufficiently explain it, as many cities in developing countries are very dense indeed, with large multigenerational families living in tight quarters often being normalised, which if anything should exacerbate spread, especially to vulnerable elderly.

thank you - that's really interesting

great questions willow pattern - I agree (my earlier post crossed wiht yours)

Many countries in the region already had bloody good epidemic containment strategies in place given experiences with eg Ebola. They rapidly established a regional taskforce through the Africa Centres for Disease Control and Prevention (CDC) that brought 55 countries together at the same time to align responses, and crucially did this early on — in February 2020. Lockdowns and border crossing restrictions were implemented very early too - by March 2020 the East African Community and SADC had shut borders. Demographics of a young population likely also played a part, but there really was a far better policy coordination response than in Europe, the US, etc.
I find the Western attitude of “how could they possibly have done better, it must be luck since they’re so backwards” to be both arrogant and racist, to be honest.

Was there some suggestion at some stage that most African countries didn't have the numbers of people vulnerable to Covid compared to western/first world countries? In essence, the vulnerable people who would be most likely to become seriously ill/die of Covid were already dead because life-expectancy is shorter.

Yes I thought the same as @BlackAmericanoNoSugar. The serious cases of covid were usually among elderly people, so in countries with a much lower average age (due to both higher mortality and higher birth rates) there were fewer serious cases compared to the number of very mild or asymptomatic cases.

When I looked at the stats the biggest risk factor was age. Most African countries have an on average significantly younger population than most European countries. I think that was a big factor in how they fared.

At the time, it was reported that it was because the population was younger. And, sadly, people more vulnerable to covid, are not likely to have survived in life, generally, in as large numbers as they do in the West.

Im going to guess that they werent testing much as tests are expensive, and their health systems dont have much excess cash or capacity to manage it

The disease was less of a risk to them as they have far fewer people as a proportion of their population in the older/over weight/kidney problems etc groups

They have plenty of other much more important diseases to be focussing on like malaria, lung disease from smoke inhalation for cooking over open flames, bilharzia just to pluck three off the top of my head, so again see my first point

Combination from what I've read. Populations are so much younger that makes so much difference

@GirlInTheDryShirt

I find the Western attitude of “how could they possibly have done better, it must be luck since they’re so backwards” to be both arrogant and racist, to be honest.

And in the replies after yours, we have:

• not many elderly left in the country to be killed by the virus (life expectancy is shorter)

• Implication that the vulnerable would not survive to any worthwhile age "people more vulnerable to covid, are not likely to have survived in life, generally, in as large numbers as they do in the West"

• They weren't testing as much as their health systems don't have that sort of capacity

• They have other conditions more important to think about, such as lung disease from smoke inhalation for cooking over open flames

Apart from most of these things being lazy stereotypes, they are racist. Additionally, Africa is not one homogeneous area. It is a composed of diverse countries with a range of social, cultural and economic identities.