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A study by the World Health Organisation’s (WHO’s) regional office for Africa finds that between 83 000 and 190 000 people could potentially die of Covid-19 this year, if containment measures fail.
This while between 29-million and 44-million people could get infected in the first year of the pandemic.
The research is based on prediction modelling and looks at 47 countries in the WHO Africa region, with a total population of one-billion people.
These estimates have been based on the risk of transmission and disease severity by variables specific to each country, while keeping in mind the unique nature of the region.
The model predicts the observed slower rate of transmission, lower age of people with severe disease and lower mortality rates, compared with what is seen in the most-affected countries in the rest of the world.
WHO Africa says this is largely driven by social and environmental factors that are slowing the transmission, and a younger population that has benefitted from the control of communicable diseases such as human immunodeficiency virus and tuberculosis to reduce possible vulnerabilities.
The lower rate of transmission, however, suggests a more prolonged outbreak over a few years, with smaller countries such as Algeria, South Africa and Cameroon being more at risk if containment measures are not prioritised.
“While Covid-19 likely will not spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,” says WHO Africa regional director Dr Matshidiso Moeti.
She adds that Covid-19 could become a fixture in peoples' lives for the next several years unless a proactive approach is taken by many governments in the region. “We need to test, trace, isolate and treat.”
The predicted number of cases that would require hospitalisation would overwhelm the available medical capacity in much of Africa.
There would be an estimated 3.6-million to 5.5-million Covid-19 hospitalisations, of which between 82 000 and 167 000 would be severe cases, requiring oxygen, and between 52 000 and 107 000 would be critical cases requiring breathing support.
Such a huge number of patients in hospitals would severely strain the health capacities of countries.
A survey of health services in the African region undertaken in March, based on self-reports by 47 countries to WHO, revealed that there were on average nine intensive care unit beds. Moeti says that these would be woefully inadequate.
Additionally, the physical access to these services by the general population is very low, suggesting many people would not even have the chance to get to the needed care.
Diseases that could be managed could easily become more complicated as a result.
The study recommends that countries across Africa need to expand the capacity particularly of primary hospitals and ensure that basic emergency care is included in primary health systems.
“The importance of promoting effective containment measures is ever more crucial, as sustained and widespread transmission of the virus could severely overwhelm our health systems.
“Curbing a large-scale outbreak is far costlier than the ongoing preventive measures governments are undertaking to contain the spread of the virus,” Moeti notes.
Containment measures, specifically physical distancing and hygiene improvement, aim to slow down the transmission of the virus so its effects happen at a rate manageable by the health system.
All countries in the WHO Africa region are using these results through the WHO country offices to inform their containment actions.