The first COVID-19 case in Africa was confirmed on February 14th, 2020, in Egypt. The first in sub-Saharan Africa appeared in Nigeria soon after. Health officials were united in a near-panic about how the novel coronavirus would roll through the world’s second most populous continent. By mid-month, the World Health Organization (WHO) listed four sub-Saharan countries on a “Top 13” global danger list because of direct air links to China. Writing for the Lancet, two scientists with the Africa Center for Disease Control outlined a catastrophe in the making:
With neither treatment nor vaccines, and without pre-existing immunity, the effect [of COVID-19] might be devastating because of the multiple health challenges the continent already faces: rapid population growth and increased movement of people; existing endemic diseases… re-emerging and emerging infectious pathogens… and others; and increasing incidence of non-communicable diseases.
Many medical professionals predicted that Africa could spin into a death spiral. “My advice to Africa is to prepare for the worst, and we must do everything we can to cut the root problem,” Tedros Adhanom Ghebreyesus, the first African director-general of the WHO, warned in March 2020. “I think Africa, my continent, must wake up.” By spring, the WHO was projecting 44 million or more cases in Africa and the World Bank issued a map of the continent colored in blood red, anticipating that the worst was imminent:
These dire warnings seemed to make sense. After all, two-thirds of the global extreme poor population (63 percent) live in sub-Saharan Africa. According to the World Bank, more than 40 percent of the region lives in extreme poverty beset by unhygienic environments, conflict, fragmented healthcare and education systems, and dysfunctional leadership—all factors that could light a match to the tinder of the SARS-CoV-2 outbreak. Scientists say that most African countries lack the capacity and expertise to manage endemic deadly diseases like malaria.
Each individual’s risk of dying from a particular disease tends to reflect access to adequate healthcare and underlying health conditions (co-morbidities). Those factors have proved to be a lethal mix in poorer communities in the US, Brazil, the UK, and other countries, with lower income groups—often ethnic and racial minorities—dying at disproportionately high rates. Africa seemed ripe for catastrophe.
But disaster never came. Africa has not been affected on anything like the scale of most countries in Asia, Europe, and North and South America. (The major exceptions being China, Taiwan, Australia, and New Zealand, which zealously enforced lockdowns.) In fact, the vast African sub-continent south of the Sahara desert, more than 1.1 billion people, has emerged as the world’s COVID-19 “cold spot,” as illustrated by an ECDC map reproduced by BBC and by graphics like these:
