What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus?

Richard G. Wamai, Jason L. Hirsch, Wim Van Damme, David Alnwick, Robert C. Bailey, Stephen Hodgins, Uzma Alam and Mamka Anyona
Additional contact information
Richard G. Wamai: Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA
Jason L. Hirsch: Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA
Wim Van Damme: Department of Public Health, Institute of Tropical Medicine, B-2000 Antwerp, Belgium
David Alnwick: DUNDEX (Deployable U.N.-Experienced Development Experts), FX68 Belturbet, Ireland
Robert C. Bailey: School of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA
Stephen Hodgins: School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
Uzma Alam: Researcher Africa Institute for Health Policy Foundation, Nairobi 020, Kenya
Mamka Anyona: T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA

IJERPH, 2021, vol. 18, issue 16, 1-18

Abstract: The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases.

Keywords: COVID-19 pandemic; Africa; SARS-CoV-2 virus spread; lower COVID-19 disease burden; African populations; demographic pyramid; trained immunity; government measures (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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