hile reports indicate rising morbidity and mortality from COVID-19 in Africa, the rates remain low compared to other regions of the world. High levels of poverty and the fact that all diseases eventually settle among the poor and disenfranchised generates the fear of mass death of Africans from the novel virus. Huge densely populated slums are pervasive in larger African cities and achieving constant 6ft distancing and adequate hand washing protocols are close to impossible in such areas. Yet despite these challenges, the continent may escape this devastation as it has other factors going for it.
Africa’s Relative Youth Insulates it from COVID-19
Africa is the continent with the youngest age distribution. The population in low-income areas of cities tends to be younger, able-bodied, and relatively healthy. However, COVID-19 causes severe ill-health and death with increases in the age of infected persons, resulting in a disproportionate toll on older populations.
Median Age Per Continent
Healthier Populations Suffer Less From COVID-19
COVID-19 preys on patients with underlying chronic health conditions. For the global poor, having a treatable chronic non-communicable disease means death. This population cannot afford basic treatment or sometimes even to get a diagnosis. Thus, many living in extreme poverty never get diagnosed for such diseases and such diseases are never recorded by the health systems , and the disease rate or such diseases in African countries is through estimation from surveys. Given the high death rate from treatable chronic diseases, people living in extreme poverty who are exposed to COVID-19 will be less likely to have the levels of pre-existing conditions that leads to complications.
In African countries, COVID-19 started to spread mostly among people that can afford to fly, meaning that its impact has been predominantly among the middle classes and up. These wealthier individuals are more likely to have underlying conditions. Examples include the Chief of Staff to the Nigerian President, Abba Kyari who had diabetes and Nelson Mandela’s daughter. The virus has visited government houses, government ministers, religious ministers, and other elites but has not gained a major foothold amongst the vast majority who are poor. This is not however a cause for joy as the slower spread of the disease among the poor is caused by high death rates due to a lack of routine healthcare available treat underlying conditions. The elite who are unable to travel on health tourism due to the global COVID-19 flight restrictions are feeling the impact of infection severely, as they now have to use the health systems they generally avoided and are getting the same high death rate it produces.
A study on morality rates from COVID-19 in China found significantly higher rates of death among those with various pre-existing health conditions.
COVID-19 Fatality Rates with Pre-existing Conditions (source)
A comparison of Nigeria and the U.S. shows lower levels of incidence of cancers but high mortality rates in Nigeria. African countries generally have lower incidence of chronic non-communicable diseases such as cancers but higher mortality from such diseases.
Pervasive levels of Infectious Diseases Improves Immune Response
Most young people living in areas of high poverty and poor sanitation have immune systems that have survived many infectious diseases and are therefore primed to combat diseases effectively. There are indications that immunizations against one disease primes the immune system to fight other diseases in the same way. The cross benefit of immunization has been preliminarily found for COVID-19 with immunization against tuberculosis and measles. Tuberculosis is extremely interesting in that it is also a disease of the lungs and only low-income countries globally still immunize the general population against the disease and have the vaccine on their vaccination schedule. Both immunization and prior exposure and survival to other infectious diseases are the basis for an immune system that acts more effectively against other infectious agents. Most of our immune system is adaptive, which means it reacts and changes based on what it is exposed to. Those who are exposed to more infectious diseases and survive thereby would have immune systems that function well against new infectious diseases they are exposed to.
Improving Health Systems is Key to Fighting Pandemics
Because COVID-19’s mortality rate increases with age and among those with underlying health conditions, Africa may have a population profile that reduces the devastation of the spread of COVID-19. As the virus spreads among lower income classes, it will encounter mostly younger people with fewer incidences of pre-existing conditions. But health systems that allow infectious diseases to run rampant in the population and cannot effectively manage cases of chronic treatable diseases have already failed the population and entrance of COVID-19 further adds to the overall stress on the health systems. Instead of diverting resources to COVID-19, shoring up health systems to make them more effective in saving lives will result in improved health outcomes regardless of the pandemic ravaging at any time.
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Fighting COVID-19 in Africa Means Improving General Health Systems
September 1, 2020
Africa's population has a relatively low rate of underlying health conditions, so the continent's best weapon in fighting COVID-19 is improving general health systems.
W
hile reports indicate rising morbidity and mortality from COVID-19 in Africa, the rates remain low compared to other regions of the world. High levels of poverty and the fact that all diseases eventually settle among the poor and disenfranchised generates the fear of mass death of Africans from the novel virus. Huge densely populated slums are pervasive in larger African cities and achieving constant 6ft distancing and adequate hand washing protocols are close to impossible in such areas. Yet despite these challenges, the continent may escape this devastation as it has other factors going for it.
Africa’s Relative Youth Insulates it from COVID-19
Africa is the continent with the youngest age distribution. The population in low-income areas of cities tends to be younger, able-bodied, and relatively healthy. However, COVID-19 causes severe ill-health and death with increases in the age of infected persons, resulting in a disproportionate toll on older populations.
Median Age Per Continent
Healthier Populations Suffer Less From COVID-19
COVID-19 preys on patients with underlying chronic health conditions. For the global poor, having a treatable chronic non-communicable disease means death. This population cannot afford basic treatment or sometimes even to get a diagnosis. Thus, many living in extreme poverty never get diagnosed for such diseases and such diseases are never recorded by the health systems , and the disease rate or such diseases in African countries is through estimation from surveys. Given the high death rate from treatable chronic diseases, people living in extreme poverty who are exposed to COVID-19 will be less likely to have the levels of pre-existing conditions that leads to complications.
In African countries, COVID-19 started to spread mostly among people that can afford to fly, meaning that its impact has been predominantly among the middle classes and up. These wealthier individuals are more likely to have underlying conditions. Examples include the Chief of Staff to the Nigerian President, Abba Kyari who had diabetes and Nelson Mandela’s daughter. The virus has visited government houses, government ministers, religious ministers, and other elites but has not gained a major foothold amongst the vast majority who are poor. This is not however a cause for joy as the slower spread of the disease among the poor is caused by high death rates due to a lack of routine healthcare available treat underlying conditions. The elite who are unable to travel on health tourism due to the global COVID-19 flight restrictions are feeling the impact of infection severely, as they now have to use the health systems they generally avoided and are getting the same high death rate it produces.
A study on morality rates from COVID-19 in China found significantly higher rates of death among those with various pre-existing health conditions.
COVID-19 Fatality Rates with Pre-existing Conditions (source)
A comparison of Nigeria and the U.S. shows lower levels of incidence of cancers but high mortality rates in Nigeria. African countries generally have lower incidence of chronic non-communicable diseases such as cancers but higher mortality from such diseases.
Pervasive levels of Infectious Diseases Improves Immune Response
Most young people living in areas of high poverty and poor sanitation have immune systems that have survived many infectious diseases and are therefore primed to combat diseases effectively. There are indications that immunizations against one disease primes the immune system to fight other diseases in the same way. The cross benefit of immunization has been preliminarily found for COVID-19 with immunization against tuberculosis and measles. Tuberculosis is extremely interesting in that it is also a disease of the lungs and only low-income countries globally still immunize the general population against the disease and have the vaccine on their vaccination schedule. Both immunization and prior exposure and survival to other infectious diseases are the basis for an immune system that acts more effectively against other infectious agents. Most of our immune system is adaptive, which means it reacts and changes based on what it is exposed to. Those who are exposed to more infectious diseases and survive thereby would have immune systems that function well against new infectious diseases they are exposed to.
Improving Health Systems is Key to Fighting Pandemics
Because COVID-19’s mortality rate increases with age and among those with underlying health conditions, Africa may have a population profile that reduces the devastation of the spread of COVID-19. As the virus spreads among lower income classes, it will encounter mostly younger people with fewer incidences of pre-existing conditions. But health systems that allow infectious diseases to run rampant in the population and cannot effectively manage cases of chronic treatable diseases have already failed the population and entrance of COVID-19 further adds to the overall stress on the health systems. Instead of diverting resources to COVID-19, shoring up health systems to make them more effective in saving lives will result in improved health outcomes regardless of the pandemic ravaging at any time.
