How the threat of COVID-19 is affecting people across Africa

Two-thirds of people in 20 African countries fear going hungry if they had to quarantine for 2 weeks, according to a survey.

Confirmed cases of COVID-19 in Africa remain comparatively low, at 51,000 as of 6 May. But those numbers are growing fast. And a new report by the Partnership for Evidence Based Response to COVID-19 (PERC) reveals some worrying findings about the impact of coronavirus on the lives of many Africans.

Half of respondents to the survey, conducted in 28 African cities, said they would run out of money if they had to stay home for 14 days. The lowest-income households expected to run out of food and money in less than a week. In Nigeria and Kenya, social media users have admitted that hunger has forced them to violate stay-at-home orders in order to search for food.

Almost 60% of people responding to the survey said they did not have the space at home to isolate sick people.

Governments across Africa responded quickly to the pandemic with public health measures to prevent the spread of the virus. South Africa declared a national state of disaster and implemented a nationwide lockdown before reporting its first death from COVID-19. Uganda suspended public gatherings before the first documented case in the country. Nigeria began screening passengers at international airports nearly one month before the first case was detected.

It is thought that this has given African countries an advantage in limiting the spread of the virus. The report by PERC says: “Early, decisive action taken by many African governments may have slowed transmission. While it is difficult to measure the precise impact of any single intervention, African Union (AU) member states have yet to document the spiralling caseloads seen in parts of the United States and Europe.”

The relative youth of the African population may be another advantage. Current data suggest older people infected with COVID-19 are at significantly greater risk of severe illness. In sub-Saharan Africa only 3% of the population are 65 years or older, and 43% are less than 15 years old. By contrast, in the European Union, 20% of the population are 65 years or older and only 17% are under 15.

The PERC report notes, however, that healthcare systems in many African countries are ill prepared for a pandemic, with low numbers of healthcare workers and little capacity for providing critical care to the severely ill.

Low and middle-income countries have limited resources to mitigate the social and economic disruption created by the pandemic. The authors write: “Public health and social measures (PHSMs) will reduce transmission of COVID-19, but as their toll on social and economic life [grows], governments will face mounting pressure to loosen the measures.”

PERC's survey found that people in the 20 African countries currently support PHSMs, but that consensus may be weak. A large share of the population expect a prolonged quarantine to result in food insecurity and grave financial hardship.

The report made three recommendations for African countries to restrict the spread of COVID-19.

1. While caseloads remain low, build public health capacity to test, trace, isolate, and treat cases – the necessary foundation for reopening society.

2. Monitor data on how PHSMs meet local COVID-19 conditions and needs, and to determine when and how to lift them in a way that balances lives and livelihoods.

3. Engage communities to adapt PHSMs to the local context and effectively communicate about risk to sustain public support, achieve widespread adherence, and shield vulnerable populations.

Dr Matshidiso Moeti, WHO Regional Director for Africa, said: “The findings of this report, along with COVID-19 trend data, will help countries make strategic decisions on relaxing their lockdowns. What we’ve learnt from Ebola and other outbreaks is that countries need to decentralize the response to the community level and increase their capacity to identify and diagnose cases.”