The Silver Lining Southern Africa makes something out of nothing to combat COVID-19

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Thabiso Scotch Mufambi

Harare – By the time Egypt announced it had recorded Africa’s first COVID-19 case on Valentine’s Day, doomsayers had already made grim predictions about how the continent would collapse under the weight of the pandemic.

Most notable was Melinda Gates who declared: “COVID-19 will be horrible in the developing world. My heart is in Africa. I am worried. The only reason why the reported cases of the coronavirus disease in Africa is low now is most likely because there has not been wide testing of people.

“The disease is going to bite hard on the continent. I see dead bodies in the streets of Africa.” 

She was not alone in her grim forecast for the continent.

"Anywhere between 300,000 and 3,3 million African people could lose their lives as a direct result of COVID-19," said the United Nations Economic Commission for Africa in April.

And after Tunisia, Togo, Tanzania, the DRC and South Africa all followed Egypt in announcing new coronavirus cases, fears mounted of “dead bodies in the streets of Africa”.

Indeed, recent weeks have seen the number of cases and deaths spiking across the continent, with South Africa now carrying the world’s fifth-largest COVID-19 infection burden, and the numbers in countries like Namibia, Zambia and Zimbabwe rising almost exponentially.

Statistics from the Africa Centres for Disease Control and Prevention (Africa CDC) show that as of August 4, 2020, the continent had recorded 980,832 cases.

A chilling statistic. But it does not tell the whole story.



More recoveries than deaths

 

Of the nearly one million cases reported in Africa, there had been 21,012 deaths as of August 4, 2020.

This means 2,15 percent of Africans who have contracted the new coronavirus have died.

Globally, the deaths in Africa translate to just over three percent of global fatalities going by the worldwide mortality figure of 700,647 as of Wednesday.

In Southern Africa, which has been the epicentre of COVID-19 on the continent, the Africa CDC says by August 4 there had been 547,221 cases and 9,427 deaths.

This translates to a case fatality rate of 1,7 percent, meaning that while the region has the most cases in Africa, its death rate attributable to COVID-19 is actually lower than that of the rest of the continent.

But that is not all.

In terms of recoveries, Africa has been registering remarkable successes.

Across the continent, countries had recorded 656,040 recoveries by August 4. For Southern Africa, 376,022 out of 547,221 infected people had recovered from the new coronavirus.

However, three Southern African countries – South Africa (first), Eswatini (second) and Namibia (fourth) – are among the four African nations with the highest daily new infection rates on the continent. Gabon in West Africa has the third highest daily new infection rate.



Staying Sharp

 

While the number of confirmed cases and deaths is still rising, African countries have generally stayed sharp after being first out of the blocks in instituting virus control measures early in the year.

Most African countries quickly implemented strict national lockdowns and some imposed curfews, while the few available resources were rapidly marshalled to shore up historically weak public health systems.

For example, in Namibia - which had 2,540 confirmed cases and 12 deaths by Wednesday - a state of emergency was promptly declared at the onset of the outbreak.

Namibia’s intervention also included a massive public awareness campaign and training of response teams and health workers from both the public and private sectors.

The government repurposed Windhoek Central Hospital’s casualty ward into a state of the art multi-bed COVID-19 emergency ICU and also built a separate isolation centre.

Construction of the new facilities at Windhoek Central Hospital started just three days after the country recorded its first cases of new coronavirus in March and were inaugurated by President Hage Geingob in June.

“Behind the scenes, plans were made rapidly to try to have facilities that are covid ready.  It is very challenging to look after covid patients because you have to have mechanisms in place that will protect existing staff and existing patients from this special group of people,” Dr  Callistus Mukahanana, head of the COVID-19 taskforce at Windhoek Central Hospital said.

Beatrix Callard, a senior registered nurse at the institution, said: “Each department has been requested to avail some of their nurses, so we have got nurses from mental health, from theatre, maternity, oncology, the main wards, the general wards, and it is actually quite good that we have that complement so that if we have a patient with a cardiac issue, we do have a cardiac team member here that we can consult, if we have a pregnant mum we do have a maternity staff member here and we do have someone from paediatrics also so we are looking at this from a holistic point of view.”

The hard work has started paying off and on Wednesday, Health and Social Services Minister Dr Kalumbi Shangula announced a record number of daily recoveries (345 against 1,872 active cases).



Making do with little

 

Zimbabwe, whose economic challenges are well-documented, has also experienced a sharp rise in COVID-19 cases in recent weeks but has tried to make the most of its resources to contain the spread of the virus.

In early March, President Emmerson Mnangagwa quickly declared the pandemic a national disaster even though very few cases had been recorded, which allowed the government to take whatever measures it could to initiate responses.

All public events and gatherings were banned, meaning the country did not even celebrate its Independence Day in April, while public awareness campaigns went into overdrive.

The government suspended taxes on essential medical drugs and materials, and the country has been in various levels of national lockdown – enforced with help from joint military and police patrols – as the country tries to make its resources cover as much ground as possible.

By Monday, Zimbabwe had 4,075 cumulative cases against 80 deaths – representing a case fatality rate of 0,02 percent.



Facing down the storm

 

Although the statistics from South Africa have stunned the world, little attention has been paid to the fact that the numbers of critically ill patients and fatalities remains relatively low when placed against the global picture.

At the weekend, President Cyril Ramaphosa highlighted this, saying the recovery rate of 68 percent was encouraging and pointing out that the country’s case fatality rate was around 1,6 percent.

So while South Africa has the fifth biggest number of cases in the world, the mortality rate (calculated as a percentage of the national population) from COVID-19 places the country 36th globally.

“The national lockdown succeeded in delaying the spread of the virus by more than two months, preventing a sudden and uncontrolled increase in infections in late March. Had South Africans not acted together to prevent this outcome, our health system would have been overwhelmed in every province. This would have resulted in a dramatic loss of life,” President Ramaphosa said.

He added: “… the health system has so far had sufficient capacity to cope with the number of admissions. This is a testament to the efforts of doctors, nurses, public health specialists and others who have worked hard to prepare for this moment. We need, however, to continue with these efforts to further increase the capacity of our health facilities.” 

Health Minister Dr Zwelini Mkhize has also been pointing out this aspect.

“Our hospitals have been battered but we have not breached our hospital capacity. Our wards are full and our ICU beds are full, but not to complete capacity. And the field hospitals that we constructed still have space.” There have been adequate supplies of oxygen for severely affected patients, he said.

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