Lack of coronavirus COVID-19 in Subsaharan Africa?

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That there is no coronavirus COVID-19 reported in Subsaharan Africa is a huge concern.

Why?

1) It seems likely that this virus spread out of China in part by Chinese people working or visiting overseas.

2) China has had a long standing diplomatic and commercial presence in several areas of Subsaharan Africa including the Congo and Sudan, and some other places.

3) These are places where illness are only barely monitored and generally not well reported.

My guess is that coronavirus COVID-19 is in the Congo and Sudan and a few other places, and it is not being addressed.

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25 thoughts on “Lack of coronavirus COVID-19 in Subsaharan Africa?

  1. “My guess is that COVID-19 is in the Congo and Sudan and a few other places, and it is not being addressed.”

    I think you’re spot on – and the small number or absolute lack of reported cases in countries of the Southern Henisphere (except, primarily, for tropical SE Asia and Australia) makes no epidemiological (or other) sense.

    I wish I could remember the article and name of a prominent CDC or WHO researcher quoted therein, who said (~ 2 days ago) something that epidemiologists often say in similar instances. Paraphrasing: “If we had a crystal ball and could use it to visualize very infected person, hundreds [thousands] of additional ‘cases’ would light up the map.”

    It is no accident that most reported cases come from countries with highly developed medical systems, but of course other anthropological variables are in play. And I think that because of the lack of a widely available patient-testing infrastructure, never mind reliable reporting, even a year hence the statistics for Africa will be extremely skewed towards the low end, compared with the West and East Asia.

    1. Joseph:

      I intend to follow your suggestion, posted on March 9, to place my comments in the most appropriate of Greg’s 3 posts on the coronavirus outbreak. But this one responds to your wish.

      I wish I could remember the article and name of a prominent CDC or WHO researcher quoted therein, who said (~ 2 days ago) something that epidemiologists often say in similar instances. Paraphrasing: “If we had a crystal ball and could use it to visualize very infected person, hundreds [thousands] of additional ‘cases’ would light up the map.”

      I don’t think this is the source you’re looking for; it post-dates your query. But it might be of some use.

      https://www.newsweek.com/who-doctor-says-we-dont-have-crystal-ball-when-asked-if-coronavirus-will-worsen-were-not-1489717

  2. Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index – Ben Oppenheim et al. BMJ Global Health (February 2019):

    “The most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population …”

    https://gh.bmj.com/content/4/1/e001157;

    See also:

    https://www.usnews.com/news/best-countries/articles/2020-02-26/commentary-coronavirus-has-potential-to-devastate-africa

    https://www.afro.who.int/news/second-covid-19-case-confirmed-africa

    https://www.ccn.com/coronavirus-may-already-be-spreading-in-africa/

    https://www.aa.com.tr/en/africa/who-urges-africa-to-prepare-for-coronavirus/1745018

  3. Thanks, Greg … So maybe – when I want to share particularly good links – I should divide my comment into parts, but limit the # of links/comment.

    I wanted to share time-sensitive links in real time, since needless to say everything about Covid-19 – and the “fire-hose” deluge of data (as this week’s Science put it) – is time-contingent.

    But my main desire was to share the BMJ Global Health (2019) link, since it’s open source AND the article was very prescient in terms of addressing reasons for lack of data from Africa.

  4. Looming threat of COVID-19 infection in Africa: act collectively, and fast
    THE LANCET. February 27, 2020
    John N Nkengasong
    Wessam Mankoula
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30464-5/fulltext

    Same journal – February 20:
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30411-6/fulltext

    Finally, THE LANCET: Covid-19 Recource Centre w/frequent updates*
    https://www.thelancet.com/coronavirus

    For example, this just published today:
    Do not violate the International Health Regulations
    Roojin Habibi, Gian Luca Burci, Thana C de Campos, et. al
    Danwood Chirwaduring the COVID-19 outbreak
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30373-1/fulltext

  5. We can’t even get hand sanitizers straight. How are we going to fight an infodemic? Or, a paninfodemic?

  6. I know, I know … Sad.

    We probably all have those times when, racing through news headlines and evocative photojournalism, we catch ourselves (as in a delayed sports replay) saying to ourselves, ‘WOW! That was some photo – let me go back and save it (screen capture or whatever) … But wait … Where DID I see that? I can’t find it now, darn!”

    Such a photo – as emblematic in this context as any I’ve seen – was that of a father and his daughter, racing through an airport, both wearing cloth surgical masks. The little girl – she was about 8, I suppose – had her adult-size face mask on upside down; moreover, it was very ill-fitting, with half of it covering her neck.

    What more to say?!!!

  7. By now it’s obvious that COVID-19 is galloping around sub-Saharan Africa.

    What has me curious though is the purported near-plateauing in China. Apparently it’s a result of their vigorous identification and isolation of infections, but with such a spread of the disease in the last month they’d have to be doing something extreme in order to have slowed the rate of new infections to one or two hundred per day. Are they under-reporting? Is there a pool of symptomless people walking around unidentified? Are they grossly abusing human rights in order to curtail the virus’s spread?

    And why on Earth is there so much hysteria about this virus? Yes, I get that it has a 0.5-3% mortality rate, but shutting down whole economies isn’t going to result in a better societal outcome than the original pandemic…

    1. Bernard,

      You raise excellent questions. I wish I could answer your queries with citations and links — I have read some relevant recent references — but at this point, I (like most of us with a scientific interest in this topic) am suffering from such information and email overload that I cannot locate them.

      But here’s my take (I’m also distilling messages from experts I trust, as well as friends “on the ground” in China):

      • What has me curious though is the purported near-plateauing in China. Apparently it’s a result of their vigorous identification and isolation of infections. – Yes, this is likely the case. It is consistent with infectious disease models. However, “containment” – in the best of situations, only possible in early stages of an epidemic – is no longer possible. Not in China, nor Italy – and certainly not in the United States. What we might well see in China is a rebound in numbers of infected persons: In other words, an initial peak (already occurred), then a decline (now evident), but soon another peak, as community transmission takes hold.

      • Are they under-reporting? – Probably not at this juncture (after Xi Jin-ping decided to change tack (following initial cover-up) a month into the epidemic), especially given current degree of international oversight and cooperation. However, there is bound to be some inter-province discrepancies in terms of the accuracy of reporting, since in China local officials will always have their heads on the block, so to speak.

      • Is there a pool of symptomless people walking around unidentified? — Certainly yes.

      • Are they grossly abusing human rights in order to curtail the virus’s spread? – Yes, they are.

      • Shutting down whole economies isn’t going to result in a better societal outcome than the original pandemic. – I couldn’t agree more.

    2. There is near-plateauing in South Korea as well. My hunch is that COVID will turn out to be much less dangerous than initially feared.

    1. Dean,
      the point of my latter comment was to put the Covid numbers in context. So far just a drop in the bucket compared to seasonal flu, and over 50% of Americans don’t even bother to get a flu shot.

      More context here (global):

      2,437,886
      Communicable disease deaths this year
      91,243
      Seasonal flu deaths this year
      1,427,431
      Deaths of children under 5 this year
      7,980,939
      Abortions this year
      58,045
      Deaths of mothers during birth this year
      41,622,615
      HIV/AIDS infected people
      315,693
      Deaths caused by HIV/AIDS this year
      1,542,336
      Deaths caused by cancer this year
      184,204
      Deaths caused by malaria this year
      9,012,494,889
      Cigarettes smoked today
      938,787
      Deaths caused by smoking this year
      469,690
      Deaths caused by alcohol this year
      201,380
      Suicides this year
      $ 75,126,687,031
      Money spent on illegal drugs this year
      253,502
      Road traffic accident fatalities this year

      https://www.worldometers.info/

  8. Snape,

    Worldometers is a source I occasionally consult, and it’s a useful one. Yet your figures (I just checked) are occasionally way off – sometimes by several orders of magnitude, even exceeding the entire world population. A typo, or a decimal comma, doesn’t explain these errors.

    But let’s grant your point about “context.” Is context only defined by gross number of deaths per unit time? Doesn’t the pattern by which these deaths occur matter? More importantly, is not the acceleration important? We are now seeing a situation in which diagnosed Covid-19 cases are increasing by 25 to 200 percent daily. Some of this geometric expansion can be explained by more reliable and more widespread testing. Most of it can not be. Epidemiologists agree that this pattern follows classic models of epidemic/pandemic spread.

    What’s most important to keep in mind, in this discussion, are two facts: (1) None – not one – of the other causes of death you cite is demonstrating an exponential increase; (2) We – by which I mean scientists collectively – have a pretty good epistemological handle on those other, AT-PRESENT higher numbers. This Is not yet the case for Covid-19.

    1. Snape,

      My apologies for questioning your figures. Carefully re-reading your post, I see that each number is listed above its category; I had misread the labels as preceding the statistic, rather than following it. (I should have looked more carefully at the first example (2,437,886 – Communicable disease deaths this year).

      Visual (as opposed to tabular) displays are an excellent conceptual way for grasping my point about the acceleration (rate of change of velocity) of this viral infection in individual countries and around the world. The two sites I most frequently check are:
      • Coronavirus COVID-19 global cases (Johns Hopkins University Center for Systems Science and Engineering)
      https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
      and
      • Novel coronavirus (COVID-19) outbreak timeline map (HealthMap) [press the green ANIMATE SPREAD button at the upper left]
      https://www.healthmap.org/covid-19/

      The first site (Johns Hopkins) is updated several times a day, so I prefer that. The second site (Health Map –managed by a consortium of universities and hospitals including Oxford, Harvard, Northeastern, and Children’s Hospital in Boston) is more fun because it’s animated … : – ) … but its data are several days old.

      Both maps allow you to zoom in or out – and by clicking on a dot, get the specific location and number of reported cases.

  9. IMPORTANT:  I’d like to offer an unsolicited request, on behalf of Greg Laden (cloned to his three Covid-19 blog posts up to this date):

    Fellow GLB blog readers, each of Greg’s three posts since this story went viral (sorry) earlier this year devoted itself to a specific aspect or question concerning Covid-19. It shouldn’t be all that difficult to keep our comments more or less on-topic – yet I notice they’re now spread out all over the place. This diminishes the accessibility and utility of the considerable amount of information that appears on the aforementioned posts.

    Not surprisingly, several recent comments that have little to do with sub-Saharan Africa appear following Greg’s most recent (Feb. 25) column. I mean, it’s the most recent post, and hence the most physically accessible. This being said, if someone comments “ectopically” on an issue that was already introduced/covered at length in an earlier published essay, any would-be replier has no choice but to reply to the inconveniently-located new comment, creating a positive feedback cycle of fluctuating on-/off-topic/malpositioned posts.

    Come on, folks, we can do better than this.

    Greg, on January 26, wrote [“famous last words?” OR “the best-laid plans …”?] as follows: “I’m not really going to live blog this virus.” But with its exploding, deleterious impact on personal and public health, economy, civil liberties, political systems, supply chains, international relations (etc.) likely to get much worse very quickly (I mean, let’s get real – this is terrible enough that many of us are bound to lose family members and friends to this disease), Greg will probably have little choice but to follow up on the scientific dimensions of Covid-19 that lie within his domains of interest and expertise.

    Let’s try our best not to complicate things by asking the writer/moderator of this blog to clean up/curate our mess. After all, irrespective of whether Greg composes further “main features” on the subject, due to its very nature – and if this discussion remains alive and current – there will soon be dozens of links, hundreds of comments, and thousands of words on Covid-19 – all theoretically accessible here. If we do our part.

    There’s some good information (and timely references) available here, covering many dimensions of this crisis – which make this a useful go-to source, especially given that it is such a wide-ranging (“Evolution – Climate Change – Education – Politics [and now, Coronavirus?]”) blog on the intersection of science and society.

    So here’s my suggestion: If you have contributions to the ongoing discussion here concerning this novel human coronavirus – any aspect of it – use the Search function (*the little magnifying glass!) at the top right of Greg’s masthead, and figure out which of these columns is the most relevant place to post your remarks, regardless of where you’ve posted them previously. And if they don’t truly fit under the two recent specialized subtopics (African Covid-19 / Face masks and contagion prevention) – then, please, go back to “Live Blogging 2019-nCoV (Wuhan coronavirus) (Jan. 26)” http://gregladen.com/blog/2020/01/26/live-blogging-2019-ncov-wuhan-coronavirus/ and post there. This way, your remark(s) will appear in red under Recent Comments at the top of GLB – thereby keeping “Live Blogging 2019-nCoV” alive.

    GLB READER’S GUIDE TO COVID-19 COLUMNS (*remember the magnifying glass – you don’t have to scroll through dozens of posts!)

    • Lack of coronavirus COVID-19 in Subsaharan Africa? (Feb. 25)
    http://gregladen.com/blog/2020/02/25/lack-of-coronavirus-covid-19-in-subsaharan-africa/

    • Should I wear a facemask to avoid the flu or some other nasty virus like Coronavirus COVIC-19? (February 12)
    http://gregladen.com/blog/2020/02/25/lack-of-coronavirus-covid-19-in-subsaharan-africa/

    • Live Blogging 2019-nCoV (Wuhan coronavirus) (Jan. 26)
    http://gregladen.com/blog/2020/01/26/live-blogging-2019-ncov-wuhan-coronavirus/

  10. CORRECTED LINKS to prior Greg Laden posts on Covid-19:
    ——————————

    GLB READER’S GUIDE TO COVID-19 COLUMNS (Jan. 26–Feb. 25) — *remember the magnifying glass – you don’t have to scroll through dozens of posts!

    • Lack of coronavirus COVID-19 in Subsaharan Africa? (Feb. 25)
    http://gregladen.com/blog/2020/02/25/lack-of-coronavirus-covid-19-in-subsaharan-africa/

    • Should I wear a facemask to avoid the flu or some other nasty virus like Coronavirus COVIC-19? (February 12)
    http://gregladen.com/blog/2020/02/12/should-i-wear-a-facemask-to-avoid-the-flu-or-some-other-nasty-virus-like-coronavirus-covic-19/

    • Live Blogging 2019-nCoV (Wuhan coronavirus) (Jan. 26)
    http://gregladen.com/blog/2020/01/26/live-blogging-2019-ncov-wuhan-coronavirus/

  11. “Safe from Covid! This I know,
    For The Donald tells me so ..”
    _________________________________
    Every Sunday my young friend Nnakaike and I get together and compare Nigerian and American societies. I have a doctorate in anthropology from a prestigious northeastern university; he attended high school in a rainforest in Igboland. Yet his insights into American culture (having immigrated here only 5 years ago) far outpace my growing understanding of his homeland.

    Yesterday he asked me, “How come Americans, in response to the coronavirus, are panic-buying guns in record-breaking numbers?”

    “I saw this on the news,’ he went on. “I can understand why there are so many Asian first-time gun buyers, considering the xenophobic and racist attacks on them and their desire to protect themselves and their families from vigilantism.”

    “Still, I watched an online video of this middle-aged white woman asking a gun-store clerk what handgun model he recommended, to which he responded, “Well, ma’am, what sort of weapon are you looking for?’ And then she answered, ‘oh, I think I’d prefer a black one.’”
    _________________________________
    Nnakaike has taught me about the remarkably varied “biomes” of tropical Nigeria. (I have no clue how many American high school graduates even know that word.) We’ve discussed the escalating atrocities committed by Boko Haram in the northeast; corruption among government officials and among tribal elders; interethnic conflicts and interethnic cooperation; the cosmopolitanism of Lagos, and medical practices in the remote villages; and – of course – Covid-19.

    But never mind all this. Never mind that Nnakaike works two full-time jobs to support his family and pay his nursing school tuition, and that he incurs heightened personal risk on the front lines fighting the coronavirus outbreak here in Massachusetts. After all, he’s an immigrant and therefore he’s up to no good.

    “How. you ask me, do I know?
    Because The Donald told me so.”

    And never mind the “fact” that, for all its fascinating geopolitical, biological, and anthropological complexity, Nigeria is a “shithole country.”

    “How, you ask me, do I know?
    Because The Donald told me so.”

    Can Nigerians mobilize against the novel coronavirus? Of course not – so you may ignore this clever amateur video Nnakaike shared with me

    After all, this is surely just a simplistic comedic attempt to educate people about Covid-19 transmission precautions, right? I mean, we Americans are doing this much and more. This couldn’t possibly ALSO be satirizing Nigerian governmental bureaucracy; poking fun at pidgin English and at how certain tribal languages – lacking the /r/ phoneme, substitute the /l/ phoneme – as in “COLONAvirus.” Which, in turn, couldn’t be a subtle dig at lingering colonial influences … Could it? And above all else, this couldn’t also be a demonstration of how people of different backgrounds can, when the urgent need arises, join forces against Covid-19, despite the competing demands placed on a fragile third world public health system by other serious diseases … or could it? NAH!!!

    “How, you ask me, do I know?
    Because The Donald told me so.”

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