Coronavirus: Africa infections have risen sharply in worst-affected countries

By Peter Mwai
BBC Reality Check

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image copyrightAFP
image captionThere's been a steep rise in infections in South Africa

With some countries across Africa continuing to see increases in Covid-19 cases, there's concern about a new variant of coronavirus in South Africa.

The World Health Organization (WHO) has called on African nations to boost their surveillance of the virus to detect any mutations that may occur.

What is happening in South Africa?

Daily new case numbers have passed the peak of mid-July, although there are now signs that cases are starting to go down again.

There's been an average increase of 17% in weekly new cases and 30% in new deaths in South Africa over the four weeks up to 17 January, according to the Africa Centers for Disease Control (CDC).

There's concern that infections are being driven in part by a new strain known as 501.V2.

Scientists are still studying this new variant, how it transmits and how it might behave in response to vaccines.

"Initial analysis indicates that the variant... may spread more readily between people," according to the WHO.

However, it doesn't appear to cause more serious illness.

The South Africa variant has so far been reported in four other African countries - Botswana, Zambia, the Gambia and Kenya.

At the end of December, South Africa became the first country in Africa to record more than a million Covid cases.

The authorities have announced new restrictions, and closed land borders to most travellers until mid-February.

What is happening elsewhere in Africa?

The WHO says cases in its Africa region (which excludes Morocco, Tunisia, Libya, Egypt, Sudan, Djibouti and Somalia) have been increasing since the middle of September.

It adds that "steeper increases have been observed since late November. "

The Africa CDC says that over the four weeks up to 17 January, apart from South Africa, there'd been significant increases in new cases in both Egypt and Nigeria - up by an average of 20% and 23% respectively.

image copyrightReuters
image captionPassengers boarding a bus in Lagos being given hand sanitiser

In Nigeria, scientists have also identified a new variant of the virus, although they say there is currently no evidence to indicate it is contributing to increased transmission.

However, cases in Nigeria have been on an upward trend since early December.

The head of the Nigeria CDC, Chikwe Ihekweazu, says the country is reaching "a critical level" at which its hospital capacity will no longer be able to cope with the more serious cases.

mapped

Confirmed cases around the world

Group 4

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Source: Johns Hopkins University, national public health agencies

Figures last updated 27 January 2021, 08:33 GMT

There are also significant variations across the continent, with countries at different stages of a resurgence of the virus.

For example, cases rose again in Kenya, Ethiopia and Uganda at different points in the latter part of 2020, but recorded daily infection rates have subsequently fallen.

Cases have however been steadily increasing in Zambia, Rwanda and Malawi.

How much testing is done in Africa?

The WHO says testing in Africa is still low compared to other regions, and there's also concern that irregular levels of testing over time may be masking the true spread of the virus.

image copyrightGetty Images
image captionA sample is taken at a testing facility in Kenya

There are wide variations in testing rates and while some countries have reduced testing, others have maintained or even increased it.

Of the bigger countries, South Africa has been doing the most and Nigeria doing relatively few tests per capita, according to Our World in Data, a UK-based project which collates Covid-19 information.

However, in some countries there are insufficient or no data available on testing to know how much is being done.

According to the Africa CDC on 17 January, there'd been an decrease of 22% in the total number of tests done over the previous week.

Ten countries accounted for 70% of the tests conducted - South Africa, Morocco, Ethiopia, Kenya, Nigeria, Egypt, Uganda, Cameroon, Rwanda and Zambia.

The King's Global Health Institute, which tracks the pandemic in sub-Saharan Africa, says that testing activity in some countries fell back after the first wave of the virus had subsided.

"Those countries that cut back on testing after the first wave will...have had less extensive and timely intelligence from surveillance," it says.

How do death rates in Africa compare?

The reported death rate per capita on the continent has been low compared with other parts of the world, despite the weak health infrastructure in many African countries.

There could be a number of reasons for the relatively low figures:

  • The relatively young population - more than 60% are under the age of 25
  • Experience in epidemic control from tackling other diseases
  • Cross-immunity from other coronaviruses
  • Low rates of travel and more outdoor living might also help

data in detail

Scroll table to see more data

*Deaths per 100,000 people

US 395,748 121.0 23,839,660
Brazil 209,847 100.2 8,488,099
India 152,419 11.3 10,571,773
Mexico 140,704 111.5 1,641,428
UK 89,261 132.9 3,395,959
Italy 82,177 135.5 2,381,277
France 70,283 108.1 2,910,989
Russia 64,601 44.3 3,530,379
Iran 56,803 69.4 1,330,411
Spain 53,314 114.2 2,252,164
Colombia 48,631 97.9 1,908,413
Germany 46,901 56.4 2,050,129
Argentina 45,407 102.4 1,799,243
Peru 38,770 121.2 1,060,567
South Africa 37,105 64.2 1,337,926
Poland 33,355 88.0 1,435,582
Indonesia 25,987 9.7 907,929
Turkey 23,997 29.1 2,387,101
Ukraine 21,834 49.3 1,201,546
Belgium 20,435 178.0 678,839
Canada 18,024 48.6 713,181
Chile 17,477 93.3 669,832
Romania 17,221 88.3 693,644
Czech Republic 14,449 135.5 891,852
Ecuador 14,319 83.8 231,482
Netherlands 13,009 76.3 912,750
Iraq 12,944 33.7 608,232
Hungary 11,341 116.8 351,828
Pakistan 10,997 5.2 521,211
Sweden 10,323 103.5 523,486
Philippines 9,895 9.3 500,577
Bolivia 9,636 84.9 187,183
Portugal 8,861 86.4 549,801
Switzerland 8,682 101.8 495,228
Egypt 8,583 8.7 156,397
Bulgaria 8,483 120.3 211,813
Morocco 7,942 22.0 459,671
Bangladesh 7,906 4.9 527,632
Austria 7,082 79.7 393,778
Saudi Arabia 6,323 18.8 364,929
Tunisia 5,692 49.2 180,090
Greece 5,469 52.0 148,607
Guatemala 5,254 30.5 148,888
China 4,797 0.3 97,939
Panama 4,787 114.6 298,019
Croatia 4,616 111.1 224,954
Bosnia and Herzegovina 4,411 132.7 117,011
Japan 4,306 3.4 330,978
Jordan 4,145 41.6 314,514
Israel 4,005 47.8 551,689
Serbia 3,750 53.7 372,533
Slovakia 3,474 63.7 223,325
Honduras 3,354 35.0 134,111
Moldova 3,250 80.2 152,854
Slovenia 3,180 153.0 149,125
Azerbaijan 3,009 30.2 227,273
Armenia 2,998 101.6 164,676
Georgia 2,958 73.9 247,915
Myanmar 2,955 5.5 134,318
Kazakhstan 2,889 15.8 215,947
Algeria 2,836 6.7 103,833
North Macedonia 2,702 129.7 88,938
Ireland 2,608 54.1 172,726
Paraguay 2,505 36.0 122,160
Lithuania 2,445 87.3 167,516
Dominican Republic 2,437 22.9 193,118
Costa Rica 2,416 48.3 184,187
Afghanistan 2,339 6.3 53,984
Ethiopia 2,030 1.9 131,195
Nepal 1,959 7.0 267,322
Lebanon 1,906 27.8 252,812
Denmark 1,775 30.9 189,088
Kenya 1,731 3.4 99,162
Palestinian Territories 1,718 35.3 152,031
Libya 1,665 24.9 109,088
Sudan 1,603 3.8 26,279
Belarus 1,582 16.7 225,461
Oman 1,512 31.3 131,790
El Salvador 1,498 23.3 50,784
Nigeria 1,435 0.7 110,387
Kosovo 1,410 76.4 55,851
Kyrgyzstan 1,387 22.0 83,178
Albania 1,277 44.3 67,690
South Korea 1,264 2.5 72,729
Venezuela 1,106 3.8 119,803
Latvia 978 50.7 55,664
Kuwait 947 22.9 157,777
Australia 909 3.7 28,721
Syria 832 4.9 13,036
United Arab Emirates 745 7.7 253,261
Montenegro 745 118.7 55,493
Zimbabwe 713 4.9 27,203
DR Congo 631 0.8 20,908
Uzbekistan 619 1.9 78,036
Finland 618 11.2 40,337
Yemen 612 2.1 2,112
Malaysia 601 1.9 158,434
Luxembourg 549 90.9 48,630
Zambia 546 3.1 37,605
Norway 517 9.7 58,651
Senegal 515 3.2 23,028
Cameroon 455 1.8 28,010
Angola 436 1.4 18,875
Mauritania 402 9.1 16,039
Eswatini 376 33.1 12,944
Bahrain 360 22.9 97,607
Ghana 346 1.2 57,714
Estonia 325 24.6 37,079
Jamaica 324 11.0 14,161
Malawi 314 1.7 12,470
Uruguay 311 9.0 32,378
Mali 310 1.6 7,839
Uganda 304 0.7 38,085
Namibia 285 11.6 30,363
Belize 281 73.4 11,580
Madagascar 273 1.0 18,301
Sri Lanka 264 1.2 53,062
Qatar 246 8.8 147,277
Mozambique 241 0.8 26,551
Haiti 240 2.2 10,781
Malta 239 54.4 15,588
Bahamas 175 45.4 8,032
Cyprus 170 14.3 28,968
Cuba 170 1.5 18,151
Guyana 170 21.8 6,908
Nicaragua 167 2.6 6,152
Guadeloupe 156 39.0 8,834
Rwanda 142 1.2 11,032
Ivory Coast 141 0.6 25,241
Suriname 141 24.5 7,527
Niger 140 0.6 4,156
Trinidad and Tobago 132 9.5 7,393
Somalia 130 0.9 4,744
Gambia 127 5.6 3,910
French Polynesia 126 45.4 17,635
Cape Verde 119 21.9 12,993
Congo 114 2.2 7,709
Chad 111 0.7 2,895
Burkina Faso 102 0.5 9,188
Lesotho 93 4.4 6,371
Andorra 91 118.2 9,083
Tajikistan 90 1.0 13,308
Equatorial Guinea 86 6.6 5,356
Liberia 84 1.7 1,887
Guinea 81 0.7 14,114
Channel Islands 78 45.7 3,363
Sierra Leone 77 1.0 3,006
French Guiana 75 26.5 14,975
Togo 73 0.9 4,302
Botswana 71 3.1 17,365
Thailand 70 0.1 12,423
Gabon 66 3.1 9,899
San Marino 65 192.4 2,778
Central African Republic 63 1.4 4,973
South Sudan 63 0.6 3,693
Djibouti 61 6.4 5,905
Mayotte 58 22.3 6,611
Aruba 52 49.1 6,435
Maldives 49 9.5 14,513
Liechtenstein 49 129.2 2,389
Benin 46 0.4 3,413
Réunion 45 5.1 9,443
Guinea-Bissau 45 2.4 2,509
Comoros 45 5.4 1,592
Martinique 43 11.4 6,227
Gibraltar 43 127.5 3,670
Vietnam 35 0.0 1,537
Singapore 29 0.5 59,113
Iceland 29 8.6 5,956
Saint Martin 27 72.5 1,656
New Zealand 25 0.5 2,262
Isle of Man 25 29.7 428
Tanzania 21 0.0 509
Curaçao 19 11.7 4,514
Sao Tome and Principe 17 8.1 1,142
Diamond Princess cruise ship 13 712
Bermuda 12 19.1 670
Mauritius 10 0.8 547
Papua New Guinea 9 0.1 834
Saint Lucia 8 4.4 611
Monaco 7 18.1 1,205
Barbados 7 2.4 1,095
Taiwan 7 0.0 855
Eritrea 6 0.2 1,877
Turks and Caicos Islands 6 15.9 1,102
Antigua and Barbuda 6 6.2 189
Brunei 3 0.7 174
Mongolia 2 0.1 1,526
Burundi 2 0.0 1,236
Seychelles 2 2.1 705
Cayman Islands 2 3.1 374
Fiji 2 0.2 55
MS Zaandam cruise ship 2 9
Bhutan 1 0.1 842
Faroe Islands 1 2.1 649
St Vincent and the Grenadines 1 0.9 478
Saint Barthelemy 1 10.2 251
Grenada 1 0.9 139
British Virgin Islands 1 3.4 114
Montserrat 1 20.0 13
Cambodia 0 0.0 439
Dominica 0 0.0 110
Timor-Leste 0 0.0 52
New Caledonia 0 0.0 44
Laos 0 0.0 41
Saint Kitts and Nevis 0 0.0 34
Falkland Islands 0 0.0 32
Greenland 0 0.0 30
Vatican 0 0.0 27
Solomon Islands 0 0.0 17
Saint Pierre and Miquelon 0 0.0 16
Anguilla 0 0.0 15
Marshall Islands 0 0.0 4
Samoa 0 0.0 2
Vanuatu 0 0.0 1

Please update your browser to see full interactive

This information is regularly updated but may not reflect the latest totals for each country.

** The past data for new cases is a three day rolling average. Due to revisions in the number of cases, an average cannot be calculated for this date.

Source: Johns Hopkins University, national public health agencies and UN population data

Figures last updated: 18 January 2021, 08:42 GMT

But there are also issues - as elsewhere in the world - over how countries record deaths, making comparisons between them difficult, and questions about whether deaths are under-recorded.

Research from the South African Medical Research Council (SAMRC) looking at excess deaths there indicates that the number of people who had died from the virus in the country could have been under-estimated.

There were 83,918 excess deaths between 6 May last year and 5 January this year - that's the number of deaths in that period above what would have been expected.

While not all of these might be directly due to Covid, the number of recorded deaths from Covid-19 since the start of the pandemic was at just above 30,000.

And South Africa was just one of eight countries on the continent that the BBC found in a recent investigation had adequate death registration systems.