Over 50 million unreported COVID-19 infections in Africa, WHO estimates
A striking new analysis by the World Health Organization (WHO) has concluded six in seven COVID-19 cases have gone undetected in Africa. The assessment indicates the real number of cases on the continent could be as high as 60 million and a new program to increase testing capacity has been proposed.
To date, there have been 8.4 million cases of COVID-19 and 214,000 deaths officially reported in Africa. However, the continent has experienced tiny levels of testing compared to the rest of the world.
Little more than 70 million COVID-19 tests have been reported by African countries since the beginning of the pandemic. These 70 million tests are a tiny fraction of the continent’s population of more than one billion.
In contrast, around 550 million tests have been administered in the United States since the beginning of the pandemic. And in the United Kingdom the number of tests is even higher, with more than four tests administered for every one person.
“With limited testing, we’re still flying blind in far too many communities in Africa,” says WHO’s regional director for Africa, Matshidiso Moeti. “Most tests are carried out on people with symptoms, but much of the transmission is driven by asymptomatic people, so what we see could just be the tip of the iceberg.”
The new WHO assessment looked at officially reported COVID-19 cases and deaths in Africa, and compared them to infection fatality rates seen in several other parts of the world. The analysis found it likely that 59 million people have been infected in Africa since the pandemic began in early 2020. This is seven times higher than the official count.
Moeti says deaths are also being undercounted in Africa, although not to the same extent as underreported cases.
“The proportion of underreporting on deaths is lower, our estimates suggest around one in three deaths are being reported,” says Moeti. “Deaths appear to be lower on the continent in part because of the predominantly younger and more active population.”
In response to these findings the WHO is beginning a pilot program designed to enhance COVID-19 surveillance. The program will initially roll out in eight countries and utilize rapid antigen testing to catch mild or asymptomatic COVID-19 cases.
When positive cases are detected a “ring approach” will be deployed, targeting people living within a radius of one hundred meters. The approach was inspired by a similar strategy successfully used to eradicate smallpox in the late 20th century.
Those flagged in the ring approach will be tested and supplied with hygiene packs including face masks and hand sanitizer. Moeti says it is time to go on the offensive and try to actively limit spread of the virus.
“Test numbers have been rising in Africa, but this community-based initiative is a radically new approach which should help significantly raise detection rates,” Moeti points out. “More testing means rapid isolation, less transmission and more lives saved through targeted action.”