Coronavirus: Is Africa the next hot spot?

If anyone looks at Worldometers tracking or any other site's tracking of coronavirus, you know that you have to scroll far down the list before you come across an African country. The first countries you come across are South Africa and Egypt. On the face of things, you might think that Africa might be spared from this pandemic. Al Jazeera unfortunately reports that this just won't be the case -- based on currently modeling, of course:

Coronavirus cases in Africa could surge from just thousands now to 10 million within three to six months, according to provisional modelling, a regional World Health Organization (WHO) official said.

. . . Separately, new research said Africa could see 300,000 deaths from the coronavirus even under the best-case scenario, according to modeling by the Imperial College London.

Under the worst-case scenario with no interventions against the virus, Africa could see 3.3 million deaths and 1.2 billion infections, the report by the UN Economic Commission for Africa said.



I think one should note that President Trump just recently made the decision to withdraw $400 million in US funding to the WHO. So it is interesting that the WHO had a press teleconference that highlighted such huge estimates around this time. (Read further down for why this $400 million is really just a drop in the bucket in terms of what Africa needs to deal with this virus.)

Yet even though this announcement might have been made due to a desire to keep the WHO funding intact, the Imperial College London is estimating 300,000 deaths while the UN Economic Commission for Africa is estimating a worse case scenario of 3.3 million deaths. Though, once again, let's question some of the numbers here. Africa has a population of around 1.3 billion people. Under the worse case scenario, they're estimating that 92% of the population will get the virus (1.2 billion of 1.3 billion population). Hmm?

ABC News appears to look more into the Imperial College London study (the way the article is written is a little confusion as they discuss both the Imperial College London and UN Economic Commission for Africa studies):

Even with “intense social distancing.” under the best-case scenario the continent could see more than 122 million infections, the report said.

Interestingly, it looks like this study estimates a CFR % of just 0.2% (0.3 million divided by 122 million). Under this scenario, the CFR % is just a little higher than the flu (which my understanding is around 0.1%). Admittedly, this is the best-cast scenario. Even the worse case by the UN Economic Commission has a CFR % of 0.3% (3.3 million divided by 1.2 billion). So both these percentages are well below the CFR % of 1.0% that I'm using to reading about.

Just for context, the CDC has a worse case estimate of 1.2 million deaths in the United States. Africa has a population of 4x that of America. So taking CDC estimates, you'd think that maybe a worse case scenario for Africa would be 4.8 million or higher. Anyways, there seems to be some interesting discrepancies between the various studies.

And for additional context, Real Clear Politics lists estimated flu deaths. If I selected all the African nations correctly, the continent has around 200,000 deaths a year from the flu.

The interesting question here for me is: how should we approach this virus if the CFR % is just double that of the flu? Now, way more people appear to end up in the hospital for the coronavirus than for the flu, but if this virus is just twice as deadly as the flu there might need to be some policy changes made on how the world confronts this pandemic. Also, how do these low CFR %'s compare to the images of piled up body bags at hospitals?

There is a fact provided by the ABC News article that puts the $400 million that President Trump is withholding from the WHO in context:

Any of the scenarios would overwhelm Africa’s largely fragile and underfunded health systems, experts have warned. Under the best-case scenario, $44 billion would be needed for testing, personal protective equipment and treatment, the report said, citing UNECA estimates. The worst-case scenario would cost $446 billion.

I personally believe that President Trump should not withhold funding from the WHO. Instead, I think the President Trump should insist that Taiwan be allowed to join as a member of the WHO. Let's be honest though, $400 million is a drop in the bucket when it comes to what Africa needs even under the best-case scenario.

Over the next 6 months, will we ever find out how many cases and deaths occur in Africa due to this virus? Probably not. It is unlikely that Africa has the ability to provide accurate estimates. Yet, after this virus has been suppressed (be it 18 months or 5 years from now), forensic scientists will likely be able to come up with reasonable estimates.