(Vienna, 10 August 2020) The expected high morbidity and mortality rate in Africa associated with the pandemic has not yet materialised. A group of African and European researchers, including tropical medicine expert Bertrand Lell from MedUni Vienna's Division of Infectious Diseases and Tropical Medicine, has now investigated the possible reasons for this. One explanation could be the greater general prevalence of infectious diseases that modify the population's immune systems. However, due to the lack of data and the introduction of measures similar to those applied in Europe, it is not yet possible to forecast how the situation will evolve. The review has been published in the leading journal "Science".
So far, the COVID-19 pandemic is not as bad in Africa as experts feared, given the poor national healthcare systems, the large conurbations, and the limited financial resources available for taking precautionary measures. It is not yet clear whether, since the pandemic started on the African continent around four months ago, it is actually evolving differently or whether there might still be a surge in mortality.
The situation has now been analysed by a group of African and European researchers, including Bertrand Lell from the Division of Infectious Diseases and Tropical Medicine of the Department of Medicine I and Head of the Centre de Recherches Médicales de Lambaréné in Gabon. The researchers came to the conclusion that most African countries prepared for the pandemic relatively early and implemented measures at the same time as Europe, including travel restrictions, school closures and testing of suspected cases: "They were therefore able to gain time for further strategic planning of quarantine regulations, contact tracing and social distancing. On top of that, Africa already has a lot of experience of dealing with infectious diseases such as Ebola and Lassa fever," explains Lell.
On the other hand, sections of the population often failed to comply with the measures but that still didn't worsen the pandemic, emphasises Lell. One explanation for this could be the comparatively young population in Africa. Deaths due to COVID-19 were predominantly among elderly people. Currently, the average age in Africa is 19.7 years as opposed to 38.6 years in the USA. The genetic variants of the coronavirus are the same as in Europe.
According to Lell, a possible explanation for the current situation in Africa could be the widespread prevalence of common infectious diseases, such as those caused by parasites. This could modify the immune system and also suppress any excessive inflammatory response, which is increasingly being recognised as the cause of severe COVID-19 courses. However, there is still not enough data on this.
Just as in Europe, measures such as restricting gatherings, closing restaurants, churches and mosques are currently being eased, despite the disease being widespread. It is not yet possible to predict how this will affect the further course. The quality of health and mortality data in Africa is generally poor, so that it is not really feasible to conduct excess mortality analyses for a cross-country comparison.
MedUni Vienna's Division of Infectious Diseases and Tropical Medicine has a long-standing partnership with the "Centre de Recherches Médicales de Lambaréné" (CERMEL) in Gabon in Central Africa. This independent institution in the African state of Gabon conducts research into infectious tropical diseases, for which it has several collaborative partners, including MedUni Vienna.
"COVID-19 in Africa: Dampening the storm? The dampened course of COVID-19 in Africa might reveal innovative solutions." Moustapha Mbow, Bertrand Lell, Simon P Jochems, Badara Cisse, Souleymane Mboup, Benjamin G. Dewals, Assan Jaye, Aalioune Dieye, Maria Yazdanbakhsh.
DOI: 10.1126/science.abd3902. https://science.sciencemag.org/content/369/6504/624