The World Health Organization (WHO) has said Africa is experiencing a resurgence in Covid-19 infections as countries relax their restrictions.
The number of new daily confirmed cases overall has started rising after slowing since mid-July, and the WHO says there’s been a “substantial rise in deaths” over the past week.
WHO Africa regional director Matshidiso Moeti says the continent is at a “pivotal moment”.
At what rate is coronavirus spreading?
The number of new cases reported during the seven days ending 14 October was 14% higher than the previous week, according to the Africa Centres for Disease Control and Prevention (Africa CDC).
And over the four weeks up to 14 October, there was a 7% average increase in new cases, and an average increase in new deaths of 8%.
The numbers grew in North, Central and East Africa, but cases declined elsewhere.
Morocco, South Africa, Tunisia, Libya and Ethiopia are the countries driving the increase.
The WHO also points out that the rising numbers come as countries ease restrictions and re-open borders and schools.
But the Africa CDC’s John Nkengasong says the rise in numbers of reported deaths could also be due to an improvement in African countries’ ability to document deaths from coronavirus.
Earlier this year, the global humanitarian relief body, the International Rescue Committee, warned that the true scale of the pandemic in Africa might have been hidden because of a lack of testing and issues with data.
Which countries have been most affected?
South Africa has the highest recorded number of total cases and reported deaths in Africa.
Prior to the latest rise, daily reported numbers and hospital admissions had been falling for nearly two months.
Health Minister Zwelini Mkhize recently said they had confirmed the country was now officially past the surge.
However, there’s been concern that the country could be missing some cases, and that the virus has been spreading in rural areas.
The WHO says although new cases have been on a steady decline in the highly populated provinces of Gauteng and the Western Cape, weekly case numbers have been rising in less populated provinces.
And research from the South African Medical Research Council (SAMRC) indicates the number of people who have died from the virus could be much higher than reported.
It says excess deaths, which is the difference between deaths over a particular period and the historical average, rose by 17,000 between May and mid-July. That’s a 59% increase compared with previous years.
Morocco has overtaken Egypt and has the second highest number of cases, although Egypt is still the second in terms of deaths recorded so far.
Egypt has the third highest number of cases, followed by Ethiopia and Nigeria.
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The reported death rate per capita has been low compared with other parts of the world, despite the poor health infrastructure in many African countries.
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The WHO says this could be partly because of the relatively young population in Africa – more than 60% under the age of 25.
Covid-19 is known to have a higher mortality rate for older age groups, and among people health problems like obesity and type 2 diabetes which are also less common in Africa.
Experts also say expertise in epidemic control from tackling other outbreaks, cross-immunity from other coronaviruses, low travel and outdoor living could also be contributing to Africa coping better.
In terms of what proportion of people who get Covid-19 go on to die, there were 12 African countries with rates comparable with or higher than the global average rate of 2.9% on 15 October.
How much testing is done in Africa?
Ten countries account for close to 80% of the total tests conducted – South Africa, Morocco, Ethiopia, Egypt, Ghana, Kenya, Nigeria, Rwanda, Uganda and Mauritius.
There are wide variations in testing rates, with South Africa doing the most and Nigeria doing relatively few per capita, according to Our World in Data, a UK-based project which collates Covid-19 information.
By 11 October, South Africa had done just over 74 tests per 1,000 people, but that compares with more than 349 in the UK and 381 in the US.
Nigeria had carried out just 2.7 tests per 1,000 people by 13 October.
About half of the countries on the continent have a ratio lower than the benchmark of doing at least 10 tests for every positive case recommended by the Africa CDC.
And in some countries, there’s insufficient data available on testing to know how much is being done.