The variant-driven coronavirus outbreak that public health officials across Africa had warned about for months is under way – and it's happening without the urgently needed ramping-up of the continent's access to vaccines.
Lesley Wroughton, Max Bearak, Halima Athumani and Danielle Paquette ·
CAPE TOWN, South Africa - The variant-driven coronavirus outbreak that public health officials across Africa had warned about for months is under way – and it's happening without the urgently needed ramping-up of the continent's access to vaccines.
The delta coronavirus variant is driving a sharp increase in infections across each of Africa’s main regions, with only a trickle of vaccination donations coming in from wealthy countries. Major moves to quicken commercial vaccine roll-out across the continent have come too late to prevent calamities, officials said.
"Anyone who cares about this pandemic in the true sense should be frustrated," John Nkengasong, head of the Africa Centres for Disease Control and Prevention (CDC), said in an interview.
"As of one week ago, we had vaccinated 1.1% of our population of Africa. If you square that with Africa's population of 1.2 billion, you see we still have a very long way to go to get to 60% if vaccines continue this way."
So far, 41.5 million Africans have received at least one dose and 11.5 million have received two doses.
On Thursday, the Africa CDC announced that the first shipments of single-shot Johnson & Johnson vaccines from a commercial deal will be delivered in August, and the first shipments of vaccines from US donations through Covax to 51 countries in Africa will begin next week. Nkengasong described the announcement as "a saving grace".
But other top officials have been furious about the lack of progress, resorting to publicly shaming countries that are vaccinating even those with low-risk profiles while many African countries are experiencing a long-avoided yet dreaded surge in severe cases and deaths.
Strive Masiyiwa, a Zimbabwean business magnate and the AU's special envoy for vaccine procurement, lambasted European leaders for the delays in Covax's distribution.
"Not a single dose, not one vial has left a European factory for Africa," Masiyiwa said at Thursday's announcement. "They have vaccinated so many of their own people they can now watch football without masks. Our people have not been vaccinated."
Mike Ryan, the World Health Organization’s top emergency expert, said the notion that supposed hesitancy among Africans to take the vaccine led to the shortage showed that a current of racism ran beneath platitudes by world leaders about working together.
"The level of paternalism, the level of colonial mind-set that says, 'We can't give you something because we're afraid you won't use it,' " he said. "I mean, seriously, in the middle of a pandemic?"
Some of the worst-hit countries, such as Namibia, which now has the second-highest rate of infection in the world, are down to their last doses. Like most other African nations, Namibia staked its vaccination plan on Covax, but India's export restrictions in the wake of its own surge have essentially suspended the initiative.
Namibia has received donations of 100 000 Sinopharm doses from China and 30 000 AstraZeneca doses from India. Despite paying Covax, it has received only 24 000 doses out of 108 000 allocated by the facility.
Measured at the continental level, cases have risen at an increasing pace each week since the beginning of May, when researchers began noticing a greater frequency of the delta variant in sequenced genomes.
"It's as bad as we feared," said Tulio de Oliveira at the KwaZulu-Natal Research Innovation and Sequencing Platform. In the span of just a few weeks, he said, the delta variant had all but completely taken over in South Africa from the previously dominant beta variant, which his lab first detected in local samples.
In sheer numbers, South Africa still accounts for the majority of new cases in Africa, which is in part the result of its better testing capacity and relatively stronger health system. Daily new cases are nearing the peak number of 21 000 the country hit during its second wave in January, and De Oliveira said he expects this wave to be larger. In the area around Johannesburg, infection rates are more than twice what was seen during the second wave.
If more people were vaccinated, de Oliveira said, "we'd have similar or a large number of infections, but people who get infected wouldn't be hospitalised. Unfortunately, I wouldn't be surprised over the next few weeks that the delta variant will start dominating the whole of Southern Africa."
Nkengasong said that although infection rates in Namibia and South Africa are worrying, other countries such as the Congo, Liberia, Sierra Leone, Uganda and Zambia are in the throes of similar waves.
The only imminent plan to expand vaccine access is the AU's deal with Johnson & Johnson. Delivery schedules are being pushed forward by weeks or even months, but punishing shutdowns have already fallen into place in many countries.
Uganda is just a third of the way through a six-week national shutdown in which only essential workers are allowed to leave home.
Third waves have been slower to manifest in West Africa, and researchers attribute that to travel patterns. The region has closer ties to Europe, for instance, while East and Southern African nations tend to welcome more visitors from delta-variant hot spots in South Asia.
Yet caseloads are gaining momentum in some areas, doctors warn.
In Sierra Leone and Liberia, positive tests had been scarce for months until June. Health officials could count weekly averages on one hand. Then new cases shot up by more than 1 000%.
"Almost all of our emergency rooms are now full," said Mosoka Fallah, a former director of the National Public Health Institute of Liberia. "This is just the beginning, and it's already spiralling out of control."
Since coronavirus tests usually take 10 to 12 days to process in Liberia, he said, the number of infections and deaths are probably far higher than the official numbers can keep up with.
"Our social media feeds used to be all 'Happy birthday' or 'Happy anniversary,' " Fallah said. "Now everybody is saying: 'Rest in peace, rest in peace.' "
WASHINGTON POST