Cases drop for first time as Africa’s fourth COVID-19 wave ebbs

Weekly COVID-19 cases in Africa have dropped significantly and deaths dipped for the first time since the peak of the fourth pandemic wave propelled by the Omicron variant. The decline nudges the continent past its shortest upsurge yet that lasted 56 days.

Newly reported cases fell by 20% in the week to 16 January, while deaths dropped by 8%. The decrease in deaths is still small and further monitoring is needed, but if the trend continues the surge in deaths will also be the shortest reported so far during this pandemic.

South Africa—where Omicron was first sequenced, and which has accounted for the bulk of cases and deaths—has recorded a downward trend over the past four weeks. Only North Africa reported an increase in cases over the past week, with a 55% spike. Cases fell across the rest of Africa, where, as of the 16 January, there were 10.4 million cumulative COVID-19 cases and more than 233 000 deaths.

The Omicron-fuelled pandemic wave has resulted in the lowest cumulative average case fatality ratio—the proportion of deaths among confirmed cases—to date in Africa, standing at 0.68% compared with the three previous waves during which the case fatality ratio was above 2.4%. The Omicron variant has now been reported in 36 African countries, and 169 globally.

“While the acceleration, peak and decline of this wave have been unmatched, its impact has been moderate, and Africa is emerging with fewer deaths and lower hospitalizations. But the continent has yet to turn the tables on this pandemic,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.

“So long as the virus continues to circulate, further pandemic waves are inevitable. Africa must not only broaden vaccinations, but also gain increased and equitable access to critical COVID-19 therapeutics to save lives and effectively combat this pandemic,” Dr Moeti said.

The African region’s current case fatality ratio remains the highest in the world, although it has been lowered in the last two waves. While improvements have been made in the availability of Intensive Care Unit (ICU) beds for COVID-19 patients from 0.8 per 100 000 population to 2.0 per 100 000, the numbers are still far from sufficient to meet the demands of the pandemic. In terms of medication, currently patients with severe forms of the virus are being treated with corticosteroids and medical oxygen. Corticosteroids are largely available and relatively affordable, but availability of medical oxygen remains a challenge across the continent.

In addition, African countries face major impediments in accessing other COVID-19 treatment due to limited availability and high cost. Last week, WHO recommended two new drugs—a rheumatoid arthritis drug called baricitinib and a monoclonal antibody called sotrovimab—raising the number of WHO approved COVID-19 therapeutics to 11. WHO is reviewing the data on two oral antivirals—paxlovid from Pfizer and molnupiravir from Merck—which the manufacturers report show promise in reducing the risk of hospitalization in some patients.

Following initial negotiations with the Swiss pharmaceutical Roche, WHO is supporting the shipment of a limited number of vials of Tocilizumab to African countries in the coming weeks. Cape Verde and Uganda have already received vials. Burkina Faso, Ghana and Tanzania are due to receive a consignment soon. Tocilizumab is an immunosuppressive drug which can be used to treat patients with severe COVID-19. Further larger-scale deliveries of the drug to the continent are expected. Through the Access to COVID-19 Tools (ACT)-Accelerator partnership, negotiations are also underway with other drug makers to procure supplies of COVID-19 treatments.

“The deep inequity that left Africa at the back of the queue for vaccines must not be repeated with life-saving treatments. Universal access to diagnostics, vaccines and therapeutics will pave the shortest path to the end of this pandemic and no region of the world should be left on the fringes of this endeavour,” said Dr Moeti.

In Africa, while vaccine supplies have been on the rise in recent months, the rate of vaccination remains low, with just 10% of the continent’s population fully vaccinated. Africa has so far received about 500 million COVID-19 vaccine doses and administered 327 million.

Significant efforts are needed to ramp up the vaccination to reach a broad swathe of the population. In 2022, an average of between 250 million and 300 million doses of vaccine will be available for supply each month. By mid-2022, the COVAX Facility expects to have enough supply for all the countries participating in the Facility’s Advance Market Commitment option to fully vaccinate 45% of their populations.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Dr Andrea Howard, Director, Clinical and Training Unit and Associate Professor of Epidemiology at Columbia University, as well as Dr Harley Feldbaum, Head of Strategy and Policy at The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Also on hand from the WHO Regional Office for Africa to respond to questions were Dr Phionah Atuhebwe Vaccines Introduction Medical Officer, Dr Nonso Ejiofor, Team Lead Health Operations, and Dr Fausta Mosha, Laboratory Medical Officer.