Friday, November 26, 2021

New African variant highlights that Africa jas been largely spared by the pandemic

As countries around the world start worrying about a new super-variant of the COVID-19 virus discovered in South Africa, it only serves to underscore the fact that Africa in general seems to have been spared the worst of the pandemic thus far.

A new variant discovered in South Africa, labelled B.1.1.529, has health experts worried because of its "unusual constellation of mutations" and the big jump in evolution it represents. The variant exhibits about 50 different mutations, including over 30 on the spike protein alone, and it is radically different from the original virus that emerged in Wuhan, China, two years ago (yes, two years!)

Scientists are not sure yet just what the implications are for the variant's transmissibility, its symptomology, and the extent to which current vaccines will be effective against it. Thus far, just a handful of cases have been identified - 77 in South Africa, 4 in neighbouring Botswana, and 1 in Hong Kong (directly linked to travel from South Africa), but many scientists are noticeably jumpy around it.

Maps of confirmed cases and deaths from COVID-19 across the world bring out the perhaps unexpected fact that Africa in general (with the marked exception of South Africa) has had a relatively easy time of  the pandemic compared to Europe, North America and Asia. Many researchers have remarked on this and tried to understand why COVID has had less of an impact in Africa, particularly sub-Saharan Africa. 

Top theories are: the relatively young age demographic of sub-Saharan Africa (the median age is half that North America, Europe and Asia); the almost complete lack of long-term care facilities (apart from, notably, South Africa); potential cross-protection from other locally circulating coronaviruses (including several from human-bat interactions); potential under-counting of both deaths and cases due to poor healthcare infrastructure in the region and a lack of adequate testing facilities; and, paradoxically, some rapid and effective government public health responses in the area (including early border closures, strict lockdowns, and the sharing of COVID-19 information across sub-Saharan Africa, and perhaps the fact that Africa's healthcare system, such as it is, is more geared towards infectious diseases than much of the rest of the world). 

I might add that the poorer regions of the world probably have less international travel (and less travel in general) than other areas, which may have had a serendipitously beneficial effect during this time. 

It is certainly notable that the outlier in Africa is South Africa, which has seen a much worse outbreak than the rest of the continent. South Africa is a much richer and more developed country than most of sub-Saharan Africa, with a much higher median age, a long-term care sector, a higher prevalence of non-communicable non-infectious diseases, and a more developed healthcare system with better diagnostic capabilities and better documentation. So, it does all kind of make sense when you stop and think about it.

UPDATE

The new variant is now known as the Omicron variant, and is officially a WHO "variant of concern". Several countries, including Canada and the USA, have already banned travel from South Africa and a few other southern African countries. But the variant has already spread from South Africa to Botswana, Hong Kong, Israel and Belgium (the latter not linked to travel from South Africa, but from Egypt, which is not known to have Omicron cases), so the genie may already be out of the bottle. 

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