To control the pandemic, WHO focuses on wider use of COVID-19 vaccines

Nearly two years after the first case of COVID-19 was reported in Africa (14 February 2020), the World Health Organization (WHO) finds that, if the current trend continues, the continent will be able to bring the pandemic under control by 2022. However, the WHO has warned that vigilance must be maintained to achieve this.

Over the past two years, the continent has experienced four waves of COVID-19, each with higher peaks or a higher total number of new cases than the previous one. These waves were mainly caused by new variants of SARS-CoV-2, which were highly transmissible but not necessarily more lethal than in previous waves. Each new wave triggered a more effective response than the previous one, and each new outbreak of cases was on average 23% shorter than the one that preceded it. While the first wave lasted about 29 weeks, the fourth wave ended after six weeks, about one-fifth the duration of the first wave.

Despite poverty, concrete actions have been taken to contain the pandemic

"Over the past two years, the African continent has become smarter, faster and more effective in responding to each new surge in COVID-19 cases," said Dr Matshidiso Moeti, WHO Regional Director for Africa. "Despite the obstacles, including significant inequalities in access to immunization, we have resiliently and selflessly weathered the COVID-19 storm, building on Africa's long experience in fighting outbreaks. But COVID-19 has cost us dearly, with the loss of more than 240,000 lives and considerable damage to our economies. »

According to the World Bank, the COVID-19 pandemic has pushed up to 40 million people into extreme poverty on the continent, and it is estimated that each one-month postponement of the lifting of lockdown measures would cost Africa a loss of US$13.8 billion. of gross domestic product.

"While COVID-19 is here to stay, we are starting to see the end of the tunnel. This year, we can end the disruption and destruction that the virus has left in its wake and regain control of our lives," said Dr. Moeti. "Bringing this pandemic under control must be a priority, but we are aware that no country has had the same experience of the pandemic as another, which means that each country must chart its own way out of this emergency. »

Africa has been able to resist

When Africa experienced its first wave, attributed to the spread of wild SARS-CoV-2, the average case fatality rate – in other words, the proportion of infected people who die from COVID-19-related causes – was high (2.5%). This figure rose to 2.7% in the second wave fed by the Beta variant, before falling back to 2.4% in the third wave due to the Delta variant. In contrast, the average case fatality rate during the fourth wave is low (0.8%). This is the first time that the surge in the number of cases during a wave has not resulted in a proportional increase in hospitalizations and deaths.

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Since the beginning of the pandemic, the continent's ability to handle COVID-19 cases has gradually improved, with increased availability of trained health workers, oxygen and other medical supplies. The number of intensive care unit beds has increased across the continent, from eight beds per one million people in 2020 to 20 beds per one million people today.

WHO has also contributed to increasing the number of oxygen production plants in Africa from 68 to 115 (an increase of 60 per cent) by supporting the repair, maintenance and purchase of new oxygen production plants. The cost of oxygen has fallen by 40% where such plants are located. Despite these improvements, the availability of oxygen remains a concern and a large majority of patients who need it as part of their clinical treatment cannot access it.

Using previous lessons learned

"As we enter this new phase of the COVID-19 pandemic, we must use the lessons learned from the past two years to strengthen our continent's health systems to be better prepared to deal with future waves of the disease," said Dr. Moeti. "As new variants are at the root of successive waves, it is essential that countries strengthen their capacity to detect variants through better genomic sequencing. It will also allow us to quickly spot other deadly viruses. »

WHO has increased the number of laboratories capable of detecting COVID-19 from two to more than 900 today, and the Organization is intensifying genetic sequencing efforts in Africa through several initiatives such as the establishment of the Regional Centre of Excellence for Genomic Surveillance and Bioinformatics in South Africa, in collaboration with the South African National Institute of Bioinformatics (SANBI) based at the University of the Western Cape. As a result of these efforts, more than 7500 samples are sequenced each month in Southern Africa compared to the situation a year ago, and sequencing data has increased by more than 54% on the continent.

What about vaccines?

Vaccination is the most powerful weapon against the appearance of new variants. To date, nearly 672 million doses of COVID-19 vaccines have been received in Africa, 65 per cent through COVAX, 29 per cent through bilateral agreements and 6 per cent through the African Vaccine Acquisition Fund established by the African Union. As of January 2022, a total of 96 million doses of vaccines have been shipped to Africa, more than double the number of vaccine doses delivered to the continent six months ago. Since January, the COVAX mechanism has only shipped vaccines to countries at their request, giving each country the opportunity to obtain the exact volume of vaccines it needs at the right time.

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"Even though Africa is lagging behind in immunization, with only 11% of its adult population fully vaccinated, we now have a steady supply of doses of COVID-19 vaccines," said Dr. Moeti. "Vaccination is paramount, but we must not forget about screening and surveillance, which we know are essential tools to bring some semblance of normalcy back into our lives. »

Testing is essential to stem the spread of COVID-19, and since the beginning of the pandemic, 95 million tests have been conducted on the continent. Screening has gradually improved, with 21 of the 47 countries in the African Region now meeting the WHO-recommended benchmark of 10 tests per 10 000 people each week. Last year, only 15 countries were capable of doing so. As the transmission of COVID-19 in Africa is mainly due to asymptomatic people, it is important to increase the number of tests and response actions within communities.

Distributed by APO Group on behalf of WHO Regional Office for Africa.

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