Morgue data hints at Africa’s true Covid-19 toll

Scientists have for some time struggled to understand the “African Paradox” with Covid-19 numbers reported substantially lower than what was expected, but now researchers at Boston University say that morgue data hints at Africa’s true toll.

The report, which has yet to be peer reviewed, looked at more than 1,000 bodies taken to a morgue in Lusaka, Zambia’s capital. They found that around one third of the corpses were infected with the virus, implying that the number who died from the disease was higher than reported.

The research was conducted after scientists noted that the numbers of cases and fatalities reported by sub-Saharan countries were much lower than what was expected. Although the study was conducted in just one country, the researchers say that the numbers suggest the true picture was much worse than what was reported.

Co-author Christopher Gill, a global-health specialist at Boston University in Massachusetts says ignoring the true extent of Covid-19: “Is so wrong. People were ill. They’ve had their families destroyed.”

He added: “It’s not hypothetical to me,” with one of his colleagues in Zambia dying of COVID-19 while working on the project.

Yakubu Lawal, an Endocrinologist at the Federal Medical Centre Azare in Nigeria, says that everyone expected that the virus would spread through Africa quickly and that the region would be affected as badly if not worse, than most European countries. However he says the numbers reported were surprisingly low leading to the perception that “severe debilitation and deaths caused by COVID-19 were somehow less in Africa compared to other continents.”

Lawal and other scientists speculated that the relative youth of Africa’s population might have helped to spare the continent, but also suspected that official numbers were under-reported. The question was by how much.

That led to Gill and his colleagues undertaking the research in Lusaka where they tested bodies over several months in 2020 and 2021. Test positivity averaged out at 32 percent but was as high as 90 percent during the peak of the Beta and Delta variants.

They also found that only 10 percent of those that had tested positive following their death, had been tested prior to their passing. Some had falsely tested negative, but most had never been tested at all.

Given the nature of the research it cannot be said with certainty that the virus is what killed the people in the morgue. However in a country of 19 million where only 4,000 confirmed deaths were reported, it could be argued that the numbers reported were substantially lower than the true figure.

A separate report published on March 10 pointed to an excess death toll of well in excess of 80,000 for the 2020 and 2021 years.

Gill and his colleagues are confident that there numbers are accurate saying that they correlate with a report by the University of the Witwatersrand, which found that in two communities only four to six percent of cases were officially documented. That study also found that around 62 percent of those participating in the study had been infected at least once.

Co-author Cheryl Cohen, an Epidemiologist at the University of the Witwatersrand in Johannesburg, South Africa, says that many of these infections were asymptomatic, but that people with symptoms might also have gone undetected because of the cost and difficulty of getting tested.

The researchers think that the disparity in numbers may be as a result of people dying in areas that lack medical care facilities, with at least 75 percent of the positive tests being found in people coming from lower income areas.

Gill says: “Nobody’s vaccinated. Nobody has masks. Nobody has access to the medical care they need, we’re in a population that is already stressed and unhealthy, and then — bam! In comes COVID.”

Amare Abera Tareke, a Physiologist at Wollo University in Dessie, Ethiopia, is one of those who disagrees with the research findings. He said: “Our experience is people get infected with the virus, are asymptomatic or have mild symptoms, and recover. While it is difficult to ignore the current finding, we have to take it cautiously.”

Gill says that the most disconcerting find is that the low numbers reported may well have contributed to the low numbers of vaccines shared with African countries, suggesting that low case rates meant less urgency.

He concludes by saying: “I suppose this could be unique to Lusaka,” he says, “But boy, you’d really have to try hard to explain why.”

Research data such as this taken from a morgue in Lusaka post pandemic which hints at COVID’s true toll in Africa, will help to understand that the true situation and will be useful in managing future situations like this one.

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