Africa vs Australia on the Covid Freak-Out By Brian Simpson
Here is older material from the great objective Covid analysis site, by no means antivax, just old school science, comparing the Australian and African responses to Covid. It was said early in the outbreak that Africa would be devastated due to lack of lockdowns and not being able to afford the vax to the same level as Australia. But, Covid infections were much lower, even given all this. Africa is a refutation of the Covid narrative, I believe.
“COVID-19 infection rates and associated severe disease and associated deaths have been noted to generally have been significantly lower in African countries. This is despite the major concern at the beginning of the pandemic that low-income countries, with less developed health infrastructure, endemic poverty, and crowded living conditions, would be overwhelmed by infection and death. Additionally, COVID-19 vaccination rates in African nations overall are far lower than developed nations. Quite the opposite occurred however, for example, with America and its sophisticated healthcare systems and relatively high vaccination rates recording more total deaths associated with SARS-coV-2, the virus behind COVID-19, than any other nation. What follows is a comparative review of two similarly sized nations from a population standpoint, yet very different results from the pandemic—Australia and Niger.
TrialSite has previously reported on the unexpectedly low COVID-19 levels in Africa, which have become the topic of research. Looking at the latest figures across the continents (Table 1), this pattern still holds true. Despite being home to nearly 18% of the global population, the African continent has suffered less than 4% of the worldwide COVID-19 deaths to date.
Table 1: Global Covid-19 Statistics by WHO Region
Continent
Population
% of Global
Population
COVID-19
Cases
COVID-19
Deaths
Vaccination
Rate (%)
Asia
4.7 billion
59.2
185 million
1.5 million
72.1
Africa
1.4 billion
17.9
12.4 million
256.7 thousand
22.9
Europe
743 million
9.3
228.4 million
1.9 million
66.3
North America
600 million
7.5
114 million
1.5 million
65
South America
437 million
5.5
64 million
1.3 million
77
Oceania
45 million
0.6
12.4 million
19.8 thousand
62.7
Sources: World Population Review: Continents, Our World in Data: Covid Cases, Our World in Data: Covid Deaths, Our World in Data: Covid Vaccinations, October 4, 2022.
In this article, TrialSite compares two countries of similar population size – Niger representing a developing African nation, and Australia serving as a representation of an advanced economy – to see what hypotheses hold true.
Comparing Niger and Australia
Despite having almost identical population sizes, the COVID-19 statistics of Niger and Australia share no similarities (Table 2). Australia’s vaccination rates are higher than the global average and Niger’s far lower, mirroring the pattern seen across advanced and developing nations. Nevertheless, Niger has experienced dramatically lower COVID infection and death figures throughout the pandemic.
Table 2: COVID-19 Statistics, Niger vs. Australia
Niger
Australia
Population
26.26 million
26.19 million
Economic status
Developing
Advanced
Deaths with or from COVID
313
14,853
Total number of cases since the pandemic began
9,411
10.19 million
Population fully vaccinated (%)
12.3
85.4
Sources: WHO, World Population Review: Niger, and World Population Review: Australia, October 4, 2022.
Why COVID-19 levels in Africa may be lower
Several hypotheses have been proposed for the disparity seen in the COVID-19 infection and death rates. According to an article by UNICEF published in October 2020, five reasons have been identified that have contributed to the lower rates of COVID-19 in Africa. These are quick action, public support, a young population (and fewer old age homes), a favorable climate, and community health systems. This wasn’t a sufficient explanation.
Government response and public support
African countries were fortunate to have had a buffer of additional time to prepare as the first cases and rise in cases came later than Europe, Asia, the Americas, and even Australia, which was not as hard hit as the others.
Additionally, funds such as the Niger COVID-19 Emergency Response Project ($13.95 million) which “helped support the rapid procurement of critical medication and equipment needed for treatment of coronavirus infections” assisted African countries to take advantage of that time to build capacity to tackle the virus.
In a recent 2022 article, the minister of health for Niger speaks about how the already low death rates declined after interventions by the government, which were taken on by the public, indicating the willingness of people to adhere to regulations. Despite the apparent support for interventions, there is also mention of the continent-wide problem of COVID-19 denial, which may be affecting control efforts out of the sight of public officials. Australia is infamous for having some of the strictest and longest-lasting lockdowns and restrictions during the pandemic, apparently far more than Niger, which ended its lockdown in May 2020 and has not had repeated lockdowns.
Australia embraced to some extent a Chinese-style zero tolerance COVID-19 policy covered extensively by this media.
Additionally, Australia shares no land borders with other countries, so it was able to have more control over who entered and left the country even as lockdowns and restrictions eased in-country. They maintained this control into 2022, far longer than most countries.
Local infrastructure
It has been suggested that Africa, in general, benefitted from pre-existing community health programs, which could then be commandeered for the COVID-19 response. Importantly, Niger is the 9th poorest country in the world with limited public infrastructure.
And any claims that community health infrastructure benefited their COVID-19 include potential confounding factor of decreased testing and monitoring infrastructure available on the continent, which is also brought up as a reason infection levels appear lower.
Regardless, a terribly poor country, Niger struggles with health infrastructure as reflected in rates of infectious disease and basic nutrition as reported by US AID.
Population and climate differences
Niger, like many African countries, has a young population, with the median age for the country being 14.8. Comparatively, Australia’s median age is 37.5. Younger people are, in general, less susceptible to severe COVID-19 than the elderly, in whom breakthrough infections are both more common and more serious.
Additionally, Niger has a low population density due to its large size and moderate population. Urbanization levels are also lower in Niger, with only about 19% of the population living in cities and large towns. Australia, on the other hand, also has a low population density across the entire land area, but the population is concentrated in a small proportion of that area. Australia’s urban population is estimated to be around 79%, and only 2.5 million people (9.6%) live in areas classified as outer regions or remote areas.
Climate may also play a role in the differences seen. 80% of Niger is desert or semi-desert (low humidity and higher temperatures) which may contribute to the decreased spread and survival of the virus. However, this is arguably true of much of Australia, and does not explain the difference in COVID-19 levels between the two countries.
Immune differences
A person’s immune system adapts to the bacteria and viruses they are exposed to, and these experiences shape the immune response. It has been suggested that antibodies against locally circulating coronaviruses in Africa may have contributed to a level of protection, although the prevalence of these antibodies in the population has not been explored.
Political and economic factors also influence the immune health of a population. For example, research suggests that modern hygiene and sanitation systems in more advanced nations, have resulted in the nearly complete extinction of many organisms that have existed in our ancestors' bodies for hundreds of millions of years. A “microbiome” perspective. This, in turn, has caused those in more advanced parts of the world to lose the protection that persons living in developing regions may have against COVID-19 and other infections.
That (un)popular antiparasitic
The difference in case numbers could also be associated with the use of ivermectin to treat helminth-related disease in endemic areas.
While the use of ivermectin in Australia is all but banned thanks to a confluence of forces involving regulators and the medical establishment and likely pharmaceutical industry backend influences, in Niger the drug has been distributed for prophylaxis and treatment of onchocerciasis (river blindness) and lymphatic filariasis since 1987. The ivermectin is postulated to contribute to the lower COVID-19 rates as compared to Australia and similar countries where such a program is not present.
The literature is overwhelmingly of the view that ivermectin is not effective as a prophylaxis or treatment for COVID-19. As TrialSite has reported, many researchers finding positive results with ivermectin have struggled to get their work published amid apparent censorship of scientific journals. This media has reported more than any other on positive studies associated with this currently approved antiparasitic drug and 92 studies the vast majority of which demonstrate positive outcomes.
The latest meta-analysis of the available literature concludes that ivermectin is not effective as a prophylaxis or treatment of COVID-19, advising readers that, “as WHO advises, use of ivermectin should be limited to clinical trials.” The paper also states that ivermectin “can possibly decrease mortality, however, most of the supporting data are from highly biased studies.” The study does leave room to incorporate further research on ivermectin’s efficacy in the future if such studies manage to get published.
Another study out of Brazil strongly supports the use of ivermectin as a prophylactic and treatment of COVID-19, suggesting “up to a 92% reduction in COVID-19 mortality rate in a dose-response manner.” This study, based on over 88,000 people, shows that perhaps there is a place for ivermectin in the prophylaxis and treatment of COVID-19.
Unfortunately, discussion about ivermectin has become incredibly politicized and depending on point of view, triggers arguments over dialogue, regardless of side.
Conclusion
Niger, like many African nations, has seen surprisingly low death and disease burden levels during the COVID-19 pandemic. Several factors seem to be contributing, such as the inherent properties of a favorable climate and the young population as well as the quick establishment of government interventions (despite limited infrastructure due to poverty and low economic output) and uptake by the population of these interventions, aided by existing community health programs. We must also be aware of the possibility of the underreporting of COVID-19 metrics. Perhaps the human microbiome is healthier in African nations? That’s just speculation at this point but investigators from America to Singapore are looking into the connections of COVID-19 and the health of the gut.
The figures provide some real-world evidence to the potential role of ivermectin prophylaxis in reducing the impact of COVID-19, as seen also in India’s Uttar Pradesh. As COVID-19 death rates rise in Australia and other highly-vaccinated nations, the WHO, CDC, and other health agencies are presenting a united front against ivermectin, challenging ivermectin researchers to publish their findings, while the scientific journals play their part to ensure such papers are removed or rejected from the literature. On the other hand, there isn’t solid proof that ivermectin can consistently treat SARS-CoV-2 by itself, and public health outcomes in low-and middle-income countries for the most part have limited evidentiary documentation.
Why did African nations like Niger, poor, limited infrastructure and often ravaged by other infectious disease, yet young and overall healthy populations but for the social determinates of health fare far better during the pandemic than wealthy, but older developed nations with highly sophisticated health systems and high vaccination rates? Why did the African nations, far less vaccinated than the wealthy developed nations, fare so much better when it comes to COVID-19 severity and death? Hopefully researchers will continue to investigate and perhaps provide an answer some day.”
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