Coronavirus: Africa’s vaccine challenge

Covid vaccination rates in Africa are still worryingly low, averaging about 14 percent.

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Daily reported coronavirus cases in the United States, seven-day average.The New York Times
A cooler with Covid-19 vaccine vials in transit to the town of Kamakwie in northern Sierra Leone, last month.Finbarr O'Reilly for The New York Times

Africa's vaccine challenge

Covid vaccination rates in Africa are still worryingly low — averaging about 14 percent across the continent — and public health experts expect Africa to experience a fifth wave of the virus in the coming months. That could potentially take the form of a new, more lethal variant that could endanger the entire world.

"Africa remains a real outlier globally in terms of how many people — including how many of the most at risk people — have been able to be vaccinated," said my colleague, Stephanie Nolen, who reported from Sierra Leone. "Coverage is overall incredibly low in most countries except South Africa and Rwanda. It's a problem for the unvaccinated countries and it's a problem for the rest of the world."

If there's good news, it's that vaccine supplies are more plentiful now than earlier in the pandemic. And the Delta and Omicron variants seem not to have wreaked as much havoc across the continent as they have in other places, although that could reflect a lack of reliable data on mortality.

Overall, however, the situation is worrisome. Health systems in much of sub-Saharan Africa are fragile (Sierra Leone has just three doctors for every 100,000 people), and countries with some of the least resources in the world are being asked to run complicated vaccination campaigns. In Sierra Leone, each vaccination site has three or four brands of vaccine — from Sinopharm, to Johnson and Johnson, to mRNA doses — each with different expiration dates and dosing requirements for different age groups.

"It's a terribly stressful set of conditions in which to try to run a big public health program," Stephanie said. "It would be a challenge for a country like Norway. It's a huge issue for Sierra Leone."

There are also more pressing issues than Covid. Hospitals in Sierra Leone are overflowing with malaria cases. Some people show up to Covid vaccination sites in Sierra Leone because they are looking for Ebola vaccines.

As some parts of the world look toward post-pandemic life, there is concern that attention to the pandemic in Africa may drop off. Stephanie said that some experts were now starting to wonder whether the goal of vaccinating 70 percent of the continent was even realistic.

"I can see waning enthusiasm for this whole undertaking on the part of both countries and donors, and without another wave, does the effort decline?" Stephanie asked. "And if it does decline, does that guarantee that next wave is even more punishing?"

But because most African countries have fared comparatively well during the pandemic, and because there are so many more immediate and deadly health issues there, it's no wonder that many African countries are diverting their precious health resources to issues other than Covid.

"Right now countries such as Sierra Leone are being asked to use their very limited health care resources to vaccinate people against a virus that is not killing people in those countries," Stephanie said. "And you can understand why some people see it as being asked to invest staff and money in order to prevent the emergence of variants — so that they don't kill Americans who are vulnerable because they won't get vaccinated."

San Tin Community Isolation Facility in Hong Kong, on Wednesday.Jerome Favre/EPA, via Shutterstock

A mix of hope and caution

As spring arrives, Americans are feeling optimistic about the pandemic. About a third are resuming pre-Covid routines, a new poll shows, and twice as many support "government lifting all Covid-19 restrictions."

But across the world, warning lights are blinking. The World Health Organization says there were 11 million new cases around the world in the week ending on March 13, up 8 percent over the previous week — the first rise since late January.

Daily new global cases, seven-day average. The New York Times

The Omicron wave is raging in Asia, with South Korea reporting a record 400,741 daily cases on Wednesday. China is suffering its worst outbreaks in two years.

In Europe, a second Omicron wave potentially looms. Per capita cases there were already the world's highest and are inching up again. Germany is nearing record levels, and numbers are increasing in France, Britain, Italy and elsewhere.

Daily new cases in the U.K., seven-day average.The New York Times

Europe's loosening pandemic restrictions may be fueling the spike, along with waning vaccine immunity and the spread of the BA.2 subvariant.

In the U.S., wastewater sampling could be an early indicator of a Covid resurgence. About 38 percent of U.S. sampling sites reported increased coronavirus levels from Feb. 24 to March 10.

One epidemiologist told The Times that Europe's worst periods throughout the pandemic have been a harbinger of what was to come in the United States.

"Every time we followed suit within a matter of weeks," he said.

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What you're doing

In March of 2020, my girlfriends and I planned a mom's mountain getaway at Big Bear. It was right when things started shutting down. We thought hard about canceling but at the last minute we decided to go, with the caveat that we would hole-up and eat dinners in. We made it home and the very next day, schools shut down. We were like, "What in the world were we thinking?" Fortunately, no one got sick. We started referring to that weekend as our "Crapaversary"— when life as we knew it went into the crapper. This year, as Covid numbers plummeted we planned another trip on the same weekend in March. Two days before the trip, I got a text from the host that she had gotten Covid from her husband. Our trip was canceled — perfect way to celebrate a Crapaversary, I guess.

— Stacey Fargnoli, Los Angeles

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Correction: Monday's newsletter misstated that millions of low-income people could lose access to Medicare. The program at issue is Medicaid, not Medicare.

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