Africa passes 1M confirmed virus cases; true number far more

Workers prepare for a burial at the Olifantsveil Cemetery outside Johannesburg, South Africa, Thursday Aug. 6, 2020. The frequency of burials in South Africa has significantly increased during the coronavirus pandemic, as the country became one of the top five worst-hit nations. New infection numbers around the world are a reminder that a return to normal life is still far off. (AP Photo/Jerome Delay)
Workers prepare for a burial at the Olifantsveil Cemetery outside Johannesburg, South Africa, Thursday Aug. 6, 2020. The frequency of burials in South Africa has significantly increased during the coronavirus pandemic, as the country became one of the top five worst-hit nations. New infection numbers around the world are a reminder that a return to normal life is still far off. (AP Photo/Jerome Delay) (Copyright 2020 The Associated Press. All rights reserved.)

JOHANNESBURG – Africa’s confirmed coronavirus cases have surpassed 1 million, but global health experts say the true toll is likely several times higher, reflecting the gaping lack of testing for the continent’s 1.3 billion people.

While experts say infection tolls in richer nations can be significant undercounts, large numbers of undetected cases are a greater danger for Africa, with many of the world’s weakest health systems. More than 22,000 people have died of COVID-19.

The World Health Organization calls the milestone a “pivotal point” for Africa as infections in several countries are surging. The virus has spread beyond major cities “into distant hinterlands” where few health resources exist and reaching care could take days.

Immediately knowing they were at a disadvantage, African nations banded together early in the pandemic to pursue badly needed testing and medical supplies and advocate for equitable access to any successful vaccine. Swift border closures delayed the virus’ spread.

But Africa’s most developed country, South Africa, has strained to cope as hospital beds fill up and confirmed cases are over a half-million, ranking fifth in the world. The country has Africa’s most extensive testing and data collection, and yet a South African Medical Research Council report last week showed many COVID-19 deaths were going uncounted. Other deaths were attributed to other diseases as people avoid health centers and resources are diverted to the pandemic.

It’s all a warning for Africa’s other 53 countries of what might lie ahead. While dire early predictions for the pandemic have not played out, “we think it’s going to be here at a slow burn,” the WHO’s Africa chief, Matshidiso Moeti, said Thursday.

Just two African countries at the start of the pandemic were equipped to test for the virus. Now virtually all have basic capacity, but supplies are often scarce. Some countries have a single testing machine. Some conduct fewer than 500 tests per million people, while richer countries overseas conduct hundreds of thousands. Samples can take days to reach labs. Even in South Africa, turnaround times for many test results have been a week or longer.

“We are fighting this disease in the dark,” International Rescue Committee expert Stacey Mearns said. In addition, Africa has just 1,500 epidemiologists, a deficit of about 4,500.