The Washington PostDemocracy Dies in Darkness

Facing the delta variant wave with few vaccine doses, African countries suffer — and bristle with anger

A Muslim burial of a covid-19 victim is held at the Westpark Cemetery in Johannesburg on June 27. South Africa has reintroduced tough restrictions as it fights a fast-increasing surge of coronavirus cases. (Ali Greeff/AP)

CAPE TOWN, South Africa — The variant-driven coronavirus outbreak that public health officials across Africa had warned about for months is underway — and it’s happening without the urgently needed ramping up of the continent’s access to vaccines.

The delta variant is driving a sharp increase in infections across each of Africa’s main regions, with only a trickle of vaccination donations coming in from wealthy countries. Major moves to quicken commercial vaccine rollout across the continent have come too late to prevent calamities, officials said.

“Anyone who cares about this pandemic in the true sense should be frustrated,” John Nkengasong, head of the Africa Centers for Disease Control and Prevention, said in an interview. “As of one week ago, we had vaccinated 1.1 percent of our population of Africa. If you square that with Africa’s population of 1.2 billion, you see we still have a very long way to go to get to 60 percent if vaccines continue this way.”

Here’s just how unequal the global coronavirus vaccine rollout has been

So far, 41.5 million Africans have received at least one dose and 11.5 million have received two doses.

On Thursday, the Africa CDC announced the first shipments of single-shot Johnson & Johnson vaccines from a commercial deal will be delivered in August, and the first shipments of vaccines from U.S. donations through Covax to 51 countries in Africa will begin next week. Nkengasong described the announcement as “a saving grace.”

But other top officials have been furious about the lack of progress, resorting to publicly shaming countries that are vaccinating even those with low risk profiles while many African countries are experiencing a long-avoided yet dreaded surge in severe cases and deaths.

Strive Masiyiwa, a Zimbabwean business magnate and the African Union’s special envoy for vaccine procurement, lambasted European leaders for the delays in Covax’s distribution.

“Not a single dose, not one vial has left a European factory for Africa,” Masiyiwa said at Thursday’s announcement. “They have vaccinated so many of their own people they can now watch football without masks. Our people have not been vaccinated.”

Mike Ryan, the World Health Organization’s top emergency expert, said the notion that supposed hesitancy among Africans to take the vaccine led to the shortage shows a current of racism ran beneath platitudes by world leaders about working together.

“The level of paternalism, the level of colonial mind-set that says, ‘We can’t give you something because we’re afraid you won’t use it,’ ” he said. “I mean, seriously, in the middle of a pandemic?”

“Just give us the vaccines,” Tedros Ghebreyesus, an Ethiopian who is the World Health Organization’s director general, said while addressing reporters.

Some of the worst-hit countries, such as Namibia, which has the second-highest rate of infection in the world, are down to their last doses. Like most other African nations, Namibia staked its vaccination plan on Covax, but India’s export restrictions in the wake of its own surge have essentially suspended the initiative.

“The third wave we are experiencing currently has impacted all corners of our country with devastating ferocity,” Namibian Health Minister Kalumbi Shangula said at a news conference Wednesday. “There is hardly a family or community in this country that has not been touched. Our country is literally in an existential struggle against this pandemic.”

Namibia has received donations of 100,000 Sinopharm doses from China and 30,000 AstraZeneca doses from India. Despite paying Covax, it has received only 24,000 doses out of 108,000 allocated by the facility.

Measured at the continental level, cases have risen at an increasing pace each week since the beginning of May, when researchers began noticing a greater frequency of the delta variant in sequenced genomes.

“It’s as bad as we feared,” said Tulio de Oliveira at South Africa’s KwaZulu-Natal Research Innovation and Sequencing Platform, one of the region’s main sequencing units. In the span of just a few weeks, he said, the delta variant had all but completely taken over in South Africa from the previously dominant beta variant, which his lab first detected in local samples.

In sheer numbers, South Africa still accounts for the majority of new cases in Africa, which is in part the result of its better testing capacity and relatively stronger health system. Daily new cases are nearing the peak number of 21,000 the country hit during its second wave in January, and de Oliveira said he expects this wave to be larger. In the area around Johannesburg, infection rates are more than twice what was seen during the second wave.

South African President Cyril Ramaphosa on Sunday tightened restrictions on the country for 14 days, banning the sale of alcohol, closing schools and extending a nationwide curfew as the country’s death toll from the pandemic neared 60,000.

“The peak of this third wave looks set to be higher than the previous two,” he said in a televised address. “The first wave lasted 15 weeks, the second wave lasted nine weeks. We don’t know how long this one will last, but indications are that it could last longer.”

Ramaphosa has come under intense political pressure from the far-left opposition Economic Freedom Fighters to push through regulatory approval for Russian and Chinese vaccines, even though the efficacy of the latter has come into question.

If more people were vaccinated, de Oliveira said, “we’d have similar or a large number of infections but people who get infected wouldn’t be hospitalized. Unfortunately, I wouldn’t be surprised over the next few weeks that the delta variant will start dominating the whole of Southern Africa.”

Nkengasong said although infection rates in Namibia and South Africa are worrying, other countries such as Congo, Liberia, Sierra Leone, Uganda and Zambia are in the throes of similar waves.

“None of them have peaked yet,” he said.

The only imminent plan to expand vaccine access is the African Union’s deal with Johnson & Johnson, which produces some of its vaccines in South Africa. Delivery schedules are being pushed forward by weeks or even months, but punishing shutdowns have already fallen into place in many countries.

Uganda is just a third of the way through a six-week national shutdown in which only essential workers are allowed to leave home. The only market businesses allowed to remain open are food stalls, and then only if the vendors sleep on their property, which often consists of a wooden cart or kiosk.

The government announced a cash transfer program that would give half a million urban households about $28 each to soften the blow of income loss, but many in the now-deserted capital, Kampala, said the one-time payment would scarcely be enough to meet their family’s needs.

In one grainy video widely shared on social media, police confronted a man who had broken the shutdown restrictions to continue selling perfume on the roadside, even though there was almost no one to sell to.

As four officers towered over him, the man, identified as Rashid Mukisa in a crowdfunding campaign to help him, broke into tears.

“I left home because there was no food, not even a coin,” he cried. “I’m here finding something to eat and you’re chasing me away. What do you think I should do?”

Initial hesitancy to get vaccinated has given way to a clamor to get the shots. Turyatemba William, 58, walked more than a mile to a health center in Kampala after hearing the news that France had donated 175,000 AstraZeneca doses to Uganda, even though the government said they would all be reserved for use as second doses and he hadn’t yet received his first.

He missed getting his first because the clinic he went to ran out of doses while he was still standing in line.

“I know what it means to get a vaccine, and that’s why I want to get it,” he said while waiting again.

Third waves have been slower to manifest in West Africa, and researchers attribute that to travel patterns: The region has closer ties to Europe, for instance, while East and Southern African nations tend to welcome more visitors from delta-variant hot spots in South Asia.

Yet caseloads are gaining momentum in some areas, doctors warn.

In Sierra Leone and Liberia, positive tests had been scarce for months until June. Health officials could count weekly averages on one hand. Then new cases shot up by more than 1,000 percent.

“Almost all of our emergency rooms are now full,” said Mosoka Fallah, a former director of the National Public Health Institute of Liberia. “This is just the beginning, and it’s already spiraling out of control.”

Since coronavirus tests usually take 10 to 12 days to process in Liberia, he said, the number of infections and deaths is probably far higher than the official numbers can keep up with.

“Our social media feeds used to be all ‘Happy birthday’ or 'Happy anniversary,’ ” Fallah said. “Now everybody is saying: ‘Rest in peace, rest in peace.’ ”

Bearak reported from Kinshasa, Congo; Athumani from Kampala, Uganda; and Paquette from Dakar, Senegal.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will likely knock out monoclonal antibodies, targeted drugs that can be used as a treatment or to protect immunocompromised people.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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