USA Today Fact check: Coronavirus deaths in Africa are far less than in U.S – True!

The claim: The African continent has only seen 46,000 novel coronavirus deaths

As countries worldwide grapple with another wave of coronavirus, one continent appears to be managing well above all others. “The entire continent of Africa has only seen 46,000 deaths from COVID-19,” “The Daily Show” host and comedian Trevor Noah states in a Nov. 14 Instagram post.

As Noah explains in an accompanying meme, one reason for this figure — slightly over a sixth of the latest U.S. COVID-19 death toll — is the continent’s large population of young, healthy people.

The claim runs counter to what had been expected early in the pandemic with experts forecasting African health care systems “overwhelmed when coronavirus cases escalate” and deaths exceeding 300,000 to nearly 3 million in a worst-case scenario.

Poor sanitation; poverty; population overcrowding, and communicable diseases such as HIV/AIDS, malaria and tuberculosis endemic to sub-Saharan Africa were also anticipated to worsen COVID-19 transmission considerably.

Age, more than just a number

While Africa has seen a slight surge in COVID-19 cases and deaths since Noah’s post, youth may still be a saving grace.

According to a study published earlier this month looking at coronavirus deaths across 16 countries, those aged 65 years and older had a “strikingly higher COVID-19 mortality compared to younger individuals,” with men more likely to die than women.

Data from the Centers for Disease Control and Prevention also shows the prospect of dying from the virus increases threefold after age 49.

Compared to the 2019 U.S. population in which the median age was around 38 years and those 60 years and older made up 23% of the population, the median age on the continent of Africa was around 18 in 2018 and those 60 and older comprise only 5.6% of the population in 2020.

Nursing homes and other long-term care facilities have been a hotbed of COVID-19 outbreaks in the U.S., representing only 1% of the population but 40% of coronavirus deaths according to the COVID Tracking Project.

While nursing and long-term care facilities are of great need in sub-Saharan Africa, such organizations are sparse; most older Africans retiring from urban jobs typically return to their rural homes, where population density and risk of exposure through social contact is low.

This is not to say older Africans are protected from or are unaffected by the virus. Individuals living with noncommunicable diseases like obesity, cardiovascular disease and type 2 diabetes – all risk factors for severe COVID-19 – account for most coronavirus deaths in Africa.

A resident from the Alexandra township gets tested for COVID-19 in Johannesburg, South Africa, on April 29, 2020.
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Not only age, also immunity

What the age-related trends have revealed is that “about 91% of COVID-19 infection in sub-Saharan Africa are among people below 60 years, and over 80% of cases are asymptomatic,” according to the WHO.

One reason for this prevalence may be exposure to infectious diseases endemic to the continent like tuberculosis, malaria, respiratory infections and even parasitic worms. It is believed these past infections can educate and train the body’s immune system to mount an attack not only against one obvious pathogen but against any others appearing vaguely suspicious, like a dog chasing after any person shaped like a mail carrier.

“Although there is no available data on immune responses in African COVID-19 patients, studies show clear differences in the activation, proinflammatory, and memory profiles of the immune cells not only in Africans versus Europeans but also among Africans with high and low exposure to microorganisms and parasites,” stated Dr. Moustapha Mbow, PhD, of Cheikh Anta Diop University of Dakar, Senegal, and colleagues in Science.

Our ruling: True

We rate this claim TRUE because it is supported by our research. While COVID-19 cases and deaths in Africa have surged slightly, a larger, more youthful population compared to the U.S. making up the bulk of infected and asymptomatic cases may be one factor contributing to the continent’s relatively low coronavirus death toll. It is possible that asymptomatic infection may result from exposure to other infectious agents thereby priming the immune system against coronavirus as well.

Our fact-check sources:

• Johns Hopkins Coronavirus Resource Center, accessed Nov. 19, “Global Map“
• World Economic Forum, April 6, “Africa has a COVID-19 time bomb to defuse“
• Imperial College COVID-19 Response Team, March 26, “The Global Impact of COVID-19 and Strategies for Mitigation and Suppression“
• United Nations Economic Commission for Africa, April 16, “Without adequate protection, estimates show that over 300,000 Africans could lose their lives due to COVID-19 -ECA report“
• BMC Public Health, Nov. 19, “COVID-19 mortality risk for older men and women“
• Centers for Disease Control and Prevention, Aug. 18, “COVID-19 Hospitalization and Death by Age“
• United States Census Bureau, June 17, “Median Age and Age by Sex“
• Statista, Sept. 4, “African countries with the lowest median age as of 2018“
• United States Census Bureau, “Africa Aging: 2020“
• World Health Organization, Sept. 24, “Social, environmental factors seen behind Africa’s low COVID-19 cases“
• The COVID Tracking Project, Nov. 5, “Cases Still Rising, Hospitalizations Spiking, Nursing Homes in Trouble: This Week in COVID-19 Data, Nov 5“
• World Health Organization, “Towards long-term care systems in sub-Saharan Africa“
• BBC News, Oct. 7, “Coronavirus in Africa: Five reasons why Covid-19 has been less deadly than elsewhere“
• World Health Organization, Sept. 10, “Noncommunicable diseases increase risk of dying from COVID-19 in Africa“
• BBC News, Nov. 26, “Coronavirus: What’s happening to the numbers in Africa?“
• Science, Aug. 7, “COVID-19 in Africa: Dampening the storm?“