Around 90% of deceased people tested at University Teaching Hospital (UTH) Mortuary during coronavirus surges were positive for SARS-CoV-2 infection, suggesting flaws in the idea of an ‘African paradox’.
Almost one-third of more than 1,000 bodies taken to a mortuary in Lusaka in 2020 and 2021 tested positive for SARS-CoV-2, implying that many more people died of COVID-19 in Zambia’s capital than official numbers suggest.
Some scientists say that the findings further undermine the ‘African paradox’, a narrative that the pandemic was less severe in Africa than in other parts of the world.
This idea arose after health experts noticed that sub-Saharan nations were reporting lower case numbers and fewer COVID-19 deaths than might be expected.
But researchers say that the findings from Zambia could reflect a broader truth — that a deficit of testing and strained medical infrastructure have masked COVID-19’s true toll on the continent.
The findings have not yet been peer-reviewed.
Ignoring the true extent of COVID-19 in Lusaka and beyond “is so wrong. People were ill. They’ve had their families destroyed,” says co-author Christopher Gill, a global-health specialist at Boston University in Massachusetts.
One of his colleagues in Zambia died of COVID-19 while working on the project.
“It’s not hypothetical to me,” says Gill.
Missing COVID cases
When SARS-CoV-2 began spreading globally, many health researchers worried that the virus would devastate sub-Saharan Africa.
But the surprisingly low numbers of reported COVID-19 cases in the region led to the perception “that severe debilitation and deaths caused by COVID-19 were somehow less in Africa compared to other continents”, says Yakubu Lawal, an endocrinologist at the Federal Medical Centre Azare in Nigeria.
Lawal and other scientists speculated that the relative youth of Africa’s population might have helped to spare the continent, but also suspected that official numbers were under-reported.
The question was by how much.
Seeking answers, Gill and his colleagues in Zambia tested bodies in one of Lusaka’s largest morgues for SARS-CoV-2 over several months in 2020 and 2021.
Test positivity was 32% overall — and reached around 90% during the peak of the waves caused by the Beta and Delta variants.
Moreover, only 10% of the people whose bodies were found to contain the virus after death had tested positive while still alive.
Some had falsely tested negative, but most had never been tested at all.
Although Gill and his colleagues can’t confirm that all of these people died of COVID-19, the results still stand in sharp contrast to official numbers.
So far, there have been fewer than 4,000 confirmed COVID-19 deaths in Zambia, a country of around 19 million people.
Separate findings published on 10 March suggest that Zambia’s ‘excess’ deaths — those above what would usually be expected — from 1 January 2020 to the end of 2021 exceeded 80,0003.
The Lusaka numbers mesh with statistics from South Africa, where a 2021 study found that only 4–6% of SARS-CoV-2 infections in two communities were officially documented4.
Further study of the same communities showed that 62% of study participants had been infected at least once from July 2020 to August 20215.
Co-author Cheryl Cohen, an epidemiologist at the University of the Witwatersrand in Johannesburg, South Africa, says that many of these infections were asymptomatic, but that people with symptoms might also have gone undetected because of the cost and difficulty of getting tested.
Gill suspects that a major reason for the gap between his results and official counts is that most people in Zambia who die of COVID-19 do so outside medical care.
Four out of five people tested in the study were never admitted to a hospital; the majority of unreported infections were in people living in Lusaka’s lowest-income neighbourhoods.
“Nobody’s vaccinated. Nobody has masks. Nobody has access to the medical care they need,” says Gill.
“We’re in a population that is already stressed and unhealthy, and then — bam! In comes COVID.”
Vast variation
But not everyone is convinced that the Lusaka findings invalidate the idea of the African paradox.
In Ethiopia, for instance, “our experience is people get infected with the virus, are asymptomatic or have mild symptoms, and recover”, says Amare Abera Tareke, a physiologist at Wollo University in Dessie.
“While it is difficult to ignore the current finding, we have to take it cautiously.”
Gill worries that the idea that Africa was spared the worst of the pandemic might have led people to take unnecessary risks or contributed to “the lack of urgency” in supplying African nations with vaccines.
“I suppose this could be unique to Lusaka,” he says, “But boy, you’d really have to try hard to explain why.”
All countries under reported COVID you d!cks, nobody new what the fvck the thing was.
Let’s move on to soccer.
The amount of corruption,outright lies , waste and abuse committed by PF regime is astounding.They truly were a rotten government of crooks.
Nostra you took the words from my mouth. I agree with you. The problem with upnd cadres is that they see politics in everything. Even when they sleep with their wlves they shout forward
The west always wanting to paint Africa black. Did China give you the correct numbers where the disease started from..
The government must just count the number of burial permits that have been issued by the local councils since the covid pandemic started.
Cause a physical visit to the local cemeteries including Chingwere and Memorial Park shows a very different picture.
Many people died in Zambia during this period and those covid figures are grossly understated,
CANT PEOPLE SUE PF FOR NEGLECT TO THE HEALTH FACILTIES
GOD WILLING WE’LL NEVER GET ANOTHER PF GOVERNMENT
We need to do basics like counting! Me thinks a limited-resourced country ought to count well to better spread its little resources…
This is a silly story. passed by an uncritical editor. You first start with “Around 90% of deceased people” bla bla bla and immediately follow with “Almost one-third of more than 1,000 bodies bla bla bla . Are those figures concomittant? One third isnt 90 percent. When you follow up with casting doubt over the African paradox just ask yourselves how many people are said to have died from covid 19 in Europe with its advanced medicines and the US. About six million. If covid had struck vaccineless Africa similarly countries like Zambia would at present have a population around 10 million. Botswana would be wiped out, Namibia with 1 million population would be gone.Under reporting doesnt halt the deaths. The paradox therefore remains. Just research on it and report concrete…
@Tikki with the way things are panning out we will have another PF government.
This we already knew even without doing any research seeing how our friends and relatives were dying every week.
This research is flawed in methodology. Being found positive retrospectively does no establish those people died of Covid. A person dies of cerebral malaria but incidentally has an inconsequential infection of COVID-19 and you want to add that to Covid deaths? That is forcing data to confirm a preconceived idea
I agree with some colleagues above, in the communities where we live, if the stuation was as bad as in other developed countries, with or without under reporting those cases, this was going to be felt friends. Remember our tradition of holding funerals, we would certainly mount tents throughout the streets. This is not to say we did not witness increase in deaths but not as was seen and reported in other countries. If the researcher wants to learn from our experience he really needs to be very objective and do more research to find out why cases in Africa were less severe.
What I fail to understand is how Mr Gill went to the morgue to examine the corpses in our own hospital. Speaking as an affected person I don’t see how the records can differ from the truth. Members of my family including myself were struck by the Covid19 with some being admitted to the Kitwe Teaching Hospital Covid19 center. We lost one member and the death certificate clearly states that the person died of SARS COV 2 which is Covid19. Anyway this world is about contradictions.
#12 Tara infact they say in communities where sick people mix a lot with healthy ones a resistance is developed in the immune system hence the perceived low reporting of Covid19 related deaths.
Funny thing is that the people blaming PF were among those accusing the PF of inflating figures so that they could get more money from donors. LT has got it all here. All you need is go to the archives.
When I was here stating this 2 years ago I was insulted …I wonder where that Germany blogger Neneh Cherry has disappeared to s/he was very gullible.
Razor – Can you imagine how it was in rural areas …mourners were ignorant as to the cause of death..it was wiping out communities people dying in their sleep ..those were the wasted Lazy Lungu Years!!
WE had a corrupt chap in the name of Chilufya and his girlfriend PS cooking the figures everyday !!
Iwe chi troll Kaizar Zero you politicize everything you hypocrite. Even your stinky PF govt lied about the cholera death toll of 2018.
Regardless of ‘under reporting’, thankfully, the fact is that relatively Africa has had lower Covid cases and deaths than most of the Western world. In my opinion this is due to; a younger population, more outdoor existence and an abundance of vitamin D from the perennial sunshine. The west has not admitted to the differences – in Europe they have a large population living longer but prone to more old age underlying illnesses. The hash winter already means more deaths for the elderly population (flu, pneumonia etc; ) Then add Covid. You have to analyse the relative context.
Poor researched paper, similar to the ” Kaingo! Kaingo!” whines…Did you visit all the provincial morgues and review their up-take two years before the Covid onslaught? Further more, your paper has not been peer-reviewed, why bring it to us? Go to sleep!
Gill and co! You tested ‘bodies’ in the mortuary … was this with consent of the relatives or you went ahead regardless… since it’s 2000-2021 ….? We have a basis for a lawsuit
Boza! The so-called Western can’t stomach the truth that Africa has not been as severely affected by Covid. So it those 1000 dead bodies come in Covid positive so what? What actually killed those individuals? Did they also check for malaria, TB or cholera? Some of rhose may have died from strokes, heart attacks or diabetes. Why can’t these guys just get over the fact that we beat this thing with simple methods?