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"Since mortality rates are generally higher in older people, it could be assumed that a younger African population distribution will lessen the death rate of COVID-19 on the continent. However, it is too early to predict the death rate as Africa is at the ascending phase of the epidemic curve. Furthermore, the high prevalence of HIV, tuberculosis, hypertension, and diabetes, coupled with weak health-care systems in Africa, might lead to high mortality rates among comorbid populations. Indeed, Egypt (3659 cases with 276 deaths; Casualty Fatality Rates (CFR) (7·5%) and Democratic Republic of the Congo (359 cases with 25 deaths; CFR 6·9%) have reported much higher CFRs than South Africa and Senegal.

Some of the interventions applicable in N. America, Europe and Asia may not be applicable in Africa. "First, the benefits of physical distancing could be substantially smaller in low-income countries due to the smaller proportions of older people and because, although physical distancing and lockdowns flatten the epidemic curve and reduce pressure on health systems, this effect is less apparent in countries with already overwhelmed and weak health-care systems. Second, the economic value in terms of lives saved by physical distancing policies is likely to be much higher in high-income countries than countries in which these policies have more detrimental effects on incomes. Although physical distancing slows the transmission of the virus, it exacts a heavy toll on the informal economic and casual labour sector. In search of income for the day-to-day livelihood of extended families, many Africans could be forced to ignore concerns about contracting COVID-19 and fend for their survival."

The above quotes are from Limiting the spread of COVID-19 in Africa: one size mitigation strategies do not fit all countries,  the Lancet, April 28. 

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