Saturday, 20 March 2021

COVID-19: Sub-Saharan Africa Report, Omnibus Edition

This is the fourth of my “omnibus” reports on the statistics of the COVID virus. Today, it’s the turn of sub-Saharan Africa. This is an area in which COVID doesn’t seem to get much coverage; perhaps because the virus has not been spreading there as effectively as in Europe or the Americas, or even the Middle East.

With North Africa having already been included in my Middle Eastern review, I divided the area into four regions: West Africa, Central Africa, East Africa and Southern Africa. As these are, geographically, extremely disparate regions, I decided to return this time to my original presentation approach. That is, I’ll look at each of the regions separately, then bring the four together for the final few scatterplots.

Here is the list of 44 countries:

West Africa

Central Africa

East Africa

Southern Afruca

Benin

Cameroon

Burundi

Angola

Burkina Faso

Central African Republic

Comoros

Botswana

Cape Verde

Congo

Djibouti

Eswatini

Cote d’Ivoire

Democratic Republic of Congo

Eritrea

Lesotho

Gambia

Equatorial Guinea

Ethiopia

Madagascar

Ghana

Gabon

Kenya

Mauritius

Guinea

Sao Tome and Principe

Malawi

Mozambique

Guinea-Bissau

South Sudan

Rwanda

Namibia

Liberia

 

Seychelles

South Africa

Nigeria

 

Somalia

Zambia

Senegal

 

Tanzania

Zimbabwe

Sierra Leone

 

Uganda

 

Togo

 

 

 

Once again, the data sources are (for epidemic data) Our World in Data and (for lockdown regulations) the Blavatnik School of Government, both at Oxford University. The data I used included figures up to and including March 14th.

West Africa

Here’s the bar chart of the United Nations HDI (Human Development Index) ratings for West Africa:

At an average of 52, that’s generally lower than North Africa. And considerably lower than any of the other regions I have looked at.

Now here are the Freedom House ratings:

In both indices, Cape Verde and Ghana are well ahead of the rest. It’s worth pointing out that Cape Verde is an island well off the mainland, so is likely to be different in kind from many of the other countries I group it with.

So, to cases. Here is the spaghetti graph of daily cases per million (weekly averaged):

That suggests there’s not much correlation between the different countries in this region. Perhaps because there isn’t much international travel between them?

Cape Verde has been hit far harder than anyone else – not surprising, as it still has close ties to Portugal – with Guinea a clear second. But even Cape Verde hasn’t quite reached the Blavatnik School of Government’s (and so, I presume, the WHO’s) “endemic” threshold of 200 new cases per million per day. And except for Cape Verde, total cases per million are orders of magnitude lower than in Europe. The region as a whole seems to have got off relatively lightly from the virus. So far, at least.

Here are the reproduction rates:

The R-rates are all over the place. But many of them have been below 1, or even well below 1, for a substantial fraction of the time.

Here are the lockdown stringencies:

Again, a very wide variation. But there has been a general tendency, after the initial very severe reaction, for the stringencies to decrease with time. As you would expect in a region that has so far suffered only relatively lightly from the virus.

Testing levels are way lower than in any of the other places I’ve looked at before:

But the cases per test figures aren’t as high as I had expected:

It looks as if, in most of these countries, the virus just hasn’t spread very well. Maybe it doesn’t much like the hot and humid conditions that are normal in West Africa?

There’s no data on hospitalizations in this region, so I’ll skip to deaths:

These are all orders of magnitude below European death rates – even in Cape Verde. And here are the deaths per case:

Apart from the first three, even those who get the virus seem to be fighting it off better than in most European countries. Combine that with low transmission rates, and I reckon that the West Africans have done better against the virus than anyone else I’ve looked at so far.

Only three countries in this region – Ghana, Senegal and Cote d’Ivoire – have reported any vaccination data at all. And even Ghana has vaccinated less than 1% of its population.

Central Africa

Passing eastwards, to Central Africa. Here are the UN HDI ratings:

And the Freedom House ratings:

Ouch! South Sudan is one of two countries in the world with a lower Freedom House rating than North Korea. Sao Tome and Principe, on the other hand, towers above the rest. Like Cape Verde, it is an island country off the African mainland, and it has close ties with Portugal. And it’s in an oil-rich region, too.

So, let’s look at the cases per million:

Like West Africa, there isn’t much if any correlation between different countries. And no-one has reached the “endemic” threshold, even though Sao Tome, Equatorial Guinea and Gabon have all made two attempts. Here are the total cases per million:

Gabon and Equatorial Guinea, like Sao Tome, are oil-producing countries. This may well have something to do with their relatively high cases per million, compared to West Africa.

Here are the R-rates and the lockdown stringencies:


A similar picture to West Africa, although South Sudan’s recent high level of lockdown stands out against the trend of relaxation elsewhere.

The only country in the region supplying any data at all on testing is South Sudan, and they have tested only just over 1% of the population.

Here are the deaths per million:


Those cumulative deaths per case are generally better even than West Africa. Why so? Heat and humidity? Native medicine practices? Poor reporting? Inquiring minds want to know.

There is no vaccination data at all for this region yet. So, we’re on to…

East Africa

Here are the UN HDI ratings:

These ratings are pulled upwards, in comparison to the previous two groups, by the Seychelles. Somalia does not appear to have a rating at all.

Here are the Freedom House ratings:

Eritrea is the other country, like South Sudan, with a Freedom House rating lower than North Korea.

Here are the cases per million:

Well, there you see it. Apart from a couple of early outbreaks in Djibouti and one in the Seychelles, all of which were quelled, the whole region had the virus basically under control until, right after Christmas, cases took off in the Seychelles. Which now has cases per million comparable with the less badly affected countries in Europe. That’s concerning in the sense that, although a country may have contained the virus well for many months, once it gets going it can still grow fast.

The R-rates show nothing of interest, while the lockdown stringencies show a wider spread than any other region I’ve looked at so far:

The average lockdown stringencies make for an interesting comparison:

Given that it has reported a total of only 3038 cases and 7 deaths in a population of three and a half million, I think that Freedom House have their rating of Eritrea right! Tanzania and Burundi, by contrast, seem to be taking a relatively relaxed attitude. And while the Seychelles did lock down to 80% in January, they are already relaxing the restrictions.

This is in contrast to the UK, where we have been at 86% lockdown or worse continuously for two and a half months. And what some might consider non-essentials – like getting your beard trimmed, getting your watchstrap repaired or buying new underpants – have been arbitrarily deemed “illegal” for months at a time. By which time, they are essentials! Sigh.

To return to reality. The only country in the East Africa region that has done significant testing is Rwanda.

As to deaths per million, the Comoros and the Seychelles predominate. Both are small island communities, vulnerable to a relatively small-scale outbreak. But their deaths per million are orders of magnitude smaller than in Europe.


But when it comes to vaccinations, the Seychelles really stand out. They have fully vaccinated 27% of the population, and part vaccinated another 30% or more. It’s unfortunate that their lockdown level has been rapidly changing during the period in which they have been rolling out the vaccinations, so I can’t even try to assess the efficacy of the vaccines there. In the rest of the region, Rwanda and Kenya have made a start on vaccinations, but no-one else has reported any vaccinations at all.

Southern Africa

Lastly for this missive, to Southern Africa. Here are the UN HDI ratings:

These are generally higher than in the rest of Africa. The last four countries, in particular, pull up the regional ratings.

And here are the Freedom House ratings:

It’s the same four which top the list here, too.

So, let’s look at the cases per million:

At last, we have an African country – South Africa – which has exceeded 200 new cases per million per day. Eswatini briefly, and recently Botswana, have just about got there too.

Here are the total cases per million:

Of the four highest countries in the ratings, three – South Africa, Namibia and Botswana – are at the top. While the fourth, Mauritius, is at the bottom; probably reflecting its island status. Mauritius seems (so far) to have been lucky, where the Seychelles were not.

Here are the R-rates and the lockdown stringencies:


It’s obvious that the R-rate in Mauritius has started to rise, so we can probably expect some more lockdowns there in the fairly near future. But discounting the lowest threads on the R-rate graph, there is a surprising resemblance to European patterns, though the peaks are lower. And since this region is in the Southern Hemisphere, the resemblance suggests that the virus may not be as seasonal as some think.

There is a bit more testing going on here than in other parts of Africa, but testing levels are generally a lot lower than in Europe:

Here are the deaths per million:

Eswatini is all but surrounded by South Africa, which may explain its relatively high death toll. These two are approaching the middle of the European range in deaths per million.

Here are the deaths per case:

The cumulative deaths per case figures in East and Southern Africa are worse than those in West and Central Africa. As are the cases per million on the mainland, excepting the oil producing areas. This suggests, maybe, that the heat and humidity of the equatorial lowlands do give some level of protection against dying from the virus. If not also against catching it in the first place.

As to vaccinations, Mauritius, Zimbabwe, South Africa and Angola have made starts. But their progress is, as yet, minimal.

Scatterplots

Now for some scatterplots referring to Sub-Saharan Africa as a whole.

The correlation of hospital bed provision with human development index is clear:

The lack of relation between cases per million and population density is, surprisingly, rather similar to the situation in Europe:

The correlation between cases per million and human development index is comparable with the Americas:

And the expected negative correlation between Freedom House rating and average lockdown stringency is there, too:

To sum up

Despite low levels of testing, West and Central Africa have done pretty well in containing the virus so far, in comparison to Europe, the Americas and even the Middle East. Cases per million are well lower, and deaths per case are comparable with, or a bit lower than, Europe. What could have caused this? Is it that African health care systems are better than European and American ones? Or, otherwise put, that European and American health care systems, despite all the money sloshing into them, fail to do their job properly? Or is it some external factor, like high heat and humidity, lessening both the virus’s reproduction and its fatality?

East and, particularly, Southern Africa are not doing as well against the virus as West and Central Africa. But the Seychelles stands out as somewhere that is taking vaccination seriously. And the variability in lockdown levels in East Africa, in particular, is amazing.

…and a wider view

Now, what have I found, from my COVID observations of the world so far? There seems to be a signal that countries with higher levels of “human development” (whatever that means) tend to be more vulnerable to the virus than those at lower levels. Oil producing countries, which presumably have more contact with Westerners than their development index would lead you to expect, also seem to be more vulnerable.

The cynic in me ponders that this virus, if it was designed (an open question), might have been designed to “even up” economic inequalities between countries. Not by bringing the lowest up towards the level of the highest; but by hitting the highest so hard, that they are dragged down into the mire of poverty with the rest. Such an attitude does, indeed, accord with the tenets of communism. But far more, it accords with the desire of the international political-corporate √©lites (and their national yes-men and -women) for world-wide hegemony. And with the “lock ’em down and make it hurt” fever, that has gripped those national yes-men, including Boris Johnson, for more than a year now.

Next up, Asia. That should be interesting.


Saturday, 13 March 2021

COVID-19: Middle East and North Africa Report, Omnibus Edition

This is the third of my “omnibus” reports on the statistics of the COVID virus. Today, I’m going to tackle the Middle East and North Africa; in essence, the Arab and Muslim world, excluding the former Soviet republics, and Muslim countries in South-East Asia.

There is also some news to report on the vaccinations front. One country, Israel, has already vaccinated more than 40% of its population. With both jabs! And the results appear, at first sight, encouraging.

I divided the area into three regions. Middle East (North) is a long strip of land, running from Turkey, via Syria and Lebanon, to Pakistan and Afghanistan. I included Armenia in this group too, because of its close relationship with its neighbour Iran. Middle East (South) comprises Saudi Arabia, the Gulf states, Jordan, Israel and Palestine. And North Africa covers the African countries north of, and including, the Sahara Desert. I excluded Burkina Faso, preferring to put it with its West African neighbours.

Here is the list of 28 countries:

Middle East (North)

Middle East (South)

North Africa

Afghanistan

Bahrain

Algeria

Armenia

Israel

Chad

Iran

Jordan

Egypt

Iraq

Kuwait

Libya

Lebanon

Oman

Mali

Pakistan

Palestine

Mauritania

Syria

Qatar

Morocco

Turkey

Saudi Arabia

Niger

 

UAE

Sudan

 

Yemen

Tunisia

Once again, the data sources are (for epidemic data) Our World in Data and (for lockdown regulations) the Blavatnik School of Government, both at Oxford University. The data I used included figures up to and including March 7th.

In this edition, I have added three new scatterplots. These show cases per million, deaths per million and deaths per case, plotted against average lockdown stringency. As these plots for Europe and the Americas will be of interest too, I’ll include those at the end of each section.

The countries

Here are bar charts of the United Nations HDI (Human Development Index) ratings for the countries in each of the three groups.



These three groups of countries look to be at different development levels from the UN’s point of view. Except for Yemen which is a war zone, the southern Middle Eastern countries tend to be at a higher development level than the rest. The Middle East (North) group are at a somewhat lower development level; and North Africa, in general, lower still.

Here are the corresponding Freedom House ratings. According to Wikipedia, the rating “measures the degree of civil liberties and political rights in every nation and significant related and disputed territories around the world.” Like the HDI rating, it is a percentage:



It’s worth pointing out that Syria has a rating of zero, while Palestine doesn’t get a rating at all. And that, except for Israel and Tunisia, this is not a very free part of the world!

I’m not going to bother with population densities, as neither Europe nor the Americas showed any kind of correlation between national population density and the course of the virus. So, I’ll go straight to…

Cases

Here are the spaghetti graphs of daily cases per million (weekly averaged) for each of the three groups:



So far, the only countries in the area to have breached the WHO’s 200 cases per million per day “endemic” threshold are Armenia, Lebanon, Qatar, Israel and Tunisia. All towards the top of their regions in the UN rating.

Now for a scatterplot of cumulative cases per million against HDI rating:

The slope of the straight trend line here is comparable with the slope for the Americas, and very much greater than in Europe. Looking at this particular graph, it’s even possible that a power function might have been a better fit than a straight line. So, I added such a line:

Well, maybe that’s a bit close to torturing the data until it confesses! But it does make the point that the more developed countries get many, many more cases per million.

Lastly for cases, here is a list of all the countries, ordered by cumulative cases per million:

The penetrations of the virus in terms of cases per million in the top five countries in this region – Israel, Bahrain, Armenia, Lebanon and Qatar – are comparable with the levels in countries such as the UK, USA and Belgium. So, they are some of the highest among major countries in the world. North Africa, on the other hand, does not seem to have been hit as hard by the virus yet as the Middle East. That may, in the longer term, be bad news for them.

Case Growth and Lockdowns

As was the case with the Americas, the weekly case growth graphs don’t show anything of great interest. So, I’ll skip them, and go for the R-rates instead.



In the north Middle East, apart from Turkey which goes all over the place, there seems to be a general downward trend in the reproduction rates. In the south Middle East, it is Yemen which goes all over the place; probably because, due to their situation, they are not spending as much effort on finding COVID cases as the other countries. (But unlike Nicaragua, I have no reason to suspect that they are doing anything less than their best in how they report the figures). And in North Africa there is again a general downward trend. Niger is set apart by its high degree of humps and troughs; probably because, like Yemen but presumably for far more enviable reasons, it has found relatively few cases per million of population.

I’ll skip the individual lockdown stringency graphs, as they too are all over the place. So, here’s the list of average lockdown stringencies:

Libya is not a good place to be right now. In contrast, Niger seems to have been doing pretty well; few cases, and a generally low lockdown level. Afghanistan also stands out.

Let’s see what happens if we plot average lockdown stringency against Freedom House rating:

No real trend up or down there. But now, let’s have a look at the first new plot, of cases per million against average lockdown stringency:

Who’d a’ thought it? The more cases per million, the harder they lock down. Or could it be, the cynic inside me asks, that harsher lockdowns tend to lead to more cases per million?

Ah, but I can apply this new plot to Europe and the Americas, too. Here they are:


In the Americas, there’s a positive correlation between cases per million and lockdowns, but it is less strong than in the Middle East and North Africa. But in Europe, the correlation all but disappears. This suggests, to the cynic in me, that many European governments have been treating the whole epidemic rather like a game of “copycat” or “follow-my-leader.” At best, they have been reacting to shortages of hospital beds or intensive care beds.

Tests

Only about half the countries in the Middle East and North Africa are reporting any testing data at all. Here is the list of countries, with total tests per hundred thousand:

The top three, the UAE, Bahrain and Israel, have already done more than 150% as many tests as their total populations. As to how effective the tests have been, here’s the list of countries with the cumulative percentages of cases per test:

This suggests that Armenia and Iran, at least, are under-resourced with test kits. And the three countries which have done most tests per head of population, have three of the four lowest rates of cases per test.

Hospitalizations

The only country in the entire Middle East and North Africa area, which is reporting any data at all on COVID hospitalizations, is Israel:

This shows that they have had a three-peak epidemic, with each peak bigger than the last. The peak in the number of hospital beds occupied by COVID patients was 4.5% of capacity. No sweat at all, in comparison to countries like Spain, Portugal, Italy, the UK and the USA.

Deaths

Total deaths per million in each region are as follows:



Here’s the league table of deaths per million:

While these are mostly low in comparison to European figures, it is concerning that some countries, like Iran, have both low cases per million and relatively high deaths per million; and the virus still shows no sign of abating there. So, there may be far more deaths to come in this part of the world.

Here’s the plot of deaths per million against HDI rating:

Just for fun, I’ve added an exponential trend line to this one!

Now for the second new plot, of deaths per million versus average lockdown stringency:

Well, whaddayaknow? The tighter the lockdown, the more the deaths per million! (Or vice versa, of course).

Let’s compare this with the Europe and Americas equivalents. (I’ve removed Nicaragua from the Americas graph, because its figures are unreliable).


Looks much of a muchness to me; the trend lines all point roughly the same way. Maybe the politicians are using deaths per million, rather than cases per million, in deciding when to lock down?

Now for cumulative deaths per case. As I’ve said before, if there is one COVID metric on which to judge a country’s health care system, this one is it. High means bad.

Yemen, obviously, has problems that are not under the control of its medical people. Syria, Sudan and Egypt are high compared with Europe and most of the Americas; comparable with Ecuador, but far less bad than Mexico’s 9%. It’s interesting to see Kuwait, Bahrain, the UAE and Qatar all together at the bottom; they must be doing something right! And Israel is just one place above them.

Let’s now look at the third new plot, deaths per case versus average lockdown stringency.

As the average lockdown stringency goes up, the deaths per case go down. Or, as the deaths per case go up, the lockdown stringency goes down. That seems a bit strange. But maybe that outlier in the top left-hand corner, Yemen, is biasing the real trend? Let’s take it out:

Cherry-picking? Moi? Encore? But seriously: Still a downward trend, but far smaller than before. I suspect it may be because those countries with poor testing capability are having a lot of infections which never get reported as cases. So, they aren’t locking down until the cases figures tell them to, as prompted by the UN’s WHO.

Now let’s look at the graphs for Europe and the Americas (minus Nicaragua):


Hel-lo! The trend in Europe is upwards! Suggesting that the countries with the worst health care systems (and we all know which ones they are) feel more need to lock down hard than the others. Or, maybe, those countries where the political class have a yen to lock people down for the sake of locking them down (and the UK is certainly one), also have the worst health care systems? Both believable inferences.

Again, a positive trend; but a much smaller one this time. It will be most interesting to see, when the epidemic has been beaten and the dust has settled, whether those countries which failed to detect early cases, so did not lock down too hard, may not end up with less deaths per million from the virus that those that put their people through the lockdown wringer?

Vaccinations

Since not many of these countries are yet reporting any vaccination data, I’ll start with the totals of people vaccinated and fully vaccinated up to March 7th:


Look at those Israelis go! More than 40% of the population fully vaccinated! The UAE is in second place, with about 22%. Both have another 10% and more who have had one vaccination. If anywhere in the world is going to show positive effects from the vaccine already, it will be these two countries. The UK had the opportunity to beat them both, but due to the stupid twelve-week gap between jabs policy, failed to do so. Sigh.

Here’s the fully-vaccinated data for the Middle East (South) region:

That means, assuming the second jab takes two weeks or so to become effective, we can’t use the UAE as a test bed yet. Israel, on the other hand, we can try. As time is of the essence in this matter, I have updated the Israeli data to the very latest at the time of writing (March 12th.) Here is the graph of daily cases and deaths (weekly averaged) for Israel so far:

And here’s the graph of weekly case growth, R-rate and lockdown stringency:

They have done some significant unlocks in February, but the R-rate has stayed below 1. And, although the weekly case growth did go positive around the middle of February, it has since gone negative again. Of course, it’s possible that they were already so close to the herd immunity threshold that vaccinating 40% of the population, or even less, pushed them over it. Time will tell, when the results from other countries roll in.

Anyway, let’s go to the Blavatnik data, and find out what the Israelis did. I’ll take the history forward from the start of the second phase of lockdowns, at the beginning of November.

Date

Stringency

Measures

20201104

65.74

Events: Mandatory cancelled

Stay at home: Required with exceptions (Regional)

Travel: Mandatory restrictions (Regional)

International: Ban some arrivals

Testing: Open

20201215

71.3

Public transport: Recommended closed

Face covering: Required when with others

20201222

74.07

International: Ban all arrivals/border closure

20201227

82.41

Workplaces: Mandatory closed

Stay at home: Required with exceptions

Travel: Mandatory restrictions

20210107

85.19

Gatherings: Up to <=10

20210131

87.04

Schools: Some closed

20210207

64.81

Workplaces: Some closed

Stay at home: No measures

Travel: No restrictions

20210211

62.96

Schools: Some closed (Regional)

20210221

57.41

Events: Recommended cancelled

20210225

73.15

Workplaces: Mandatory closed (Regional)

Stay at home: Required with exceptions (Regional)

Travel: Mandatory restrictions (Regional)

20210228

57.41

Workplaces: Some closed

Stay at home: No measures

Travel: No restrictions

20210307

54.63

Gatherings: Up to 11-100

            

Apart from the regional excursion near the end of February, that looks like a moderately impressive set of unlocks. The R-rate has stayed under 1 throughout, and after the wobble, cases are dropping again. They still have the following measures in place, though: Schools: Some closed (Regional). Workplaces: Some closed. Events: Recommended cancelled. Gatherings: Up to 11-100. Public transport: Recommended closed. International: Ban all arrivals/border closure. Public info: Co-ordinated. Testing: Open. Contact tracing: Comprehensive. Face covering: Required when with others.

In particular, they still need to re-open all workplaces, including bars and restaurants. And to get rid of face coverings. And further, to re-open the borders; which may prove a harder task.

So, to sum up: The immediate effects of the Israeli vaccinations look encouraging. But the fat lady has not yet picked up her microphone.