Covid-19: Africa’s game-changing variants

By Olivier Marbot

Posted on Monday, 12 July 2021 18:46
A Ugandan doctor receives their first injection of the AstraZeneca vaccine at Mulago Hospital in Kampala on 10 March 2021. BADRU KATUMBA/AFP

Will Africa’s third coronavirus wave be its most deadly? Many people are beginning to fear that it will be, following the latest report on new cases and deaths as well as the list of countries that have seen a sharp rise in numbers.

“The rampant spread of more contagious variants is dramatically changing the nature of the threat to Africa,” World Health Organisation’s (WHO) Africa director Matshidiso Moeti said on 1 July, adding that the third wave is “unlike anything we have seen so far”.

The most recent development is that new variants are rapidly emerging. For 18 months now, scientists have been explaining how the virus is mutating and how new forms are appearing, sometimes with unprecedented characteristics.

All kinds of mutations

Not all mutations make the virus more dangerous, however, those that do – like the Delta version – often tend to overtake the others. Delta is more aggressive and with a transmissibility rate of 30 to 60% higher than other forms of Covid-19, it is highly contagious.

Two other variants have been identified on the continent but their severity has not yet been assessed. B.1.1.318 and B.1.620 were detected in January and February 2021 respectively.

For example, in Uganda – one of the African countries hardest hit by the current third wave – 66% of severe cases detected in people aged 45 and over are due to the Delta strain. According to the latest statistics, Delta accounted for 97% of positive tests in Uganda and 79% in the Democratic Republic of Congo (DRC).

It is on its way to becoming the majority form of the disease on the continent, with consequences that can already be seen: during the last week of June, there was a 25% increase in new cases and a 15% increase in mortality in 38 countries.

Labels like Alpha and Delta were only recently introduced after the WHO announced a new naming system for Covid-19 variants. Until the spring of 2021, new versions of the SARS-CoV-2 coronavirus were named according to the first country where they had been detected: for example, the South African variant and Breton variant.

Stigmatising names

The health authorities argued that these names were stigmatising. Therefore, at the end of May, WHO decided to rename all the variants using Greek letters: Alpha, Beta, Gamma, Delta, Eta, Kappa, Iota, Lambda and Theta; and the list is likely to grow.

Moreover, these different forms are classified into three distinct categories according to their level of seriousness: variants of concern (VOC), variants of interest (VOI) and variants under evaluation (VUM) – the most recently detected strains.

However, there is concern that new forms of Covid-19 that are resistant to the currently available vaccines may emerge. In an attempt to shed some light on this, here is a list of the main variants present on the continent to date, their characteristics as known at this stage and the countries in which they have already been detected.

The three most worrying variants

Alpha variant

  • Identified in September 2020 in the UK.
  • Currently detected in Morocco, Algeria, Tunisia, Libya, Egypt, Cabo Verde, Senegal, Gambia, Mauritania, Guinea-Bissau, Guinea, Liberia, Chad, Burkina Faso, Côte d’Ivoire, Ghana, Togo, Nigeria, Gabon, Cameroon, Republic of Congo, Central African Republic, DRC, Equatorial Guinea, Uganda, Rwanda, Ethiopia, Somalia, Kenya, Angola, Malawi, Madagascar and South Africa.
  • Known characteristics: 50-75% more contagious than the usual strains, affects children more easily but does not usually lead to severe forms of the disease.

Beta variant

  • Identified in August 2020 in South Africa.
  • Currently detected in Tunisia, Libya, Senegal, Guinea Bissau, Côte d’Ivoire, Ghana, Togo, Republic of Congo, Equatorial Guinea, Gabon, DRC, Uganda, Kenya, Rwanda, Tanzania, Angola, Malawi, Mozambique, Zambia, Zimbabwe, Namibia, Botswana, South Africa, Lesotho, Eswatini, Madagascar and Comoros.
  • Known characteristics: spreads more rapidly than the usual strains and settles more easily within the body, affects young people more frequently without necessarily causing symptoms but sometimes exhibits more severe forms of the disease and higher risk of re-infection.

Delta variant

  • Identified in October 2020 in India.
  • Currently detected in Morocco, Algeria, Tunisia, Mauritania, Gambia, Ghana, Nigeria, Gabon, DRC, Uganda, Kenya, Angola, Zambia, Zimbabwe, Botswana, South Africa and Mauritius.
  • Known characteristics: this variant has mutated and is now more resistant to antibodies, more contagious and causes new symptoms such as nose bleeding. It was classified as worrying by the WHO in May 2021 and seems to generate more serious forms of the disease.

New forms that are causing concern

Eta variant

  • Identified in December 2020 in the UK and Nigeria.
  • Currently detected in Nigeria, Gabon, Cameroon, Angola, Uganda and Tanzania.
  • Known characteristics: To date, little data is available for this variant, which was also detected in the US and Europe. Like other VOC, it modifies the spike protein, which plays an important role in allowing the virus to contaminate cells and is thus cause for concern.

Variant B.1.1.207

  • Identified in August 2020 in Nigeria.
  • Little data at this stage. This variant is only present in a small number of positive cases. IT is being monitored by the health authorities.

Two other variants – B.1.1.318 and B.1.620 – have been identified on the continent but their severity has not yet been assessed. They were detected in January and February 2021 respectively.

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