‘Zambia under-reported Covid deaths’

Lusaka. — Around 90 percent 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.

The findings have not yet been peer-reviewed.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.

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 percent overall — and reached around 90 percent during the peak of the waves caused by the Beta and Delta variants.

Moreover, only 10 percent 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 March 10 suggest that Zambia’s “excess” deaths — those above what would usually be expected — from January 1, 2020, to the end of 2021 exceeded 80 000.

The Lusaka numbers mesh with statistics from South Africa, where a 2021 study found that only 4–6 percent of SARS-CoV-2 infections in two communities were officially documented.

Further study of the same communities showed that 62 percent of study participants had been infected at least once from July 2020 to August 2021.

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.”

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.” — Times of Lusaka.