Niger is the country that Covid-19 has forgotten

NIAMEY, Niger – The main coronavirus ward of this desert capital has been empty for several months, and rapidly constructed isolation facilities are gathering dust. Masks are almost unheard of on the streets, and many days go by without a single person testing positive for Covid-19. There is so little demand for vaccines that the government has sent thousands of doses abroad.

Welcome to Niger, the land that coronavirus somehow forgot.

This vast West African nation – home to one of the world’s highest birth and poverty rates – was once identified by the World Health Organization as one of the most vulnerable to the coronavirus outbreak on a continent that the United Nations predicted would kill millions . Over a year later, many other countries across Africa are in the third wave of the pandemic, with new varieties sending infections to record levels.

But while Niger is struggling with a number of economic and security challenges, it is among a small group of nations on the southern edge of the Sahara that have so far largely avoided the coronavirus plague. The causes – which appear to include a hot and dry climate, sparsely populated and poorly connected settlements and the world’s youngest population – have made Niger a crucial case study for virologists studying the development of Covid-19, experts say.

Niger is among a small group of nations on the southern edge of the Sahara that have mostly escaped coronavirus.

There are few signs of the pandemic in Niamey, the desert capital of the Niger River.

Doctors say the proliferation of the highly transmissible Delta variant and the reopening of national borders in recent weeks still pose a threat to the largely unvaccinated country and its health system. But in Niamey, the quiet capital of the Niger River, there are few signs of a pandemic raging in many other countries across the continent.

At Le Pilier, a restaurant popular with wealthy locals and expatriates, Italian owner Vittorio Gioni says weekends are full and he brings home the same daily things as two years ago. The business dived in the spring of 2020, when the country’s air borders were closed, but recovered quickly. One of his regulars is Sani Issoufou, the oil minister: “Here we still live as it is 2019,” he says with a smile.

As of mid-June, Niger, a country twice the size of Texas with a population slightly larger than New York State, 24 million, has only confirmed 194 deaths and about 5,500 Covid cases since its first case was registered in March. 2020. These are fewer than the small Italian enclave of San Marino, population 34,000.

Niger was once identified by the World Health Organization as one of the countries most vulnerable to coronavirus outbreaks.


Photo:

Isma’l Mahamadou Laouali for The Wall Street Journal

“We expected to be overwhelmed by cases, but it never happened,” said Adamou Foumakoye Gado, anesthesiologist who heads the country’s largest Covid-19 intensive care unit.

“The virus has had a very short life here,” he says, walking the empty corridors of his 70-bed ward at Niamey’s newly renovated General Reference Hospital. Without intensive care patients at his facility since April, Mr. Gado to work on the more serious effects of malaria. “Now it’s me who’s being shot!”

At the end of May, Niger even took the unusual step of lending 100,000 AstraZeneca vaccines to the Ivory Coast, another West African country with roughly the same population – but four times smaller geographically and with 10 times more cases. Niger has prioritized vaccination of key workers and only a small part of the population has had the vaccine.

There have been no intensive care units in the Covid-19 ward at Niamey’s recently renovated General Reference Hospital since April.

Many days go by without a single person in Niger testing positive for coronavirus.

Meanwhile, several days often pass at Niamey’s main test center without anyone testing positive. Four large tents set up to isolate patients at the onset of the pandemic are now home to a pair of muddy rubber boots and some plastic buckets.

Niger’s apparent escape from the worst of the pandemic is in striking contrast to many parts of the African continent, where the WHO has warned that infections are on track to surpass their previous peak in January. In Uganda, located near the equator, hospitals have been so overwhelmed by new Covid-19 cases in recent weeks that the sick are dying while waiting for a bed.

Since the virus first appeared in Africa in early 2020, infection rates have been low in the Sahel – a 3,000-mile semi-arid area on the south bank of the Sahara that also includes Burkina Faso, Mali and Chad. Throughout the duration of the pandemic, the Covid-positive results in Niger averaged 4.5% for a total of approx. 125,000 cotton swabs compared to countries with similar test levels per Population, Afghanistan and Madagascar with 16% and 30%.

The country’s low infection rates have sparked interest from epidemiologists and WHO officials, who have concluded that Niger is one of the world’s most hostile environments for Covid-19. Sahel’s crushing heat and dry climate is one of the least hospitable on the planet.

“The climate is very harmful for the survival of the virus in the body,” says Dr. Gado. “There is a silver lining to our misfortune.”

Niger has the youngest population in the world with half of its citizens under 15 years of age.

Academic research shows high levels of sun exposure and heat greatly reduce the risk of contamination from the virus, both through airborne particles and surface exposure.

A simulation on the US Department of Health website using median ultraviolet exposure, temperature and humidity to compare New York with Niamey shows the virus’ transmission half twice as fast under the climatic conditions of the Nigerian capital.

In addition to the climate, Niger also has the youngest population in the world – half of its citizens are under the age of 15 – and most of its citizens live in isolated settlements, another barrier to the disease.

“Niger has long used large pastoralist communities outdoors in good ventilation, which also plays a significant role in reducing transmission,” said Osman Dar, a global health systems expert at Chatham House, a British think tank.

Experts say politics also played a role: Authorities locked down, banned common prayer in mosques and closed borders in March 2020, five months before nations like Britain began restricting international travel.

“We killed a fly with a hammer,” said President Mohamed Bazoum, then interior minister. “Coronavirus arrived, but it never succeeded.”

Covid-19 is just the latest plague to arrive in a region that is in crisis: An Islamist uprising has killed over 8,000 and displaced one million, global warming is depleting precious agricultural resources, and many locals are dying prematurely from other infectious diseases.

In March, jihadists killed 137 villagers in southwestern Niger, the deadliest of suspected jihadists in the country’s history. In June, terrorists also massacred 160 people in nearby Burkina Faso – as many as recorded Covid-19 deaths in the country during the whole pandemic.

Most of the citizens of Niger live in isolated settlements. Above an ice cream supplier in Kombo.

While Niger has largely avoided the epidemiological impact of the virus, its economy has been destroyed. The number of people in extreme poverty – already almost half of the population – increased by 400,000 as a result of Covid-19 restrictions in 2020, the World Bank estimates. On the streets of the capital, the number of people begging for extra replacement or leftover food has increased since last year, local officials say.

Taxi driver Moussa Soumoula is less worried about getting a vaccine than where his next fare comes from.

“Out of 300 people in my neighborhood, only one tested positive,” he says. His biggest headache is covering $ 200 in arrears for his children’s school fees after the government imposed restrictions on the number of passengers he can accept for each trip.

The lockdown crunch has captured some of the country’s biggest celebrities. Local rock star Omara “Bombino” Moctar, who in 2019 spent nine months on tour venues from London to New York, is now scraping a living choking after a dozen guests in a private garden.

“Covid never really reached Niger,” he says. “But we still feel like we’re living in a hole.”

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