Only eight African countries register their deaths. This simple fact would be enough to understand that the situation in Africa can become explosive.
COVID monitoring practically does not exist, except in Egypt, South Africa, Tunisia, Algeria, Cape Verde, São Tomé and Príncipe, Seychelles and Mauritius. There are mandatory and universal civil registration systems (CRVS systems) that record deaths. Other countries have paper-based systems used for some local services. In fact, it is chaos.
Impossible in Africa to calculate "excess deaths"
African medical and health systems are in constant trouble: a dramatic situation, which also causes high infant and maternal mortality. Diseases are often not diagnosed or treated. This can be true, and indeed it is true, even more so for the coronavirus.
In Africa there are likely to be indirect COVID deaths and COVID deaths being lost. The pandemic can overload health systems, fear of going to hospital and an economic downturn.
A Lancet study conducted in 118 low- and middle-income countries estimated that the continued disruption of health systems from Covid-19 could result 1.157.000 additional infant deaths and 56.700 additional maternal deaths.
The estimates are worrying
South Africa alone, to get a measure of the situation, has recorded almost 138.000 excess deaths since the start of the pandemic, almost three times the official figure provided for deaths from Covid-19. If Covid affects other countries in Africa in the same way it affects South Africa, there are over 1 million COVID deaths and 3 million indirect deaths caused by the impact of COVID on health systems.
A more conservative estimate of uncounted COVID deaths in Africa is 0,5 million. The Lancet estimate of high infant and maternal mortality combined with missing COVID and other indirect deaths establishes an alternative estimate of 1,5 million indirect deaths in Africa.