In Africa, lack of coronavirus data raises fears of 'silent epidemic'


UNDERSTANDING COVID-19

In Africa, a lack of data raises fears of ‘silent epidemic’

Africa could face a “silent epidemic” if its leaders do not prioritize testing for the new coronavirus, the World Health Organization (WHO) has said. Just over 420 tests per 100,000 people have been carried out across the continent of 1.3 billion, a Reuters analysis found.

Testing rates

vary widely across Africa

Tanzania has not published nationwide figures since May 8, when it had recorded 509 cases and 21 deaths.

Tests per million

No data

0

1K

10K

100K

Tunisia

Morocco

Algeria

Lybia

Egypt

Mauritania

Sudan

Mali

Niger

Chad

Nigeria

Ghana

Ethiopia

CAR

In West Africa, Ghana’s testing is unrivalled. There are over 21,000 confirmed cases from more than 313,000 tests. Three countries to the north, which are battling Islamists militants, have carried out 31,000 tests between them.

DRC

Tanzania

Zambia

Madagascar

Botswana

South

Africa

South Africa, home to nearly 60 million people, has carried out 1.9 million tests, by far the most on the continent. It accounts for over 40% of Africa’s cases.

It took three months before Democratic Republic of Congo was able to process tests outside the capital Kinshasa. In many areas, it still takes two weeks to get results.

Source: United Nations, Africa Centres for Disease Control and Prevention

Testing rates

vary widely across Africa

Tests per million

No data

Tunisia

0

1K

10K

100K

Morocco

Algeria

Lybia

Egypt

Mauritania

Sudan

Mali

Niger

Chad

Tanzania has not published nationwide figures since May 8, when it had recorded 509 cases and 21 deaths.

Senegal

B.Faso

Nigeria

Somalia

Ethiopia

Ghana

South Sudan

CAR

Cameroon

Uganda

In West Africa, Ghana’s testing is unrivalled. There are over 21,000 confirmed cases from more than 313,000 tests. Three countries to the north, which are battling Islamists militants, have carried out 31,000 tests between them.

Kenya

DRC

Tanzania

Angola

Mozambique

Zambia

Madagascar

Zimbabwe

Namibia

Botswana

It took three months before Democratic Republic of Congo was able to process tests outside the capital Kinshasa. In many areas, it still takes two weeks to get results.

South Africa, home to nearly 60 million people, has carried out 1.9 million tests, by far the most on the continent. It accounts for over 40% of Africa’s cases.

South

Africa

Source: United Nations, Africa Centres for Disease Control and Prevention

Tests per million

No data

Testing rates

vary widely across Africa

Tunisia

0

1K

10K

100K

Morocco

Algeria

Lybia

Egypt

Mauritania

Sudan

Mali

Niger

Chad

In West Africa, Ghana’s testing is unrivalled. There are over 21,000 confirmed cases from more than 313,000 tests. Three countries to the north, which are battling Islamists militants, have carried out 31,000 tests between them.

Senegal

B.Faso

Tanzania has not published nationwide figures since May 8, when it had recorded 509 cases and 21 deaths.

Nigeria

Somalia

Ethiopia

Ghana

South Sudan

CAR

Cameroon

Uganda

Kenya

DRC

Tanzania

Angola

It took three months before Democratic Republic of Congo was able to process tests outside the capital Kinshasa. In many areas, it still takes two weeks to get results.

Mozambique

Zambia

Madagascar

Zimbabwe

Namibia

Botswana

South Africa, home to nearly 60 million people, has carried out 1.9 million tests, by far the most on the continent. It accounts for over 40% of Africa’s cases.

South

Africa

Source: United Nations, Africa Centres for Disease Control and Prevention

Testing rates

vary widely across Africa

Tanzania has not published nationwide figures since May 8, when it had recorded 509 cases and 21 deaths.

Tests per million

No data

0

1K

10K

100K

Tunisia

Morocco

Algeria

Lybia

Egypt

Mauritania

Sudan

Mali

Niger

Chad

Nigeria

Ghana

Ethiopia

CAR

In West Africa, Ghana’s testing is unrivalled. There are over 21,000 confirmed cases from more than 313,000 tests. Three countries to the north, which are battling Islamists militants, have carried out 31,000 tests between them.

DRC

Tanzania

Zambia

Madagascar

Botswana

South

Africa

South Africa, home to nearly 60 million people, has carried out 1.9 million tests, by far the most on the continent. It accounts for over 40% of Africa’s cases.

It took three months before Democratic Republic of Congo was able to process tests outside the capital Kinshasa. In many areas, it still takes two weeks to get results.

Source: United Nations, Africa Centres for Disease Control and Prevention

As global cases of the new coronavirus climb past the 11 million mark, Africa still accounts for a small fraction of infections, with over 493,000 confirmed cases and 11,600 deaths to date. However, the official figures almost certainly do not tell the whole story. Testing across a swathe of African countries is patchy at best and sometimes non-existent.

By July 7, 4,200 tests per million people had been carried out across the continent, according to a Reuters analysis of figures from the Africa Centres for Disease Control and Prevention (Africa CDC), a body set up by the African Union in 2017. That compares with averages of 7,650 in Asia and 74,255 in Europe.

“It is difficult to give advice when you only get access to part of the data.”

Michel Yao, head of emergency operations for the WHO in Africa

Shortages of materials, personnel and funding have led many African nations to limit testing. In West Africa, some countries have the laboratory capacity to process 300 tests per day but only have the personnel to handle 100-200 tests, the Tony Blair Institute for Global Change, a think tank set up by the former British prime minister, told Reuters.

Nigeria, Africa’s most populous nation, has the laboratory capacity to carry out 10,000 tests per day, but insufficient technicians and logistical problems like poor roads make it hard to carry out more than 2,500, the institute said. Olujimi Oyetomi, a Nigerian health ministry spokesman, said the institute’s analysis was out of date and that more testing machines and materials were being deployed. In the week ending July 5, Nigeria ran an average 2,950 tests per day, according to the Nigeria Centre for Disease Control.

Tests vs. positive cases

Tests per million

140k

Mauritius

120k

Fewer positive

cases from more tests

100k

80k

Europe average

60k

More positive cases

from fewer tests

Djibouti

Cape Verde

40k

South Africa

Morocco

20k

S. Tome and

Prince

Africa average

Algeria

0

Sudan

Nigeria

Angola

DRC

Tanzania

0

5

10

15

20

25

30

35

40%

Percentage of tests

that are positive cases

Source: United Nations, Africa Centres for Disease Control and Prevention

Tests vs. positive cases

Tests per million

140k

Mauritius

120k

Fewer positive

cases from more tests

100k

80k

Europe average

More positive cases

from fewer tests

60k

Djibouti

Cape Verde

40k

Morocco

20k

Eq. Guinea

eSwatini

Africa average

Sao Tome and P.

Egypt

Uganda

Comoros

Algeria

0

Benin

Sudan

Nigeria

0

5

10

15

20

25

30

35

40

Percentage of tests that are positive cases

Source: United Nations, Africa Centres for Disease Control and Prevention

Tests vs. positive cases

Tests per million

140k

Mauritius

120k

Fewer positive

cases from more tests

100k

80k

Europe average

More positive cases

from fewer tests

60k

Djibouti

Cape Verde

40k

Morocco

20k

Eq. Guinea

eSwatini

Africa average

Sao Tome and P.

Egypt

Uganda

Comoros

Algeria

0

Benin

Sudan

Nigeria

0

5

10

15

20

25

30

35

40

Percentage of tests that are positive cases

Source: United Nations, Africa Centres for Disease Control and Prevention

Tests vs. positive cases

Tests per million

140k

Mauritius

120k

Fewer positive

cases from more tests

100k

80k

Europe average

More positive cases

from fewer tests

60k

Djibouti

Cape Verde

40k

South Africa

Morocco

20k

S. Tome and

Prince

Africa average

Algeria

0

Sudan

Nigeria

Angola

DRC

Tanzania

0

5

10

15

20

25

30

35

40%

Percentage of tests

that are positive cases

Source: United Nations, Africa Centres for Disease Control and Prevention

It took three months before Democratic Republic of Congo was able to process tests outside the capital Kinshasa, said Steve Ahuka, a member of the country’s COVID-19 response committee, citing a lack of laboratories, equipment and personnel. Even now, shortages of testing materials and transport challenges mean it can take two weeks to get results in some areas, two doctors told Reuters.

Of the continent’s 54 countries, only a handful, including South Africa, Morocco, Djibouti and Ghana, have been able to test widely. “The spread of the virus seems to be outpacing testing,” said Tim Bromfield, the institute's regional director for East and Southern Africa. “So far, there have been low numbers of severe cases. But the risk is that if the number of severe cases increases… African healthcare systems become overwhelmed”.


Surveillance gaps

More testing means more confirmed cases, but the Reuters analysis found that in at least 30 countries the number of positive results is increasing faster than the number of tests carried out. That suggests the virus is spreading faster than it is being tracked, Bromfield said.

How the proportion

of positive cases has changed

July 6

June 6

0

10

20

30

40

50%

S. Tome and P.

Sudan

Algeria

DRC

Comoros

Somalia

Guinea-Bissau

Ivory Coast

Egypt

Nigeria

Chad

South Sudan

Mali

Equatorial Guinea

Guinea

CAR

Cameroon

Sierra Leone

Niger

Liberia

Gabon

Congo

Tanzania

Madagascar

Seychelles

Mauritania

South Africa

Malawi

Burkina Faso

Djibouti

Senegal

Burundi

eSwatini

Ghana

Cape Verde

Benin

Kenya

Namibia

Libya

Mozambique

Zambia

Eritrea

Ethiopia

Togo

Lesotho

Morocco

Gambia

Tunisia

Angola

Zimbabwe

Rwanda

Botswana

Uganda

Mauritius

0

10

20

30

40

50%

Source: Africa Centres for Disease Control and Prevention

How the proportion

of positive cases has changed

July 6

June 6

0

10

20

30

40

50%

Sao Tome and Principe

25.6

39

38.2

Sudan

47

33.4

Algeria

42.2

28.9

Democratic Republic of Congo

24.8

26.5

Comoros

19.4

25.4

Somalia

48.1

21.9

Guinea-Bissau

18.7

21.6

Ivory Coast

11.5

Egypt

19.6

17.6

19

Nigeria

15.8

Chad

18.5

22.8

17.3

South Sudan

23.1

17.2

17.2

Mali

Equatorial Guinea

16.6

15.4

Guinea

16.2

18.3

Central African Republic

15.8

8.3

Cameroon

15.7

23.5

Sierra Leone

15.4

14.4

Niger

15

15.6

14.2

Liberia

14.7

14.2

Gabon

18.5

13.2

Congo

17.4

13.1

Tanzania

19

Madagascar

12

7.2

11.5

Seychelles

1.8

Mauritania

10.9

10.1

South Africa

10.8

4.9

Malawi

10.4

6.5

10.1

Burkina Faso

11.7

Djibouti

10

11.7

Senegal

9.4

7.7

Burundi

7.2

8.2

eSwatini

7.1

4.4

6.5

Ghana

4

Cape Verde

6.3

13.3

5.9

Benin

1.8

4.2

Kenya

2.6

Namibia

3.5

0.5

Libya

3.3

2.6

Mozambique

3

2.6

2.9

Zambia

3.9

Eritrea

2.7

0.9

Ethiopia

2.3

1.3

2.1

Togo

2.2

Lesotho

2

0.3

Morocco

1.9

2.8

1.8

Gambia

1.3

Tunisia

1.7

2

Angola

1.2

0.9

0.9

Zimbabwe

1.2

Rwanda

0.7

0.6

Botswana

0.5

0.2

Uganda

0.5

0.5

0.2

Mauritius

0.3

Source: Africa Centres for Disease Control and Prevention

How the proportion

of positive cases has changed

July 6

June 6

0

10

20

30

40

50%

25.6

39

Sao Tome and Principe

38.2

47

Sudan

33.4

42.2

Algeria

28.9

24.8

Democratic Republic of Congo

26.5

19.4

Comoros

25.4

48.1

Somalia

21.9

18.7

Guinea-Bissau

21.6

11.5

Ivory Coast

19.6

17.6

Egypt

19

15.8

Nigeria

18.5

22.8

Chad

17.3

23.1

South Sudan

17.2

17.2

Mali

16.6

15.4

Equatorial Guinea

16.2

18.3

Guinea

15.8

8.3

Central African Republic

15.7

23.5

Cameroon

15.4

14.4

Sierra Leone

15

15.6

Niger

14.2

14.7

Liberia

14.2

18.5

Gabon

13.2

17.4

Congo

13.1

19

Tanzania

12

7.2

Madagascar

11.5

1.8

Seychelles

10.9

10.1

Mauritania

10.8

4.9

South Africa

10.4

6.5

Malawi

10.1

11.7

Burkina Faso

10

11.7

Djibouti

9.4

7.7

Senegal

7.2

8.2

Burundi

7.1

4.4

eSwatini

6.5

4

Ghana

6.3

13.3

Cape Verde

5.9

1.8

Benin

4.2

2.6

Kenya

3.5

0.5

Namibia

3.3

2.6

Libya

3

2.6

Mozambique

2.9

3.9

Zambia

2.7

0.9

Eritrea

2.3

1.3

Ethiopia

2.1

2.2

Togo

2

0.3

Lesotho

1.9

2.8

Morocco

1.8

1.3

Gambia

1.7

2

Tunisia

1.2

0.9

Angola

0.9

1.2

Zimbabwe

0.7

0.6

Rwanda

0.5

0.2

Botswana

0.5

0.5

Uganda

0.2

0.3

Mauritius

Source: Africa Centres for Disease Control and Prevention

How the proportion

of positive cases has changed

July 6

June 6

0

10

20

30

40

50%

S. Tome and P.

Sudan

Algeria

DRC

Comoros

Somalia

Guinea-Bissau

Ivory Coast

Egypt

Nigeria

Chad

South Sudan

Mali

Equatorial Guinea

Guinea

CAR

Cameroon

Sierra Leone

Niger

Liberia

Gabon

Congo

Tanzania

Madagascar

Seychelles

Mauritania

South Africa

Malawi

Burkina Faso

Djibouti

Senegal

Burundi

eSwatini

Ghana

Cape Verde

Benin

Kenya

Namibia

Libya

Mozambique

Zambia

Eritrea

Ethiopia

Togo

Lesotho

Morocco

Gambia

Tunisia

Angola

Zimbabwe

Rwanda

Botswana

Uganda

Mauritius

0

10

20

30

40

50%

Source: Africa Centres for Disease Control and Prevention

Sharing information is vital to tackling the pandemic in Africa – both for planning the response and mobilising donor funding. But some governments are reluctant to acknowledge growing epidemics or to expose their crumbling health systems to outside scrutiny. Other nations simply cannot carry out significant testing because they are so ravaged by poverty and conflict.

“Even at the best of times, collecting quality data from countries is not easy because people are stretched thin,” said John Nkengasong, director of the Africa CDC. “Combine that with an emergency, and it becomes very, very difficult.”

A Kenyan ministry of health worker tests a truck driver for the novel coronavirus. REUTERS/Thomas Mukoya

A health worker takes a swab from another truck driver at Kenya’s border with Tanzania. REUTERS/Thomas Mukoya

Commuters are seen following social distancing rules while they queue for public transport before a curfew in downtown Nairobi. REUTERS/Thomas Mukoya

Tanzania’s failure to share information about its outbreak has frustrated neighbours, who fear that gains won through painful lockdowns in their own countries could be jeopardized as Tanzanians cross porous borders. The East African country has not published nationwide figures about its epidemic since May 8, when it had recorded 509 cases and 21 deaths. Tanzania’s health minister and government spokesman did not return messages seeking comment.

“It is difficult to give advice when you only get access to part of the data,” said Michel Yao, head of emergency operations for the WHO in Africa. “We cannot help a country against its own will.”

Workers prepare face shields at the Zaidi Recyclers workshop in Dar es Salaam, Tanzania. REUTERS/Stringer

A worker makes a face shield from recycled plastic to stop the spread of COVID-19. REUTERS/Stringer

Nuns celebrate mass in a nearly empty cathedral in Ouagadougou, Burkina Faso, during the pandemic. REUTERS/Anne Mimault


The search for other measures

In the absence of reliable testing data, researchers are looking to other yardsticks to judge the prevalence of the coronavirus.

Comparing countries

One imperfect method to evaluate what is happening in countries where information is scarce is to compare it with what is happening just across the border, in nations that are more transparent.

Until this month, Burundi permitted large sporting events and held mass rallies for its May elections. The tiny East African nation has carried out only 2,359 tests and confirmed 191 cases of COVID-19 in a country of 12 million people. Its population is just a million less than neighbour Rwanda, which enforced a strict lockdown for six weeks and is gradually easing it. Rwanda has carried out 163,384 tests and confirmed 1,113 cases.

2,359 tests

163,384 tests

11.9 million

population

12.9 million

population

Burundi

191 cases from 2,359 tests

Former President Pierre Nkurunziza implemented few coronavirus restrictions. Election rallies drew tens of thousands in the run-up to a May 20 poll, and the government expelled the WHO representative and three colleagues.

Rwanda

1,113 cases from 163,384 tests

On March 22, Rwanda imposed one of the strictest lockdowns in Africa. Borders were closed except for returning citizens, who had to go into quarantine for 14 days. Movement was restricted, and police flew drones fitted with megaphones to enforce the rules.

13,602 tests

 

78,371 tests

 

20.2 million

population

16.7 million

population

Mali

2,331 cases from 13,602 tests

Anti-government protests have drawn tens of thousands into the streets in Mali, which is also battling Islamist militants across much of the country. It has carried out little testing outside the capital.

Senegal

7,478 cases from 78,371 tests

Senegal closed its border, banned public gatherings and imposed a curfew in March. It has begun easing restrictions and plans to restart international flights in July.

3,880 tests

 

191,394 tests

 

59.7 million

population

53.7 million

population

Tanzania

509 cases from 3,880 tests

Tanzania was slow to restrict travel and impose social distancing rules. President John Magufuli dismissed imported testing kits as faulty, saying they had also returned positive results on samples taken from a goat and a pawpaw fruit.

Kenya

8,067 cases from 191,394 tests

Kenya has been locked down since mid-March. International travel is barred except for returning citizens; schools are closed until January; people are encouraged to work from home; an overnight curfew is in force.

Source: United Nations, Africa Centres for Disease Control and Prevention

2,359 tests

163,384 tests

11.9 million

population

12.9 million

population

Burundi

191 cases from 2,359 tests

Former President Pierre Nkurunziza implemented few coronavirus restrictions. Election rallies drew tens of thousands in the run-up to a May 20 poll, and the government expelled the WHO representative and three colleagues.

Rwanda

1,113 cases from 163,384 tests

On March 22, Rwanda imposed one of the strictest lockdowns in Africa. Borders were closed except for returning citizens, who had to go into quarantine for 14 days. Movement was restricted, and police flew drones fitted with megaphones to enforce the rules.

13,602 tests

 

78,371 tests

 

20.2 million

population

16.7 million

population

Mali

2,331 cases from 13,602 tests

Anti-government protests have drawn tens of thousands into the streets in Mali, which is also battling Islamist militants across much of the country. It has carried out little testing outside the capital.

Senegal

7,478 cases from 78,371 tests

Senegal closed its border, banned public gatherings and imposed a curfew in March. It has begun easing restrictions and plans to restart international flights in July.

3,880 tests

 

191,394 tests

 

59.7 million

population

53.7 million

population

Tanzania

509 cases from 3,880 tests

Tanzania was slow to restrict travel and impose social distancing rules. President John Magufuli dismissed imported testing kits as faulty, saying they had also returned positive results on samples taken from a goat and a pawpaw fruit.

Kenya

8,067 cases from 191,394 tests

Kenya has been locked down since mid-March. International travel is barred except for returning citizens; schools are closed until January; people are encouraged to work from home; an overnight curfew is in force.

Source: United Nations, Africa Centres for Disease Control and Prevention

2,359 tests

163,384 tests

11.9 million

population

12.9 million

population

Burundi

191 cases from 2,359 tests

Former President Pierre Nkurunziza implemented few coronavirus restrictions. Election rallies drew tens of thousands in the run-up to a May 20 poll, and the government expelled the WHO representative and three colleagues.

Rwanda

1,113 cases from 163,384 tests

On March 22, Rwanda imposed one of the strictest lockdowns in Africa. Borders were closed except for returning citizens, who had to go into quarantine for 14 days. Movement was restricted, and police flew drones fitted with megaphones to enforce the rules.

13,602 tests

 

78,371 tests

 

20.2 million

population

16.7 million

population

Mali

2,331 cases from 13,602 tests

Anti-government protests have drawn tens of thousands into the streets in Mali, which is also battling Islamist militants across much of the country. It has carried out little testing outside the capital.

Senegal

7,478 cases from 78,371 tests

Senegal closed its border, banned public gatherings and imposed a curfew in March. It has begun easing restrictions and plans to restart international flights in July.

3,880 tests

 

191,394 tests

 

59.7 million

population

53.7 million

population

Tanzania

509 cases from 3,880 tests

Tanzania was slow to restrict travel and impose social distancing rules. President John Magufuli dismissed imported testing kits as faulty, saying they had also returned positive results on samples taken from a goat and a pawpaw fruit.

Kenya

8,067 cases from 191,394 tests

Kenya has been locked down since mid-March. International travel is barred except for returning citizens; schools are closed until January; people are encouraged to work from home; an overnight curfew is in force.

Source: United Nations, Africa Centres for Disease Control and Prevention

Burundi

191 cases from 2,359 tests

Former President Pierre Nkurunziza implemented few coronavirus restrictions. Election rallies drew tens of thousands in the run-up to a May 20 poll, and the government expelled the WHO representative and three colleagues.

2,359 tests

11.9 million

population

163,384 tests

12.9 million

population

Rwanda

1,113 cases from

163,384 tests

On March 22, Rwanda imposed one of the strictest lockdowns in Africa. Borders were closed except for returning citizens, who had to go into quarantine for 14 days. Movement was restricted, and police flew drones fitted with megaphones to enforce the rules.

Mali

2,331 cases from 13,602 tests

Anti-government protests have drawn tens of thousands into the streets in Mali, which is also battling Islamist militants across much of the country. It has carried out little testing outside the capital.

13,602 tests

 

20.2 million

population

78,371 tests

 

16.7 million

population

Senegal

7,478 cases

from 78,371 tests

Senegal closed its border, banned public gatherings and imposed a curfew in March. It has begun easing restrictions and plans to restart international flights in July.

3,880 tests

 

59.7 million

population

191,394 tests

 

Tanzania

509 cases from 3,880 tests

Tanzania was slow to restrict travel and impose social distancing rules. President John Magufuli dismissed imported testing kits as faulty, saying they had also returned positive results on samples taken from a goat and a pawpaw fruit.

53.7 million

population

Kenya

8,067 cases from

191,394 tests

Kenya has been locked down since mid-March. International travel is barred except for returning citizens; schools are closed until January; people are encouraged to work from home; an overnight curfew is in force.

Source: United Nations, Africa Centres for Disease Control and Prevention

Excess deaths

In other parts of the world, researchers have tried to gauge the impact of the virus by reviewing the number of deaths that exceed the average for the time of year.

But that is not possible in most of Africa, because data from previous years is lacking. Only eight countries - Algeria, Cape Verde, Djibouti, Egypt, Mauritius, Namibia, Seychelles, and South Africa - register more than 75% of deaths, according to the United Nations. Ghana registers 25% and Niger less than 4%.

“Without clarity on data, it is very hard to justify the economic pain that shutting down countries causes.”

Amanda McClelland, senior vice president at Resolve to Save Lives

Some nations, including Rwanda, Senegal and Ethiopia, are setting up programs to monitor graveyards to try to detect spikes in burials. They are interviewing gravediggers and community leaders to establish the usual average.

Coverage of death

registration

<90%

100

75

50

25

0%

No data

Source: United Nations

Coverage of death

registration

100

75

50

25

0%

No data

Less than 90%

Source: United Nations

Coverage of death

registration

Less than 90%

100

75

50

25

0%

No data

Source: United Nations

Coverage of death

registration

100

75

50

25

0%

<90%

No data

Source: United Nations

Unless governments know how severe an outbreak is and what resources are available to deal with it, nations risk lifting lockdowns too soon or maintaining them too long, said Amanda McClelland, of the U.S.-based health policy initiative Resolve to Save Lives. “Without clarity on data, it is very hard to justify the economic pain that shutting down countries causes,” she told Reuters.

Family members and funeral workers carry the coffin of a 51-year-old man who died from COVID-19 at a cemetery in Cape Town. REUTERS/Sumaya Hisham

Counting Google searches

Patrick Berlinquette, a researcher based in New York, is scrutinising Google searches to track health trends, a method he used on a study with Stanford University academics on suicide prevention. This year he started tracking outbreaks of COVID-19 in cities across the United States by tracking the number of people who search for “Why can’t I smell?” – a frequent symptom of the disease. His data for U.S. cities suggests a relationship between searches and case numbers.

Using Google searches in Tanzania as an indicator of COVID-19

Google searches for “Why I can't smell”, a frequent symptom, could be an indicator of COVID-19 spread.

Peak on May 13

with 200 searches

200

Most searches in

Dar es Salaam

150

100

81

72

66

67

61

50

0

May 8

May 13

May 22

May 30

June 7

June 12

June 22

June 29

Sources: Patrick Berlinquette, Google

Using Google searches in Tanzania as an indicator of COVID-19

Google searches for “Why I can't smell”, a frequent symptom, could be an indicator of COVID-19 spread.

Peak on May 13

with 200 searches

200

Most searches in

Dar es Salaam

150

100

81

72

66

67

61

50

0

May 8

May 13

May 22

May 30

June 7

June 12

June 22

June 29

Sources: Patrick Berlinquette, Google

Using Google searches in Tanzania as an indicator of COVID-19

Google searches for “Why I can't smell”, a frequent symptom, could be an indicator of COVID-19 spread.

Peak on May 13

with 200 searches

200

Most searches in

Dar es Salaam

150

100

81

72

66

67

61

50

0

May 8

May 13

May 22

May 30

June 7

June 12

June 22

June 29

Sources: Patrick Berlinquette, Google

Using Google searches in Tanzania

as an indicator of COVID-19

Google searches for “Why I can't smell”, a frequent symptom, could be an indicator of COVID-19 spread.

Peak on May 13

with 200 searches

200

150

100

81

72

66

67

61

50

0

May 13

June 29

Sources: Patrick Berlinquette, Google

The method is not ideal for a country like Tanzania, where many people don’t have smartphones, and where Google only tracks searches in English, not Kiswahili, the language used by most nationals. Berlinquette only began tracking searches in Tanzania in May, but his data shows a spike in the number of searches for those symptoms in the first half of the month.

On May 13, the U.S. Embassy warned its citizens that hospitals in the main city Dar es Salaam were “overwhelmed”, an assertion denied by Tanzania’s government. But infections may have been escalating even earlier. Two doctors in Tanzania told Reuters they had seen spikes in patients with coronavirus-like symptoms in late March and April, when there weren’t enough beds at some facilities to treat all of them. Tanzania’s health minister and government spokesman did not return messages seeking comment.


Additional reporting by Paul Carsten and Camillus Eboh in Abuja, Hereward Holland in Calstock, England, Ryan McNeill in London, Giulia Paravicini in Addis Ababa, and Alexander Winning in Johannesburg.

Graphic by Samuel Granados

Edited by Alexandra Zavis, Jon McClure and Crispian Balmer

Sources: Reuters reporting; Africa Centres for Disease Control and Prevention; World Health Organisation; Tony Blair Institute for Global Change; Resolve to Save Lives, an initiative of Vital Strategies.