Why is Covid relatively less of a problem in Africa?

I'm from Algiers, Africa. Practically nobody wears masks. It is extremely rare to find someone wearing one. Few people are vaccinated. Most people I know had it (young) with minor effects (taste and smell loss, some had a mild fever, others had sore muscles).

I spend a lot of time in places with extreme proximity and promiscuity. Closed spaces with a hundred usual people wearing no masks.

The underlying vibe is that whatever could have happened would have happened in two years already. It wasn't like that in the beginning. We had lockdowns and curfews. We spent a lot of time forbidden from going out before 0600 and after 1300. They change it "according to the situation" (1500,1700,1800,1900,2000,2200,2300, etc). There's no curfew now but they may apply it soon, there's no communication except when they enforce it.

I don't recall where I have read something on the impact of BCG vaccine on COVID-19, and others claiming it has no effects, but all Algerians have a scar on the forearm. You only notice that it's a thing when traveling for the first time and people ask you about it, and when there are memes like "How do you recognize an Algerian abroad ? Look at their forearm for a scar". Mine looks like a spaceship.

Some other sources address the possibility of the different genetics having a role.

There are relatively few sources of information about the stats. Testing is practically non existent.

I also know a few people who have died and the communicated cause of death was COVID-19. Parents of friends of the family and older people.

This is only anecdotal. There's practically no data, and there's a heavy survivorship bias.

There was a good article on this in the New Yorker middle of last year [0], most of it probably still applies. Some points from memory:

- much younger, healthier, less obese populations

- more of an outdoor, or drafty, lifestyle

- under reporting w distributed population, minimal formal healthcare and governments keeping the numbers low

- potential for greater prior immunity from previous corona viruses.

Still plenty of mystery though.

https://www.newyorker.com/magazine/2021/03/01/why-does-the-p...

As others note, only quite wealthy countries have the capacity to actually test everyone who dies. Many countries in Africa do not have the infrastructure that tracks regular births and deaths for the census. This means we don't even have centralized excess mortality data.

In fact, South Africa is one of the few on the continent south of the Sahara that does. I've set up a plot of South Africa, Canada and UK excess mortality since the start of this: https://ourworldindata.org/grapher/excess-mortality-p-scores... Looks pretty bad. Of course, it may be different in African countries with a much lower HIV rate. The data isn't available as far as I know.

Africa in parts also have a bunch of other diseases, typhoid, malaria, dyptheria, dengue fever amongst many others which are at very high levels alongside chronic poverty and poor nutrition.

The focus from the west seems off.

The much younger population is presumably a factor. Weather might be, too; cold places tend to see covid spikes in the winter, when everyone is indoors.

At least two hypotheses:

1. underreporting - this one is clear. One can report a deaths from covid only if the person has been tested.

2. climate - covid looks to be influenced by the weather and Africa has much warmer climate which inhibits the virus.

Covid is less of a problem in all countries with Malaria because they use Hydroxychloroquine to treat the Malaria which is also clinically proven to stop Covid.

But there's no money in that, so it's conveniently ignored.

[0] https://pubmed.ncbi.nlm.nih.gov/32194981/

[1] https://pubmed.ncbi.nlm.nih.gov/32405156/

[2] https://pubmed.ncbi.nlm.nih.gov/32344177/

and plenty more if you search pubmed