The delta variant of the coronavirus that is rapidly becoming dominant in most parts of the world is now taking a heavy toll on dozens of developing countries, where vaccination levels are insufficient to prevent a spike in cases from turning into a wave of deaths.
As economies in Europe and the United States that have successfully weakened the link between infections and deaths begin to emerge, poor countries with low vaccination rates are in some cases entering their worst phases of the epidemic.
“The world thinks this pandemic is over,” said Fatima Hassan, founder of the South African Health Equity Initiative. “But we still don’t have an adequate supply of the vaccine in the system despite the global realization that the delta variant is very destructive.”
The delta variant first identified in India accounts for 95 percent of cases in South Africa where the genetic code has been sequenced. Less than 3 percent of people are fully vaccinated in South Africa, where vaccine release has been hampered by supply failures and, more recently, a wave of political violence.
Ninety-nine percent of the serial cases in Indonesia, where only 6 percent of the population has been fully vaccinated, are of the delta type. Both South Africa and Indonesia have reported record numbers of cases this month. In Indonesia, the total number of cases recorded on July 14 alone, of 54,517, was four times the level recorded in January.
The same pattern is evident across much of Africa, which last week recorded a 43 percent week-over-week rise in Covid-19 deaths, according to the World Health Organization. Five countries – Namibia, South Africa, Tunisia, Uganda and Zambia – accounted for 83 percent of the deaths.
Africa recorded 1 million new cases over the past month, the shortest time it took to add that number, bringing the total infections across the continent to more than 6 million.
“The double barrier of vaccine scarcity and treatment challenges seriously undermines an effective response to the growing epidemic,” said Matshidiso Moeti, WHO regional director.
She blamed the sudden increase in the more transmissible delta variant and general fatigue on measures such as wearing masks after more than a year of intermittent shutdowns. She said alpha and beta variants, first identified in the UK and South Africa respectfully, have also been widely detected.
In Europe, the United Kingdom and Portugal are among those facing rising delta-type infections, but high vaccination rates have dampened the impact.
In the UK, where more than half the population has been fully vaccinated, the death-to-case ratio has fallen from around one in 50 during the winter wave to one in 750. Despite UK daily infection rates of more than 40,000 – a figure That before vaccines were introduced it would have resulted in about 800 deaths per day – the current daily number is about 50.
In contrast, Namibia, which has only been vaccinated with 1.2 percent of the population, records one death for every 22 cases. Namibia’s daily death rate of 28 deaths per million people is the highest in the world, well above peak levels recorded in the UK and Italy.
Tunisia, where the high number of infections is causing people to die faster than at any time during the pandemic, has the second highest Covid death rate in the world. In Mexico, an estimated 84 percent of cases are delta infections, a potential warning that the variant could take hold in Latin America as well.
The delta variant was an important factor in the spike, said Trudy Lang, director of the Global Health Network in the Oxford University Department of Medicine, adding that new mutations would continue to phase out old ones.
She stressed that it was important not to look at delta in isolation. She said the decline in adherence to social distancing measures in poor countries, where many people have to work to survive, was playing a large role in the increase in deaths.
“We’re tired because everyone wants to go on vacation and our kids want to go to music festivals,” Lang said of the impact of lockdowns on wealthier countries. “But if you are an ordinary family trying to make a living together in the favela area of Rio [de Janeiro] Or a market stall in Dhaka, being tired of closings is an entirely different story.”
In South Africa, the situation is particularly acute in Gauteng province, where not only cases, but hospitalizations and deaths have reached record levels. There are more than 8,000 Covid patients in county hospitals, with more than 100 deaths a day.
Hassan, of the Health Equity Initiative, said vaccine suppliers, who have not fulfilled their contracts with South Africa and some other poor countries, bear great responsibility for what she described as an overwhelming crisis.
In South Africa, months of lockdown have contributed to the anger that has recently spilled onto the streets in a wave of lockdowns looting and destructionShe said.
“Had we had enough vaccine supplies a few months ago, we would have been in a much better position to mitigate the effect of the delta variant,” she said. “Vaccine companies are playing God’s role in the pandemic. Where is the world? Why don’t they send us 50 million vaccines? We really need it now.”