A sudden, sharp rise in coronavirus cases in many parts of Africa could amount to a continental third wave, the World Health Organization warned on Thursday, a portent of deeper trouble for a continent whose immunization drives have been crippled by shortfalls in funding and vaccine doses.
The W.H.O., an arm of the United Nations, said test positivity had risen in 14 African countries over the last seven days, with eight reporting a surge of over 30 percent in new cases. Infections are steadily climbing in South Africa, where four of nine provinces are battling a third wave. There has also been a sharp increase in cases in Uganda, with hospitals overwhelmed with Covid patients and the authorities mulling a lockdown.
The W.H.O. attributed the rise to loose compliance with social restrictions, and increasing travel along with the arrival of the winter season in southern Africa.
Experts also believe the spread of new coronavirus variants — like those first identified in Britain, India and South Africa — is contributing to the surge and the ensuing rise in deaths. While Africa has reported less than 3 percent of global coronavirus cases, the W.H.O. said the continent accounted for 3.7 percent of total deaths. And that is almost certainly a severe undercount, since in the vast majority of countries on the African continent, most deaths are never formally registered.
“The threat of a third wave in Africa is real and rising,” Dr. Matshidiso Moeti, the W.H.O. regional director for Africa, said in a statement. “It’s crucial that we swiftly get vaccines into the arms of Africans at high risk of falling seriously ill and dying of Covid-19.”
While many wealthier countries have vigorous vaccination campaigns and some are on track to fully reopen, many of Africa’s poorer countries face a huge challenge in accessing vaccines.
Out of a continental population of 1.3 billion people, only 31 million have received at least one dose, Dr. Moeti said. Seven million are fully vaccinated. In Kenya, one of Africa’s biggest economies, with more than 50 million people, only 1,386 have received two doses of a vaccine.
Countries like Ghana and Rwanda have run through their first deliveries of vaccines through Covax, the global facility working to ensure the equitable distribution of vaccines.
Vaccine hesitancy has afflicted the rollout in nations like Malawi, while concerns over rare blood clots and limitations in inoculation capacity pushed the Democratic Republic of Congo to donate millions of doses to other African states before they expired.
The rising cases, the W.H.O. warned, could overwhelm already creaky health care systems that are struggling with limited intensive care beds, oxygen and ventilators. To forestall a full-blown crisis, Dr. Moeti urged “countries that have reached a significant vaccination coverage to release doses and keep the most vulnerable Africans out of critical care.”
After a school year rife with debate over the safety of returning to classrooms, experts say that the United States is edging closer to a safe return to in-person learning in the fall.
First, there is continuing good news on the vaccine front. Last month, about 17 million children ages 12 to 15 became eligible to get the Pfizer-BioNTech vaccine. And Moderna plans this month to ask the Food and Drug Administration to clear its vaccine for use in 12- to 17-year-olds.
For more than a year, parents across the United States have scrambled to adapt to online learning and keep their children focused. (And parents who balanced remote learning with work were the lucky ones. Many others lost their jobs, lacked adequate internet access or stopped work to tend to their families.)
Until vaccines are approved for children of all ages, rapid antigen testing might be the best way to limit rare outbreaks of the virus, detect them early and keep schools open consistently.
There are signs that Abbott’s BinaxNOW, a widely available antigen test, is highly sensitive in young children with symptoms of Covid-19, according to a small new study. Among children younger than 7, the test detected 100 percent of coronavirus cases, researchers write in a forthcoming paper in the journal Pediatrics.
The study, led by researchers at the Children’s Hospital of Pittsburgh, enrolled 199 children and young adults, ranging from 2 months to 20 years old. All participants had at least one symptom of Covid-19 and had been symptomatic for less than a week.
The Abbott test was somewhat less sensitive in older children, however, and generated a substantial number of false positives in children of all ages. Among children who did not have the virus, 8 to 10 percent tested positive on the antigen test, the researchers found.
“One hundred percent sensitivity in children less than seven years is excellent — outstanding,” said Dr. Alejandro Hoberman, a pediatrician at the Children’s Hospital of Pittsburgh and the senior author of the study. “The problem was the false positives.”
The findings suggest that while the test could help schools and day cares operate more safely, it might be more useful for ruling infections out than at definitively detecting them.
Experts say that more research is needed. “It is important data to have, but we need reinforcing studies that replicate what this study has done with larger numbers of children,” said Dr. Irwin Redlener, a pediatrician and founding director of the National Center for Disaster Preparedness at Columbia University.
Dr. Redlener expects that all children will be eligible to be vaccinated against Covid-19 toward the end of the year or early in 2022.
Dr. Anthony S. Fauci, President Biden’s chief medical adviser for the pandemic, said in an interview with CNN on Thursday that he was “cautiously optimistic” that children younger than 12 would be eligible for vaccinations by Thanksgiving.
Until then, experts are confident that masks, distancing, hand washing, cleaning and ventilation — along with rapid tests — can enable a return to full-time in-person classroom settings.
Mara Aspinall, an expert in biomedical diagnostics at Arizona State University, said that children had become comfortable with tests to the point of administering swabs themselves. “The perception of testing — that it was expensive, it took a long time, it was tickling your brain — none of that is true anymore,” she said. “We’ve made such progress on the technology.”
Having this kind of testing available everywhere, Dr. Redlener said, “should help reassure schools and parents that it’s safe to return to the classroom.”
Lauren McCarthy and
Travelers returning to Britain from Portugal and its island territories of Madeira and the Azores will no longer be able to avoid quarantining as of Tuesday, British officials said on Thursday, complicating the plans of people hoping for easy getaways this summer.
Last month, Britain had put Portugal and 12 other countries and territories with low coronavirus caseloads on a “green list,” allowing visitors coming from Britain to avoid a quarantine period upon returning from those locations.
Britons fatigued by a miserable winter and a four-month national lockdown had begun flocking to Portugal, because most of the other green-listed places were either not accepting tourists or were not already favored destinations. The process still involved several forms and P.C.R. virus tests, whose costs can total hundreds of dollars.
The decision to move the country off the green list was a “safety first approach” Grant Shapps, Britain’s transportation secretary, told the BBC on Thursday.
Portugal had remained on Britain’s green list even as the rate of positive coronavirus cases there rose 37 percent over the past two weeks. British fans poured into the city of Porto to see two of England’s top soccer teams, Chelsea and Manchester United, face off in the Champions League final last Saturday. (Chelsea won.)
Portugal has seen the spread of the virus variant first identified in India, now known as Delta, Mr. Shapps said in a public statement released on Thursday.
Officials did not add any new countries to the green list — a decision that also dealt a blow to Spain, particularly for its two tourism-dependent archipelagos, the Canary Islands and the Balearic Islands, which had seen improvement in their virus numbers. British travelers are the largest international contingent of visitors to Spain, accounting for 18 million of the almost 84 million who came to the country in 2019, before the pandemic.
The announcements caused disappointment for British visitors who had booked trips already or hoped that wider travel in Europe was on the rebound. It also caused dismay for the travel industry, which has been hit hard by the pandemic.
In Portugal, vendors had been excited to welcome back tourists, although some in the country had grumbled about foreign visitors not following local restrictions, which include mask wearing outdoors and a 10:30 p.m. curfew.
The move by British officials comes as cases remain generally low in Britain, though officials have been working to contain surges of the Delta variant.
Milloni Doshi, a 25-year-old student from India who is supposed to start her master’s degree this fall at Columbia University in New York, has received two doses of a Covid vaccine. But her inoculation was with Covaxin, a vaccine made by an Indian manufacturer and widely used in India.
That vaccine is not approved by the World Health Organization, as required by the university. So Columbia has told her that she must be inoculated wtih a different vaccine once she arrives on campus, even though no one can say for sure whether it is safe to do so.
“I am just concerned about taking two different vaccines,” she said. “They said the application process would be the toughest part of the cycle, but it’s really been all of this that has been uncertain and anxiety inducing.”
Since March, more than 400 colleges and universities in the United States have announced vaccine mandates that require students to be immunized against Covid-19, but the rules have been designed primarily with domestic students in mind. They have access to the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines, three of the eight authorized by W.H.O., according to a spokesman for the health agency.
The disparity could hinder not just the students, but also the colleges that have made it a major priority to retain them. International students brought in close to $39 billion in tuition dollars in the year before the pandemic, according to one analysis.