Africa is facing an endemic coronavirus

A black mask covered almost the whole of face of Bridget Akankwasa, a student at St. Maria Parents Primary School in Kiwatule, a township in the Ugandan capital, Kampala. "It does not feel good," Akankwasa told DW. She is one of 15 million children returning to classes this week as Uganda becomes the last country in Africa to reopen schools after closing them in March 2020, according to UNESCO. She said she missed being able to hug her friends on her first day back.

Very few other children have returned to the private primary school after the lengthy break. St. Maria's owner, Joseph Mukasa, said he was surprised by the lack of students. "When we had to close down the school almost two years ago, we had 300 pupils here," he said. "But, today, not even 20 pupils came to class." Mukasa is hoping that attendance will pick up in the next few days. Otherwise, he joked, he'll have to think about starting a business.

Education officials expect that a large proportion of children in African countries will not return to school. Many had to get jobs to help support their families after the coronavirus pandemic brought public life to a standstill in many places in spring 2020. Numerous girls were forced into marriage. But life after the shutdowns now appears to be beginning again in Africa as the pandemic continues. 

John Nkengasong, the director of the Africa Centres for Disease Control and Prevention (Africa CDC), said severe shutdowns were no longer the best way to slow the spread of the coronavirus. He praised South Africa for its measured response to the latest wave of infections triggered by the omicron variant.

South Africa began experiencing a steep rise in COVID-19 infections at the end of November — about the time that the world was being warned of the emergence of omicron. But the variant appeared to cause milder cases of illness, so the government decided against imposing major restrictions. It was even possible to relax the rules ahead of New Year's Eve. The number of new infections has now subsided.

According to Wolfgang Preiser, a virologist at the University of Stellenbosch, 60%-80% of adult South Africans had already caught the coronavirus before the fourth wave, which was sparked by omicron. He said this had created short-term herd immunity and protected South Africa from the worst of it.

Here to stay?

Fewer than one in 10 Africans are completely vaccinated against COVID-19, according to the latest figures from Africa CDC. Given the slow pace of the vaccine rollout, Nkengasong fears that COVID-19 could become endemic across the continent, if countries do not manage to increase their vaccination rates to 70% or 80% by the end of 2022.

Many scientists across the world already believe that the coronavirus is turning endemic. That means that the virus will always be present to some extent in the population, just like the flu or chicken pox.

Angelique Coetzee, the head of the South African Medical Association, called the idea of increasing vaccination rates across Africa over the next few months to 60%-70% was wishful thinking.

Coetzee, a general practitioner and one of the first doctors to notice the unusual symptoms of the omicron variant, told DW that vaccine supply was not the only problem. Others include the logistics of the rollout and the staff needed. "Vaccines are difficult to distribute in Africa with the temperature and the cold chain, vast distances between cities and rural areas," she said. Coetzee is calling for drugs and nasal sprays as an alternative to vaccines.

If the coronavirus were to become endemic, Coetzee said, the illness would become seasonal. "Certain times of the year, there will be high outbreaks," she said. She added that continued masking and social distancing would play a role in reducing spread. "You will never be able to vaccinate yourself out of this situation," she said.

'Severe and long-term'

Preiser does not believe that things should simply be allowed to take their course: "The price would be a high number of severe and long-term cases ­— long COVID ­— and of deaths." He said even people who are triple-jabbed could get infected with omicron.

Yap Boum, a Cameroonian professor and the regional representative for Epicenter Africa, the research arm of Doctors Without Borders, told DW that it is still too early to tell how the pandemic would develop. But, he said, it is interesting that the extremely contagious omicron variant has been able to displace the other variants.

"If we have the stability and no other variant being predominant, then we can learn to live with it," Boum said. He said vaccinations would have to be made available to older people or people with conditions, as well as travelers. He doesn't think that travel restrictions will exist in the long term. "If it is endemic," he said, "it means you can meet COVID almost everywhere, even if it is in very small numbers." That, he said, will become the new normal.

Julius Mugambwa contributed reporting from Kampala.

This article was originally written in German.