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Niger is the country that the Covid-19 has forgotten


NIAMEY, Niger — The main coronavirus ward in this desert capital has been empty for months and hastily erected isolation facilities are collecting dust. Masks are almost unheard of on the streets and many days go by without a single person testing positive for Covid-19. Demand for vaccines is so low that the government has sent thousands of doses overseas.

Welcome to Niger, the land that the coronavirus has somehow forgotten.

This vast West African country – home to one of the highest birth rates and poverty rates in the world – was once identified by the World Health Organization as one of the most vulnerable to the coronavirus epidemic on a continent that the United Nations says is killing millions of people. More than a year later, many more countries in Africa are in the grip of the third wave of the pandemic, with new variants sending infections to record levels.

But as Niger grapples with a host of economic and security challenges, it is one of a small group of nations on the southern edge of the Sahara that so far has mostly escaped the scourge of the coronavirus. The reasons – which appear to include a hot and dry climate, sparsely populated and poorly connected settlements, and the world’s youngest population – have made Niger a crucial case study for virologists studying the evolution of Covid-19, according to the experts.

Niger is one of a small group of nations on the southern edge of the Sahara that has mostly escaped the coronavirus.

There is little evidence of the pandemic in Niamey, the desert capital perched on the Niger River.

Doctors say the spread of the highly transmissible delta variant and the reopening of land borders in recent weeks still pose a threat to the largely unvaccinated country and its healthcare system. But in Niamey, the quiet capital perched on the Niger River, there is little evidence of the pandemic raging in many other countries on the continent.

At Le Pilier, a restaurant popular with wealthy locals and expats, Italian owner Vittorio Gioni says weekends are full and he’s bringing home the same daily recipes as two years ago. Business plunged in the spring of 2020 when the country’s air borders were closed, but quickly recovered. One of his regulars is Sani Issoufou, the Minister of Oil: “Here, we still live as if it was 2019,” he said, with a smile on his face.

As of mid-June, Niger, a country twice the size of Texas with a population slightly larger than New York State, at 24 million, only confirmed 194 deaths and about 5,500 cases of Covid since its first case was recorded in March 2020. That’s less than the tiny Italian enclave of San Marino, which has 34,000 inhabitants.

Niger has been identified by the World Health Organization as one of the countries most vulnerable to the coronavirus epidemic.


Photo:

Ismaël Mahamadou Laouali for the Wall Street Journal

“We expected to be inundated with cases but it never happened,” said Adamou Foumakoye Gado, the anesthesiologist at the head of the country’s largest intensive care unit dedicated to Covid-19.

“The virus has had a very short life here,” he says, walking through the empty corridors of his 70-bed ward at the recently renovated General Referral Hospital in Niamey. With no intensive care patients at his facility since April, Mr. Gado has been redeployed to work on the most serious impacts of malaria. “Now I am the one who is being put on leave!” “

At the end of May, Niger even took the unusual decision to lend 100,000 AstraZeneca vaccines to Côte d’Ivoire, another West African country with roughly the same population, but four times smaller geographically and with 10 times more cases. Niger has prioritized the vaccination of essential workers, and few of the general population have received the vaccine.

There have been no intensive care patients in the Covid-19 ward of the recently renovated general referral hospital in Niamey since April.

Many days go by without a single person in Niger testing positive for the coronavirus.

Meanwhile, at Niamey’s main testing center, several days often go by without anyone testing positive. Four large tents set up to isolate patients at the start of the pandemic now house a pair of muddy rubber boots and plastic wash buckets.

Niger’s apparent escape from the worst of the pandemic contrasts starkly with many parts of the African continent, where the WHO has warned that infections are on track to exceed their previous peak in January. In Uganda, located on the equator, hospitals have been so overwhelmed with new cases of Covid-19 in recent weeks that patients are dying while waiting for a bed.

Since the virus first appeared in Africa in early 2020, infection rates have been low in the Sahel, a 3,000-mile semi-arid territory on the southern shore of the Sahara that also includes Burkina Faso, Mali and Chad. Throughout the pandemic, positive Covid results in Niger have averaged 4.5% for a total of around 125,000 swabs, against countries with similar test levels per capita, Afghanistan and Madagascar with 16% and 30%.

The country’s low infection rates have sparked interest from epidemiologists and WHO officials, who have concluded that Niger is one of the most hostile environments in the world for Covid-19. The extremely hot and dry climate of the Sahel is one of the least hospitable on the planet.

“The climate is very harmful for the survival of the virus in the body,” explains Dr. Gado. “There is a glimmer of hope in our misfortune.”

Niger has the youngest population in the world, with half of its citizens under the age of 15.

University research shows that high levels of sun and heat exposure significantly reduce the risk of contamination with the virus, both from airborne particles and surface exposure.

A simulation on the US Department of Health website, which uses median rates of ultraviolet exposure, temperature and humidity to compare New York to Niamey, shows that the transmissibility of the virus is twice as fast in the climatic conditions of the Nigerien capital.

Beyond the climate, Niger also has the youngest population in the world – half of its citizens are under the age of 15 – and most of its citizens live in isolated neighborhoods, another barrier to disease.

“Niger has large pastoralist communities with considerable time spent outdoors in good ventilation, which also plays an important role in reducing transmission,” said Osman Dar, global health systems expert at Chatham House, a British think tank.

Experts say politics played a role as well: authorities locked down, banned community prayer in mosques and closed borders in March 2020, five months before countries like the UK started restricting international travel .

“We killed a fly with a hammer,” said President Mohamed Bazoum, then Minister of the Interior. “The coronavirus has arrived but it never thrived. “

Covid-19 is just the latest scourge to arrive in a crisis-ridden region: an Islamist insurgency has killed more than 8,000 people and displaced a million, global warming is depleting precious agricultural resources and many residents are dying prematurely other infectious diseases.

In March, jihadists killed 137 villagers in southwestern Niger, the deadliest by suspected jihadists in the country’s history. In June, terrorists also slaughtered 160 in neighboring Burkina Faso, as many as the number of Covid-19 deaths recorded in the country during the entire pandemic.

Most Nigerien citizens live in isolated neighborhoods. Above, an ice cream parlor in Kombo.

While Niger has largely escaped the epidemiological impact of the virus, its economy has been devastated. The number of people living in extreme poverty – already nearly half the population – has increased by 400,000 due to COVID-19 restrictions in 2020, estimates the World Bank. In the streets of the capital, the number of people begging for change or leftover food has increased since last year, according to local officials.

Taxi driver Moussa Soumoula is less worried about getting the vaccine than where his next trip will come from.

“Out of 300 people in my neighborhood, only one tested positive,” he says. His main headache is covering $ 200 in arrears for his children’s school fees after the government imposed restrictions on the number of passengers he can take on each trip.

The lockdown crisis has trapped some of the country’s biggest celebrities. Local rock star Omara “Bombino” Moctar, who in 2019 spent nine months touring from London to New York, now makes a living scratching a dozen guests in a private garden.

“Covid never really arrived in Niger,” he says. “But we still feel like we’re living in a hole.”

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