COVID and Vaccination Rates: Probability of Developing Severe Cases Highest in Africa and South America

COVID and Vaccination Rates: Probability of Developing Severe Cases Highest in Africa and South America

The lowest probabilities of developing severe COVID cases found in Europe and North America

Nashon J. Adero

Nashon J. Adero ·5 min read

Apart from COVID-19 responses informed by sound research and proof, everything else about the global pandemic remains opinion — a daring experiment in adventure and luxury.

Key Highlights

In July 2021, the proportional measures of COVID-19 cases had reached a point of relative stability in the continental shares, in terms of total casessevere (serious or critical) cases, and COVID-19 deaths.

Asia, the most populous continent with almost 60% of the world’s population, has been leading in the share of global cases at 31%, followed by Europe (26%), North America (22%), South America (18%), Africa (3%), and lastly Oceania (less than 1%). Going by the population sizes of the continents, the much lower COVID-19 testing capacity in Africa, the second most populous continent after Asia with more than 17% of the global population, becomes evident in these revealing statistics.

But Asia has also posted the lowest case fatality rate (1.4%) as South America (3.1%) and Africa (2.5%) receive the worst hit on this metric.

Only Europe and North America are the continents whose shares of severe COVID-19 cases globally fall below the corresponding shares of the total cases globally. This is a bold outcome confirming that their leading vaccination rates are substantially reducing severe cases of COVID-19.

Henceforth, the fluid metric worth monitoring closely as new waves and variants arise is the probability of developing severe cases of COVID-19 out of the reported cumulative cases, by region and country. This will help inform the adequate pace and measures for containment, case management, and vaccination rates towards herd immunity.

The new trend of infections in late July leaves little room to be lackluster or lackadaisical about pronouncing the emergence of the earlier predicted fourth wave in Kenya.

Global Overview

As of July 31, 2021, the total COVID-19 cases globally had exceeded 198.3 million with more than 6.7 million cases in Africa. In July, the common measures expressed as case fatality rates or shares of cases and deaths have remained more or less steady. The radar plots below graphically illustrate the practically constant parameters as analysed between July 5 and July 31.

Enveloped in these revealing statistics of proportional shares, which evidently go against the population shares of the continents, is the glaring message of wide differences in testing capacity and the timeliness or overall efficacy of case reporting and case management and containment including COVID-19 vaccination rates. 

Which Metric Needs Emphasis from August 2021 and Why?

The common metrics illustrated above have almost stabilised by continent and country. As shown in the two radar plots below of July 5 and July 30, the probability of developing severe cases has, however, been more fluid. This nature qualifies it as the metric deserving more emphasis on monitoring from August 2021 onwards. The continuing random mutations yielding variants named after the Greek alphabet is likely to aggravate this fluidity depending on the geographical prevalence of the variants of concern. Europe (below 0.02%) and North America (0.038%) are the regions that have remained safely below a probability of 0.04% in developing severe COVID-19 cases over the same period.

As a strong policy message, the probability of developing severe COVID-19 cases should be tracked more keenly as new waves and variants of concern emerge. A country like Kenya, for example, is arguably entering a vicious fourth wave as this modelling series had earlier predicted in May 2021.

Though the probability of developing severe COVID-cases increased substantially in Oceania, from 0.04% as of July 5 to 0.11% as of July 31, South America and Africa remained on a high score of between 0.06% and 0.09% throughout July on this measure. Their overall case fatality rates have also remained higher than the other continents’ and the global average of about 2%. The lower vaccination rates in these continents must be a compelling part of the explanation of this severity.

The Rising Likelihood of Severe COVID Cases in Kenya and across Africa

With 203,213 cases as at July 31 and only about 3% of the population vaccinated by then, Kenya has been posting positivity rates at an all-time high with double digits, hitting 15.6% on the last day of July. This modelling and study series had predicted that the fourth wave in this East African country ravaged by the Delta variant would pick up the pace in the second half of July. The latest developments are enough to justify the dreaded reality of a fourth wave developing in the country.

Furthermore, the probability of developing severe cases of COVID-19 in Kenya has risen on the last day of July to 0.09%, up from 0.06% where it had stayed a week before. This was above Africa’s average of 0.06% as of July 31, 2021. In East Africa over the second half of July, Kenya’s neighbours of Uganda and Rwanda were even posting more worrying probabilities on this metric, at 0.70–0.96% and 0.14% respectively. As of July 5, Cameroon had a probability of 0.19% and Madagascar 0.08% . South Africa had 0.02% and Morocco 0.05% by the same date.


The analysis presented here has shown the wide disparity in COVID-19 outcomes across regions and countries. As the other metrics stabilise and become more predictable, the probability of developing severe COVID-19 cases remains the compelling parameter to monitor so as to inform the policy and strategic responses needed for effective containment, case management, and herd immunity through expedited vaccination.

As the map of COVID-19 vaccine inequity evolves, Africa and South America remain the key regions of concern in terms of case fatality rates and the likelihood of developing severe cases, which require HDU and ICU. These regions need more determined support from the global community to bridge the gap in vaccination outcomes.

For Kenya, the new trend of infections in late July leaves little room to be lacklustre or lackadaisical about pronouncing the emergence of the earlier predicted fourth wave.

From August 2021 onwards, the key decision makers in Africa and South America must wake up to the reality that they are late in the race against time towards herd immunity. Redoubling efforts in research and proven containment measures and every decisive action towards the desired end are urgent and justified. Apart from such responses informed by sound research and proof, everything else about the global pandemic remains opinion and a daring experiment in adventure and luxury


This is the product of more than a decade of dedicated experience in research, skills development, training, and mentorship. Through mentorship and career development fora, IBD empowers youth with the knowledge, international exposure, and digital fluency they need to be emancipated global citizens with borderless influence for sustainable development.