s Explaining Why Africa had Much Lower COVID-19 Fatalities Per Million than Europe and North America

This letter aims to explain the observed difference between COVID-19 fatalities in Europe and America compared to Africa. At present (May 3, 2023), the cumulative number of COVID-19 fatalities per million people has been 3,093 in South America, 2,761 in Europe, and 2,662 in North America. In particular, the United States and the United Kingdom had 3,323 and 3,320, respectively. With fewer opportunities to practice social distancing or hygiene and much more limited access to health care, Africa only had 181 fatalities per million. The better performances of Africa have been ascribed to the positive effects of reduced hygiene, increased biome diversity, lack of masking mandates and restrictions, better access to antivirals, a younger population, and lower vaccination rates, which all may have contributed to the better performances of Africa compared to Europe and North America against COVID-19.