Why do countries with most malaria fatalities have the least COVID-19 deaths per million?

This is a tale of two plagues – malaria and COVID-19, and how they seem related. It begins with this current advice from U.S. health experts:

Both adults and children should take one dose of chloroquine per week starting at least 1 week before traveling to the area (Africa) where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving. The weekly dosage for adults is 300mg base (500mg salt). – Centers for Disease Control and Prevention (CDC)

Without a preventative treatment, malaria is deadly – more than 405,000 deaths annually – and Africa is where most of those fatalities occur. If you visit that continent the Center scientists say you should take an anti-malarial drug, and they recommends hydroxychloroquine (HCL) or chloroquine. The CDC page explains:

HCL helps the body fight off blood-stage parasites and is used for prevention and treatment of malaria. Ivermectin is another effective anti-malarial that is widely distributed free in Africa to protect and cure the disease.

On the other hand, the Food and Drug Administration has revoked its emergency use of HCL, claiming it could be dangerous to some patients.

The U.S. Food and Drug Administration (FDA) revoked the emergency use authorization (EUA) that allowed for chloroquine phosphate and  hydroxychloroquine sulfate donated to the Strategic National Stockpile to be used to treat certain hospitalized patients with COVID-19.

In short, HCL is okay if you’re going to Africa to prevent or cure malaria, but too dangerous to use against COVID-19.

HCL (and other anti-parasitic drugs) are widely used in nations with high malaria death rates. Could there be a connection between taking anti-parasitic drugs and a reduction in COVID-19 death rates? Or, is it just pure coincidence?

Judge for yourself. The following table lists the nations in Africa by highest number of malaria cases and compares that to their death rate by COVD-19:

COVID-19 Deaths per Million
Total Malaria Active Cases COVID-19 Deaths
Country/area Population
Uganda 32,709,864 9,775,318 35 1.1
Kenya 39,802,012 8,123,689 594 14.9
Congo 66,832,000 6,749,112 162 2.4
Malawi 15,263,415 5,455,423 176 11.5
Burkina Faso 15,756,929 4,399,837 55 3.5
Mozambique 22,894,291 4,310,086 160 7.0
Nigeria 154,728,895 4,295,686 1,051 6.8
Ethiopia 82,824,732 3,043,203 880 10.6
Zambia 12,935,371 2,976,395 292 22.6
Angola 18,497,632 2,221,076 115 6.2
Ghana 23,837,261 1,899,544 283 11.9
Cameroon 19,521,645 1,883,199 415 21.3
Burundi 8,303,329 1,757,387 1 0.1
Mali 13,010,209 1,633,423 128 9.8
Benin 8,934,986 1,256,708 40 4.5
Rwanda 9,997,614 1,247,583 18 1.8
Liberia 3,954,977 871,560 82 20.7
Guinea 10,068,721 812,471 61 6.1
Zimbabwe 12,522,784 736,897 206 16.5
Sierra Leone 5,696,471 646,808 71 12.5
Togo 6,618,613 618,842 31 4.7
Gambia 1,705,211 479,409 99 58.1
Niger 15,290,101 309,675 69 4.5
Senegal 12,534,228 222,232 290 23.1
Madagascar 19,625,029 215,110 199 10.1
Chad 11,206,152 182,415 77 6.9
C. African Republic 4,422,397 175,210 62 14.0
Mauritania 3,290,631 167,705 160 48.6
Guinea-Bissau 1,610,748 143,011 61 37.9
Gabon 1,474,588 112,840 53 35.9
Congo 3,683,181 92,855 102 27.7
Namibia 2,171,140 81,812 87 40.1
Equatorial Guinea 676,274 78,983 38 56.2
Somalia 9,133,124 56,153 97 10.6
Comoros 676,036 49,679 7 10.4
Totals 672,210,591 67,081,336 6,257 9.3

Africa has twice the population of the United States and has suffered only 6,257 deaths, compared to our total 192,293. You are 63 times as likely to have died from COVID-19 in the U.S., compared to the continent of Africa’s average rate, and 195 times as likely if you lived in New Jersey.

Even Alaska – the safest COVID-19 state – has a death rate 6 times the African average.

Since any advice – true or not – on COVID-19 treatments will cause a message or post to be removed from Twitter and Facebook (where this post also appears), the answer to that vital question of “why” is entirely left to you.

What follows is the breakdown of COVID-19 deaths per million state-by-state, compared to Africa:

Population in millions Covid-19 Deaths Covid deaths per Million
Africa
672.21 6,257 9.3
United States 328.20 192,293 585.9
New Jersey 8.88 16,091 1811.6
New York 19.45 33,073 1700.1
Massachusetts 6.89 9,116 1322.6
Connecticut 3.57 4,468 1253.2
Louisiana 4.65 5,093 1095.6
Rhode Island 1.06 1,055 995.9
Mississippi 2.98 2,584 868.2
Arizona 7.28 5,221 717.3
Michigan 9.99 6,806 681.5
Illinois 12.67 8,390 662.1
Maryland 6.05 3,799 628.4
Delaware 0.97 609 625.4
Pennsylvania 12.80 7,856 613.7
Georgia 10.62 6,037 568.6
South Carolina 5.15 2,887 560.7
Florida 21.48 11,850 551.7
Indiana 6.73 3,364 499.7
Texas 29.00 13,696 472.3
Alabama 4.90 2,276 464.2
Nevada 3.08 1,389 451.0
New Mexico 2.10 800 381.5
Iowa 3.16 1,165 369.2
Ohio 11.69 4,263 364.7
California 39.51 13,711 347.0
Colorado 5.76 1,971 342.3
Minnesota 5.64 1,909 338.5
New Hampshire 1.36 432 317.7
Virginia 8.54 2,678 313.7
Arkansas 3.02 882 292.3
Missouri 6.14 1,756 286.1
North Carolina 10.49 2,928 279.2
Tennessee 6.83 1,865 273.1
Washington 7.61 1,953 256.5
Kentucky 4.47 993 222.3
Oklahoma 3.96 853 215.6
Idaho 1.79 384 214.9
Nebraska 1.93 404 208.8
North Dakota 0.76 156 204.7
Wisconsin 5.82 1,168 200.6
South Dakota 0.88 173 195.6
Kansas 2.91 481 165.1
West Virginia 1.79 246 137.3
Utah 3.21 422 131.6
Oregon 4.22 481 114.0
Montana 1.07 117 109.5
Maine 1.34 134 99.7
Vermont 0.62 58 93.0
Wyoming 0.58 42 72.6
Hawaii 1.42 84 59.3
Alaska 0.73 42 57.4

Good news is that yesterday marked the lowest death total from the virus since March – just 286 in the United States.

Bad news is that we must have been doing something wrong in this battle against COVID-19, because the U.S. has a higher death rate per million than 204 other nations. Only 11 countries have fared worse – Italy, Brazil, Ecuador, Bolivia, Chile, United Kingdom, Spain, Andorra, Belgium, Peru and San Marino.

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