So I started wondering about Africa ...

It's hard to stop raging and mourning the 60,000 or so excess deaths this country has seen in the pandemic, so many more than might have happened if our political system had generated leaders who would heed scientists.

And then I find myself thinking of the many places in the world even less equipped than we are to respond to a novel lethal virus. Big thinker Ezra Klein interviewed Bill Gates, the Microsoft engineering brainiac and now capitalist health philanthropist, and he's having the same thought, equipped with a lot more information. The entire interview is worth listening to.

So I dug around a bit. The Mail & Guardian from South Africa reports that the developing situation might have been worse.

At the World Health Organisation’s (WHO’s) African headquarters in Brazzaville, Republic of Congo, staff members have been quietly impressed with how most African countries have responded to the pandemic. Although resources are scarce, the majority of leaders have taken difficult, proactive decisions to contain the spread of Covid-19, and are listening carefully to scientists and public health experts.

Most, but not all.

There is a short list of countries that the WHO is worried about. Insiders say this list includes Burundi, Cameroon, the Democratic Republic of Congo (DRC) and Eritrea. Madagascar, South Sudan, Somalia and Zimbabwe are also countries of concern. The list is topped by Tanzania.

Since I have a good friend in Tanzania, I inquired about what she is seeing. Her family is holed up in a rural area; they are fine and feeling reasonably secure. But also, she retired from the public health field and what she's seen of the local response has been encouraging. Schools are closed; people are sheltering insofar as they can. She sees the danger in crowded cities like Dar es Salaam. She pointed me to African Arguments, an English language publication which offers a variety of perspectives on the continent.

And there I came upon this:
One size fits all? Why lockdowns might not be Africa’s best bet.

Many governments in Africa have also imposed lockdowns to deal with the pandemic. Yet these countries have radically different age demographics to those in Asia and Europe. Take two extremes. In Japan, 40% of people are over 55, and 28% are over 65. In Uganda, the equivalent figures are 5% and 2%. In Japan, 13% of the population is made of up children under 14. In Uganda, this figure is 48%.

These different age demographics are very important. Mortality rates for coronavirus start to increase for people aged 55 and higher. Meanwhile, young people are statistically highly unlikely to suffer severe symptoms. This means that in countries with a lower proportion of old people, the relative benefits of lockdown are more limited and are more likely to be outweighed by the downsides. ...

I'm not qualified to opine on this thesis, but I'm sure a lot of better informed people are thinking about it.

Wondering about Africa led me to a paper and thread of comments about the prevalence of COVID-19 infection among people living with HIV, a vast percentage of the population in parts of the continent including particularly South Africa. Dr. Josep M. Llibre reported from Spain at the 2020 Conference on Retroviruses and Opportunistic Infections. Contrary to the fears and expectations of so many of us ...

In Spain, we have sadly surpassed 100,000 cases of COVID-19 at the time of this writing (April 1, 2020), with a mortality rate of 8.9% among those diagnosed. Quite unexpectedly, we have seen that PLWH [People Living With HIV] are not at increased risk of acquiring COVID-19 or of progressing to acute respiratory distress syndrome (ARDS) once infected, across the 3 risk classes defined above. For reasons that are as yet unknown, it appears that their risk may even be lower than that of the general population.

The doctor answers questions from international medical colleagues making similar observations in the comments. The whole is absolutely worth reading.

It's easy to go down an internet rabbit hole during this lockdown -- but this one felt worth the time.