There are only two remotely viable reasons to doubt the accuracy and the relevance of the sub-Saharan African ("SSA") data. On is that the SSA data is somehow inaccurate in its collection or reporting. The other is that the reports of coronavirus death in SSA are inaccurate because of large differences in age demographics, that the SSA populations are much younger than residents of other parts of the world. The data integrity issue is dealt with elsewhere. Here we will look at the age-adjustment of the mortality data..
Coronavirus Disproportionately Impacts the Elderly.
The reason that age-adjustment is an issue is because the COVID fatality rate is higher in elderly population groups. Africa has much lower percentage of elderly residents than the U.S. or most of the rest of the world. Thus, the argument goes, SSA will have a falsely lowered fatality rate compare to most of the world. While there is no doubt a small element of truth in this, age demographic differences cannot begin to explain the profound discrepancy in the COVID mortality rates between SSA and the rest of the world.
Age Disparity is Inadequate as an Explanation for Disparate COVID Fatality Rates.
Furthermore, this writer is unaware that anyone has ever offered proof that age discrepancy can actually discredit or nullify the low COVID mortality rates seen in SSA. There have only been insinuations to this effect. In fact, there is distinct evidence that age disparity is not as significant as some might think. For example, within the U.S., Florida has a much higher percentage of elderly residents than New York. However, despite this fact, New York has a much higher COVID mortality rate than Florida. New York's raw, population-adjusted mortality rate as of December 1, 2020, is 1,775 per million. Florida's is 865 per million, half of New York's rate. Adjusted for age, New York's mortality rate is 2.5 times that of Florida. Age demographics do not adequately explain why New York's COVID fatality rate is higher than Florida's. New York's claimed large elderly population simply does not explain its excessive COVID death rate. FLodida has much higher percentage of elderly residents and a much lower COVID death rate. Thus, age demographics also do not adequately explain why SSA's fatality rates are so much lower and their COVID outcomes so much better than the rest of the world.
With a Smaller Percentage of Elderly Residents, Age-Adjustment Actually Increases the Apparent Number of U.S. Deaths as Well as SSA Deaths Relative to Europe.
Finally, the reader will note that the U.S. mortality rates appear a bit higher on the age-adjusted charts shown here on the this website. This is because Italy is the gold standard for age adjustment with the highest percentage of elderly residents, the U.S. COVID mortality rate per million population appears higher here on the covid-ssa charts when corrected for age along with the data for SSA. The average, raw, population-adjusted mortality rate for SSA is about 4 patients per million. When adjusted for age, the corrected SSA COVID fatality rate is 34. Know that these age-adjusted rates are statistical fictions, "corrected," fictitious rates created to compensate for the age discrepancies between countries. However, because the U.S. has only 16% of its population over 65 years of age compared to Italy's 23%, the age-adjusted U.S. fatality rate, like SSA's, appears elevated, although the U.S. rate is not elevated nearly as much. The population adjusted COVD fatality rate for the U.S. is generally quoted to be about 800 deaths per million. When age-adjusted along with the SSA countries, the U.S. rate, with its 16% elderly population is about 1,100 per million.
Age Demographics Do Not Explain the Profoundly Lower COVID Fatality Rates in SSA.
Thus, even adjusted for age, the discrepancy between the COVD fatality rates between SSA and the developed West is profoundly disparate. The only logical response to this disparity is to follow the data to its logical conclusion - COVID outcomes are better in malaria-endemic countries of sub-Saharan Africa.