NAIROBI, Kenya -- Africa has surpassed 2 million confirmed coronavirus cases as the continent's top public-health official warned Thursday that "we are inevitably edging toward a second wave" of infections.
The Africa Centers for Disease Control and Prevention said the 54-nation continent has had more than 48,000 deaths from covid-19. Its infections and deaths make up less than 4% of the global total.
The African continent of 1.3 billion people is being warned against "prevention fatigue" as countries loosen pandemic restrictions to ease their economies' suffering and more people travel.
"We cannot relent. If we relent, then all the sacrifices we put into efforts over the past 10 months will be wiped away," John Nkengasong, director of the African health agency, told reporters. He expressed concern that "many countries are not enforcing public-health measures, including masking, which is extremely important."
While the world takes hope from promising covid-19 vaccines, African health officials also worry the continent will suffer as richer countries buy up supplies.
"Let's celebrate the good news" first, Nkengasong said. But he warned that the Pfizer vaccine requires storage at minus-94 degrees Fahrenheit, and such a requirement "already creates an imbalance in the fair distribution or access to those vaccines" as richer countries will be better equipped to move quickly.
A storage network at minus-94 degrees was put in place for West Africa's devastating Ebola outbreak a few years ago, but that was localized, Nkengasong said.
"If we were to deploy across the whole continent, it would be extremely challenging to scale it," he said.
The Moderna vaccine requires storage at minus-4 degrees, which Nkengasong called promising. But the price of any covid-19 vaccine is another factor in a fair distribution, he said. "So if a vaccine is $40 it becomes almost exclusive to parts of the world" that can afford it.
But he offered an optimistic early look at attitudes across Africa toward any covid-19 vaccine. Early data from a vaccine perception survey in 11 countries show 81% of respondents would accept a vaccine, he said. "So that's very, very encouraging news."
In a separate briefing, the World Health Organization's Africa chief Matshidiso Moeti acknowledged "very hot competition at the global level to reserve doses" but expressed her hope that "as time goes on, other countries are willing to, if you like, concede that you don't need to try to cover all the population at once."
Salim Abdool Karim, chairman of South Africa's covid-19 advisory committee, said there was no sign that the vaccines now showing promise won't be just as effective in Africa as in their clinical trials elsewhere in the world.
Nearly 20 countries in Africa are now seeing a more than 20% increase in cases over the past four weeks, the WHO said. This time the surge is driven not by South Africa, but by North African nations as temperatures fall there.
Several African countries have confirmed virus cases in the six figures. South Africa leads with more than 750,000, while Morocco has more than 300,000, Egypt more than 110,000 and Ethiopia more than 100,000.
Kenya is the latest concern as it now sees a fresh surge in cases. At least four doctors died on Saturday, leading a powerful health union in the country to threaten a nationwide strike starting next month.
In Europe, the second coronavirus wave may be starting to ease, a top World Health Organization official said Thursday.
The assessment came after new diagnoses of the coronavirus slowed across Europe to 1.8 million cases, compared with 2 million the week before. Some of the worst-hit countries -- including Belgium, the Czech Republic and France -- have seen significant declines, while in Germany and elsewhere the case numbers are rising.
But hospitals remain packed, and deaths across the WHO's 51-nation European region have been rising.
"There is good news and not so good news," Hans Kluge, the WHO's regional director for Europe, said at a news conference, describing the drop in new diagnoses as "a small signal, but it's a signal nevertheless."
He attributed the decline to national lockdowns and other restrictions imposed across much of Europe this past month. But he urged nations not to lift restrictions too quickly, warning that the small gains could vanish if they threw open doors as rapidly as they did in the summer.
"Too often we have seen the negative impact of easing too quickly following an understandable will from policymakers to free the public from periods of stringency," he said. "Too often as well, we have also seen how much these short political gains are quickly offset by the devastating impact of having to reinstall mandates shortly after they are eased."
Information for this article was contributed by Cara Anna of The Associated Press; and by Michael Birnbaum, Loveday Morris, Luisa Beck and James McAuley of The Washington Post.