While the attention in much of the developed world is turning to post-pandemic issues of easing restrictions, vacations and a return to normal, Africa is in the grip of a crippling third wave of infections and bracing for a fourth—and maybe even a fifth.

As the more contagious Delta variant starts to spread across the least-vaccinated continent, cases are rising, hospitals are being overrun and deaths are mounting. With little prospect of a significant proportion of Africans being vaccinated in coming months as rich nations continue to hoard shots, epidemiologists expect another wave of disease will follow before the end of the year. That carries the risk of more vaccine-resistant variants developing, endangering not just Africans but also the rest of the world.

"This third wave is going to be devastating because in Africa and South Africa we couldn't get access to vaccines when we needed them most," said Tulio de Oliveira, director of Krisp, a South African genetic-sequencing institute. "If we don't get vaccines in the next couple of months we risk another devastating wave, not only in numbers but in lives."

Africa remains woefully under-vaccinated, with only 1.1% of the continent's 1.2 billion people having gotten a jab compared with about 50% of the populations of the US and the U.K. that are fully inoculated. Only 50 million of the more than 3 billion doses of vaccines that have been administered globally have been in Africa, according to the Africa Centers for Disease Control and Prevention, and the effects of that are becoming apparent.

Cases are doubling every three weeks, and the continent is on the verge of exceeding its worst week of the pandemic. On Friday, the number of South African daily coronavirus infections surged to a record. Cities from Johannesburg to Kampala have been forced to lock down and intensive care units are overflowing. In the continent's poorer countries, patients are dying because of a lack of oxygen and health-care workers are overwhelmed, with nurses looking after as many as 40 patients each.

Unprecedented scale

In Gauteng, South Africa's economic hub and the richest area on the continent, excess deaths rose to a pandemic-era record in the week to June 20 and private hospitals are airlifting patients to other provinces. With 4,795 cases per million people, Namibia had the worst epidemic globally over the last seven days. Meanwhile, medical facilities and mortuaries in many countries are struggling to cope.

Coffin makers and florists in Lusaka, Zambia's capital, say they are struggling to keep pace with demand. Laura Miti, a social activist in the country, told Bloomberg a colleague died of Covid-19 after spending time in a hospital, where patients perished as power outages interrupted oxygen supply. The shortage of front-line workers is also taking a toll, she said.

"The nurses are overwhelmed, frustrated," Miti said. "There's just not enough of them."

According to the Africa CDC, the continent has had just under 5.4 million confirmed Covid-19 infections and about 141,000 deaths since the pandemic began. But the numbers are seen to be grossly under-reported, with excess deaths in South Africa alone standing at 176,000.

"The speed and scale of Africa's third wave is like nothing we've seen before," said Matshidiso Moeti, Africa director for the World Health Organization, on a conference call on Thursday.

The latest wave has taken the pandemic to a whole new level, and with poor access to vaccines there's little hope that the same situation won't play out again.

Soccer vs curfews

Rich nations are sitting on shots, having purchased way more than they need, and Covax, the WHO-backed vaccine-sharing initiative, has shipped just 91 million doses out of its target of sending 1.8 billion doses to 90 poor nations by early 2022. India, where much of Covax's supply was coming from, halted exports to deal with its own devastating outbreak.

Africa is not looking for charity, Richard Mihigo, program area manager for immunization and vaccine development at the WHO's Africa office, said in an interview. "It is to give the chance to the international community not to see a more transmissible variant emerge that would put all the efforts of even high-income countries to zero."

Stung by criticism, wealthy countries including the US and UK have pledged to donate millions of doses. Shipments of Pfizer Inc. and Johnson & Johnson vaccines donated by the US are set to arrive next week, said Strive Masiyiwa, the telecommunications billionaire tasked with helping the African Union secure shots.

Meanwhile, as the Delta variant rapidly spreads around the globe, the fates of vaccinated and unvaccinated nations are beginning to diverge. On July 1, the UK recorded almost 28,000 cases but just 22 deaths. In contrast, South Africa reported 21,500 cases and 382 deaths.

In Europe a continent-wide soccer tournament is taking place complete with spectators cheering on national teams in stadiums. In South Africa a curfew means people have to be home by 9 p.m., and in Uganda parliament has been closed to slow the spread of the virus.

"If we do not vaccinate at speed, our economy will continue to be damaged," John Nkengasong, director of the Africa CDC, said on Thursday. "You will see a fourth, fifth and sixth wave and it will be extremely difficult for us to survive as a people. Let us be very clear that is what is at stake."

Key developments:

Indian vaccination count hits 350 million

India's vaccination drive has covered 350 million people so far, including those who have received only one shot. The nation of 1.3 billion has administered the first dose to 99 million in the 18-to-44 age group, while 2.71 million have received both jabs, the government said. The country reported 955 deaths in the last 24 hours, with the total number of fatalities climbing to 402,005.

Sydney residents urged to abide by curbs

Sydney residents are being urged to comply with lockdown rules for another week amid encouraging signs Australia's largest city is getting on top of its Delta-variant outbreak. There were just 16 new cases of Covid-19 overnight, down from 35 the previous day, New South Wales state Premier Gladys Berejiklian said. However, there were concerns about rules being flouted as warm weather saw people flock to parks and beaches this weekend, she said.

Delta variant surges in Bangkok, study finds

The delta coronavirus variant is surging rapidly across Bangkok and now accounts for 70% of new infections in the Thai capital, according to a study by Chulalongkorn University's Center of Excellence in Clinical Virology. The variant is highly contagious and will likely lead to more infections, Yong Poovorawan, the center's director, said in a Facebook post. On Sunday, Thailand reported 5,916 new infections and a further 44 deaths, with the third wave of the outbreak showing no sign yet of easing after three months.

Olympics eyeing no spectators at big venues

Tokyo Olympics organizers are leaning toward barring spectators from events held in large venues such as soccer and track and field, Nikkei reported.

The organizing committee is considering the move if the Japanese government extends a set of quasi-emergency measures in place to combat Covid-19, Nikkei reported Sunday, without saying where it got the information.

The government is planning to extend the quasi-emergency beyond its current expiry date of July 11 in the Greater Tokyo area, the Yomiuri newspaper said separately on Sunday, and could keep it in place for up to one month more. The decision will be made on July 8, while the Games start on July 23.

Spectators may be barred from the opening and closing ceremonies and events in venues with a capacity of 20,000 or more in the Greater Tokyo area, Nikkei said. Organizers could extend the move to include events taking place at night.

UK set to remove mask rule

UK Prime Minister Boris Johnson has signed off on a series of measures on how the country will live with coronavirus, including the removal of compulsory wearing of masks, the Sunday Telegraph reported.

The government is getting ready to replace legal restrictions from July 19, with a call for "common sense," the newspaper said. Part of the plan will involve scrapping rules for the over one-meter distancing rule in pubs and restaurants as well dropping the legal requirement for customers to sign in to venues using QR codes or sharing contact details.

Johnson is due to announce the changes this week and will make the point that the rollout of vaccinations breaks the link between virus cases and hospitalizations, the Telegraph said.

Biden takes 'Independence' message to Michigan

President Joe Biden traveled to Michigan to celebrate US progress in fighting Covid and promote infrastructure spending, part of a slate of Fourth of July weekend events by the administration to signal a return to pre-pandemic life.

Slightly less than 67% of the US adult population has at least one dose of a vaccine, short of the president's goal of getting that number to 70% by Independence Day.

British doctors say restrictions should remain

Leading doctors in the U.K. urged the government to keep some pandemic restrictions in place in England, pushing back against Downing Street's plans to relax measures from July 19.

"The idea that on the 19th of July we can return to a pre-Covid world of having no restrictions, we think is not sensible in light of what are spiraling infection rates," Chaand Nagpaul, chair of the British Medical Association Council, told the BBC. While the link between cases and hospitalizations has weakened, it hasn't been broken, he added.

US airports at busiest since pandemic began

The Transportation Security Administration screened almost 2.2 million travelers at US airports on Friday, the highest number since the start of the pandemic, according to a tweet Saturday from a spokesperson.

On Thursday, the TSA said many US airports were already at or exceeding the pre-pandemic numbers of passengers going through security checkpoints, especially near popular summer beach spots.

Domestic airline passenger volumes this week were down just 17% from 2019, according to Airlines for America, and an average 89.2% of available aircraft seats were filled, just one percentage point below the same week two years ago.

Delta variant clouds US revival hopes

The fast-spreading Delta variant is clouding Americans' hopes for a carefree summer —and casting a shadow of doubt over plans to get back to business as usual in the fall.

The shift in sentiment marks a reversal from the spring, when it looked like the US immunization campaign would turn the tide definitively against the coronavirus. As hospitalizations rise in some states, the Biden administration is sending response teams to less-vaccinated areas to try to combat its spread.

Separately, Anthony Fauci, the top US infectious-disease official, said he doesn't expect another nationwide spike of cases over the variant, given that a "substantial proportion" of the US population has been vaccinated. His full comments are set to air in an interview on NBC's "Meet the Press" on Sunday.

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