The coronavirus pandemic was relatively mild in Malawi last year, but a new “devastating wave” is overwhelming the country's health care system, medical aid group MSF has told the BBC.
The first few weeks of January has seen the number of Covid-19 cases double every four to five days, MSF says.
"We have now between 800 and 1,200 new cases per day - and this is most likely an underestimation considering the number of tests performed is still limited," MSF's Fabrice Weissman told Focus on Africa.
He says the cases are mainly concentrated in the cities of Blantyre and Lilongwe and it is likely that the South Africa variant is responsible for this second wave during the festive season.
"It started in December - the first cases were related to Malawian workers coming back from South Africa and since then it has been local transmission.
"This strain appears to be maybe not more severe, but a lot more contagious."
He said health workers were working extremely hard and capably to increase bed capacity to cope with the situation, but they were suffering too.
"The main constraints to fight the epidemic is the lack of human resources because we have more than 1,100 health staff who have contracted the disease in Malawi... the health work force is deeply affected."
The other problem was oxygen, which was in short supply, he said.
Vaccinations were needed urgently but delivery was unlikely until April, he added.
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