NAIROBI, Kenya (AP) — The African continent has surpassed 2 million confirmed cases as health officials warn of infections starting to creep up again into a second surge.

The Africa Centers for Disease Control and Prevention said Thursday that the continent had crossed that milestone. Its numbers show the 54-country continent also has seen more than 48,000 deaths from COVID-19.

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.

The Africa CDC director this week openly worried that the level of mask-wearing has gone down and called that dangerous.

“We don’t know how high the second peak will come," John Nkengasong said Monday.

While the world takes hope from recent news about promising COVID-19 vaccines, African health officials also worry that the continent will suffer as richer countries buy up supplies.

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 alone, leading a powerful health union in the country to threaten a nationwide strike starting next month.

The African continent has conducted nearly 20 million coronavirus tests since the pandemic began, but shortages mean the true number of infections is unknown.