COVID-19 pandemic in Africa’s island nations during the first 9 months: a descriptive study of variation in patterns of infection, severe disease, and response measures

Abstract

The geographic and economic characteristics unique to island nations create a different set of conditions for, and responses to, the spread of a pandemic compared with those of mainland countries. Here, we aimed to describe the initial period of the COVID-19 pandemic, along with the potential conditions and responses affecting variation in the burden of infections and severe disease burden, across the six island nations of the WHO’s Africa region: Cabo Verde, Comoros, Madagascar, Mauritius, São Tomé e Príncipe and Seychelles. We analysed the publicly available COVID-19 data on confirmed cases and deaths from the beginning of the pandemic through 29 November 2020. To understand variation in the course of the pandemic in these nations, we explored differences in their economic statuses, healthcare expenditures and facilities, age and sex distributions, leading health risk factors, densities of the overall and urban populations and the main industries in these countries. We also reviewed the non-pharmaceutical response measures implemented nationally. We found that the burden of SARS-CoV-2 infection was reduced by strict early limitations on movement and biased towards nations where detection capacity was higher, while the burden of severe COVID-19 was skewed towards countries that invested less in healthcare and those that had older populations and greater prevalence of key underlying health risk factors. These findings highlight the need for Africa’s island nations to invest more in healthcare and in local testing capacity to reduce the need for reliance on border closures that have dire consequences for their economies.

A panel dataset of COVID-19 vaccination policies in 185 countries

“…Many countries in the WHO West Pacific Region adopted policies closer to the elimination model, perhaps in part due to the region’s previous experience with SARS 11 , 13 . Relatedly, it has also been hypothesized that island nations may have been more likely to pursue elimination models during COVID-19 due to their geographical advantage of isolation and ability to seal national borders, although for many low-income countries (LICs) and LMICs, this came at appreciable economic cost 11 , 15 – 18 . Finally, early responses to the COVID-19 pandemic have also highlighted distinctions between mitigation and elimination strategies based on the Organisation for Economic Co-operation and Development (OECD) countries, such as high-performing surveillance systems with early and targeted contact tracing and widespread efficient testing in eliminator countries 12 , 14 .…”

Developing forecasting capacity for public health emergency management in Africa using syndemics approach: lessons from the COVID-19 pandemic

“…12 13 Notably, the establishment of the GRAPH network-a group of African multidisciplinary scientists and international collaborators-during the early phase of the COVID-19 pandemic has remained very instrumental to the continued understanding of the COVID-19 pandemic dynamics in the African region. [14][15][16][17] Certainly, with these developments, we believe that the WHO AFRO and other African health partners are already well positioned to support the development of a sustainable forecasting capacity in Africa for future pandemics as well as other emergencies.…”

“…This is because, for example, the GRAPH network and WHO Hub for Pandemic and Epidemic Intelligence, which seek to strengthen surveillance systems and data analytics for improved decision-making during public health emergencies in the African region and globally, respectively, have recognised modelling as an essential component of their activities 12 13. Notably, the establishment of the GRAPH network—a group of African multidisciplinary scientists and international collaborators—during the early phase of the COVID-19 pandemic has remained very instrumental to the continued understanding of the COVID-19 pandemic dynamics in the African region 14–17. Certainly, with these developments, we believe that the WHO AFRO and other African health partners are already well positioned to support the development of a sustainable forecasting capacity in Africa for future pandemics as well as other emergencies.…”

The Practice of Post-vaccination COVID-19 Prevention Strategy Among Healthcare Professionals in Felege Hiwot Referral Hospital, Northwest Ethiopia

“…3 The burden of severe COVID-19 outcomes was the highest in African countries with older populations, limited healthcare resources, and a high frequency of pre-existing health risks such as cancer, diabetes, air pollution, and obesity. [4][5][6][7] However, multiple factors can weaken epidemic preparedness. Preparedness in low-income countries (LICs) is further faced by the general weakness of health structures: poor quality of healthcare, low human resources capacity, lack of equipment and facilities, and vulnerable supply chains.…”