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Coronavirus – Africa: Outbreak Brief #40 – Coronavirus Disease 2019 (COVID-19) Pandemic

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Outbreak Update: Since the last brief (13 October 2020), 2,524,173 new confirmed [1] coronavirus disease 2019 (COVID-19) cases and 36,810 new deaths have been reported globally. To date, a total of 39,952,759 COVID-19 cases and 1,112,108 related deaths (case fatality rate (CFR): 2.8%) have been reported from 219 countries and territories. This week, one new territory, Wallis & Futuna, reported its first case. The distribution of cumulative cases (proportion of global cases) from the World Health Organization (WHO) reporting regions (excluding Africa) are as follows: Eastern Mediterranean Region 2,377,444 (6%), European Region 8,027,640 (20%), Region of the Americas 18,709,984 (47%), South-East Asia Region 8,489,775 (21%) and Western Pacific Region 684,698 (2%). Among the affected locations, India, the United States, France, Brazil, the United Kingdom, and Russia have reported over 100,000 new cases over the past week. For more detailed information on cases and deaths being reported outside of Africa, refer to the WHO daily situation reports. [2]

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As of 9 am East African Time (EAT) 20 October 2020, a total of 1,654,406 COVID-19 cases and 39,864 deaths (CFR: 2.4%) have been reported in 55 African Union (AU) Member States. This is 4% of all cases reported globally. Since the last brief, 69,922 new COVID-19 cases have been reported, which is a 6% increase in the number of new cases reported when compared to the 13 October 2020 brief. The proportion of new COVID-19 cases by AU region is as follows: 58% from the Northern region (40,574 cases; 6% increase from previous week), 23% from the Southern region (15,979; 10% increase), 13% from the Eastern region (9,393; 2% increase), 5% from the Western region (3,356; 8% increase) and 1% from the Central region (626; 3% decrease).

Six countries account for approximately 86% of the new COVID-19 cases reported since the last brief: Morocco (32%), South Africa (17%), Tunisia (15%), Libya (9%), Ethiopia (8%), and Kenya (5%). Countries reporting the highest incidence (COVID-19 cases per 100,000 population) over the past seven days in Africa include Cabo Verde (118), Libya (97), Tunisia (96), Morocco (52), South Africa (19), Namibia (12) and Sao-Tome (8). Of the countries actively reporting COVID-19 epidemiologic data, thirteen countries are reporting case fatality rates higher than the global case fatality rate of 2.8%, These include Sahrawi Arab Democratic Republic (7.1%), Chad (6.7%), Sudan (6.1%), Liberia (5.9%), Egypt (5.8), Niger (5.7%), Mali (3.9%), Algeria (3.4%), Angola (3.2%), Gambia (3.2%), Sierra Leone (3.1%) and Malawi (3.1%).

Table 1 highlights the reported cases and deaths from COVID-19 in all countries in Africa. In addition, the table reports the current phase of the epidemic for each country. Figure 1 shows the trend of new COVID-19 cases reported by day and region from 29 February to date. We observed a decline in the daily new cases being reported in Africa during the month of July and August, mostly influenced by South Africa. During the month of October, there has been a slight increase in the number of new cases being reported. The countries (i.e. Libya, Morocco, and Tunisia) in the Northern region along with are contributing in recent weeks.

Table 1. Confirmed COVID-19 cases, deaths and recoveries reported in Africa [3] as of 20 October 2020, 9 am East Africa Time

Country

Number of cases

(new)

Percent change in new cases since the previous brief

Number of deaths (new)

Percent change in new deaths since the previous brief

Epidemic phase [4]

Central Region

59,395 (626)

-3%

1,127 (29)

107%

Burundi

549 (24)

118%

1 (0)

NA*

2

Cameroon

21,506 (303)

9%

424 (1)

-67%

3

Central African Republic

4,855 (1)

-96%

62 (0)

NA*

3

Chad

1,390 (82)

-4%

93 (1)

-83%

3

Congo

5,156 (0)

-100%

92 (0)

-100%

3

Democratic Republic of Congo

11,052 (184)

104%

303 (27)

1250%

3

Equatorial Guinea

5,070 (4)

-81%

83 (0)

NA*

3

Gabon

8,884 (24)

-54%

54 (0)

NA*

3

Sao Tome and Principe

933 (4)

-75%

15 (0)

NA*

2

Eastern Region

195,381 (9,393)

2%

3,664 (134)

-2%

Comoros

502 (7)

-13%

7 (0)

NA*

3

Djibouti

5,469 (43)

760%

61 (0)

NA*

2

Eritrea

452 (38)

138%

(0)

NA*

1

Ethiopia

89,860 (4,724)

-17%

1,365 (64)

-10%

3

Kenya

45,076 (3,457)

59%

839 (62)

48%

3

Madagascar

16,814 (88)

-44%

238 (1)

-75%

3

Mauritius

419 (15)

-21%

10 (0)

NA*

1

Rwanda

4,992 (87)

129%

34 (2)

-33%

2

Seychelles

149 (1)

-75%

(0)

NA*

1

Somalia

3,890 (26)

-78%

101 (2)

NA*

1

South Sudan

2,847 (60)

-2%

55 (0)

-100%

3

Sudan

13,711 (20)

-47%

836 (0)

NA*

3

Tanzania

509 (0)

NA*

21 (0)

NA*

3

Uganda

10,691 (827)

-8%

97 (3)

-75%

2

Northern Region

436,010 (40,574)

6%

12,546 (458)

-23%

Algeria

54,402 (1,334)

40%

1,856 (-247)

-702%

3

Egypt

105,547 (899)

4%

6,130 (68)

-6%

2

Libya

49,949 (6,128)

-13%

732 (88)

69%

2

Mauritania

7,608 (54)

59%

163 (0)

-100%

3

Morocco

175,749 (21,988)

15%

2,976 (340)

27%

2

Tunisia

42,727 (10,171)

-2%

687 (209)

33%

2

Sahrawi Arab Democratic Republic

28 (0)

NA*

2 (0)

NA*

1

Southern Region

778,300 (15,979)

10%

19,884 (671)

-26%

Angola

7,829 (1,341)

23%

248 (29)

21%

2

Botswana

4,274 (759)

121%

21 (1)

-75%

2

Eswatini

5,788 (105)

1%

116 (3)

200%

3

Lesotho

1,833 (28)

-77%

42 (0)

-100%

2

Malawi

5,860 (36)

20%

181 (1)

NA*

3

Mozambique

11,080 (992)

25%

75 (3)

-50%

3

Namibia

12,326 (337)

-7%

131 (2)

-67%

3

South Africa

705,254 (11,895)

7%

18,492 (629)

-26%

3

Zambia

15,897 (348)

-24%

346 (1)

-92%

3

Zimbabwe

8,159 (138)

12%

232 (2)

No change

3

Western Region

185,326 (3,356)

8%

2,704 (36)

24%

Benin

2,496 (85)

57%

41 (0)

NA*

3

Burkina Faso

2,387 (93)

-15%

65 (2)

-50%

3

Cape Verde

7,800 (645)

-11%

87 (12)

71%

2

Côte d’Ivoire

20,324 (169)

-37%

121 (1)

NA*

3

Gambia

3,649 (17)

-55%

118 (1)

-50%

3

Ghana

47,372 (342)

70%

310 (2)

-60%

3

Guinea

11,518 (456)

74%

70 (0)

-100%

3

Guinea-Bissau

2,389 (4)

-83%

41 (1)

No change

3

Liberia

1,381 (10)

-41%

82 (0)

NA*

3

Mali

3,407 (111)

4%

132 (0)

-100%

3

Niger

1,211 (9)

350%

69 (0)

NA*

2

Nigeria

61,558 (1,128)

17%

1,125 (10)

400%

3

Senegal

15,432 (140)

-38%

319 (4)

33%

3

Sierra Leone

2,331 (25)

-32%

73 (1)

NA*

3

Togo

2,071 (122)

44%

51 (2)

100%

3

Total

1,654,412 (69,928)

6%

39,925 (1,328)

-21%

*No new cases/deaths reported in the previous week.

 NEW Africa CDC Response Activities:

General:

  1. Africa CDC held its last weekly press briefings on Monday 12 October 2020 at 7 am EAT to launch the Pathogen Genomics Initiative. The speaker for the week was Dr. John Nkengasong, Director of Africa CDC, Dr. David Blazes, President of Global Health at the Bill and Melinda Gates Foundation and Dr. Phillip Febbo, CEO of Illumina Inc. The recording for this press brief session is available on the Africa CDC Facebook page. Link: https://web.facebook.com/watch/?v=757691255074767&extid=gyiQO5GcQdC8XNaY
  2. Africa CDC Public Health Emergency Operations Centres (PHEOCs) and COVID-19 Management held its weekly webinar series and online community of practice on Thursday, 15 October 2020 at 3 pm EAT. Link: https://t.co/nP42sfkWBj?amp=1
  3. Africa CDC is hosting the last in its series of One Health and COVID-19 webinars on Monday, 26 October 2020 at 4 pm EAT. This webinar will focus on Africa CDC’s new guidance document, Framework for One Health Practice in National Public Health Institutes: Zoonotic Disease Prevention and Control. Please register here: https://zoom.us/webinar/register/WN_emn-WEp0TSq7qGnAuT-STA  

Healthcare Preparedness and Medical Countermeasures:

Case Management

  1. The Africa CDC Case Management TWG held the 26th clinical webinar titled “COVID-19 vaccine development and access in AU member states” on 15 October 2020 at 2 pm EAT. The recording can be accessed here: https://www.africacdc.training/courses/ccop

Infection and Prevention Control (IPC)

  1. This week, the IPC TWG will hold a webinar titled “Tuberculosis and COVID-19: Risk of delay in TB diagnosis and treatment and IPC overlap” in English on 21 October 2020 at 1 pm EAT. Register here: https://zoom.us/webinar/register/WN_IIC9yfL9QDSyFQmvo61tOw

Laboratory:

  1. Over 16 million tests for COVID-19 have been conducted to date with a positivity rate of 9.7% and test per case ratio of 10.3, which is an increase of 5.3% from last week.
  2. Africa CDC on 8 October 2020 received the 3rd donation of 702,000 RT-PCR testing kits from the Government of German and the European Union (EU). The testing kits would be distributed to more than 30 Member States.

Surveillance:

  1. Africa CDC surveillance TWG will hold 5 webinar series of “Demography and COVID-19 in Africa: Evidence and Policy Responses to Safeguard the Demographic Dividend”. The first webinar is on Wednesday 21 October 2020 at 3 – 5 pm EAT. This webinar will include real-time French interpretation. Registration link: https://forms.gle/w4VeWPhUdwqUzSAv6
  2. To join the Surveillance community of practice (COP): https://t.me/joinchat/LcgdqBSrCkAArYQfFC8Bcw

Sciences, Standards and Regulations:

  1. Access the weekly COVID-19 Scientific and Public Health Policy Update which is published every other week on Tuesdays at https://africacdc.org/download/covid-19-scientific-and-public-health-policy-update-20-october-2020/ or at the WHO AFRO link: https://afrolib.afro.who.int/pmb/opac_css/doc_num.php?explnum_id=7728  

Recommendations for the Member States:

  1. All Member States should continue to enhance their surveillance [5] to include COVID-19 [6] and severe acute respiratory infections (SARI) [7]. Examples of enhanced surveillance include:
    1. Adding questions about travel, contact history, and testing for coronaviruses to existing influenza surveillance systems;
    2. Notifying healthcare facilities to immediately inform local public health officials about persons who meet the case definition for COVID-19, SARI and/or have recent travel to a country with local transmission or history of contact with a case.
  2. Member States should perform contact tracing of confirmed cases based on transmission type and country capacity. [8]
  3. Member states should notify and routinely share with WHO and Africa CDC data regarding suspected or confirmed COVID-19 cases, deaths, recoveries, tests conducted and healthcare workers infected to continually inform these and other updates. Notify Africa CDC by emailing: AfricaCDCEBS@africa-union.org.
  4. Member states should continue to provide guidance to the general public about seeking immediate medical care and informing healthcare providers about recent travel or contact history in anyone who develops symptoms of severe respiratory illness.
 


[2] WHO coronavirus disease (COVID-19) situation reports: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

[3] New numbers reported since last weekly report (13 October 2020, 9am EAT)

[4] Phases defined according to Africa CDC’s Recommendations for a stepwise COVID-19 response – https://africacdc.org/download/recommendations-for-stepwise-response-to-covid-19/: Phase 0 (No COVID-19 case): no reported case in-country; Phase 1 (Early stage outbreak): one or more imported cases, limited local transmission related to imported cases; Phase 2 (Expanding outbreak): increasing number of imported cases, increased local spread but all cases linked to known transmission chains, outbreak clusters with a known common exposure; Phase 3 (Advancing outbreak): localized outbreaks start to merge, one or more cases or deaths occur outside known transmission, multiple generations in transmission chains, cases are detected among severe acute respiratory illness (SARI) case with no known exposure; Phase 4 (Large outbreak with nationwide transmission): widespread sustained community transmission, multiple generation transmission chains can be identified but most cases occurring outside of chains, community-wide transmission throughout all or nearly all of the country

[7] WHO SARI case definition: anyone with an acute respiratory infection with a history of fever (or measured fever of ≥ 38 C°) and cough with symptom onset within the last 10 days that requires hospitalization.   https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/

[8] Africa CDC Guidance on Contact Tracing for COVID-19 Pandemic: https://africacdc.org/download/guidance-on-contact-tracing-for-covid-19-pandemic/

Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).


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