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Coronavirus – Africa: Outbreak Brief #42 – Coronavirus Disease 2019 (COVID-19) Pandemic

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Outbreak Update: Since the last brief (27 October 2020), 3,434,225 new confirmed [1] coronavirus disease 2019 (COVID-19) cases and 40,289 new deaths have been reported globally. To date, a total of 46,412,100 COVID-19 cases and 1,193,177 related deaths (case fatality rate (CFR): 2.6%) have been reported from 219 countries and territories. 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 2,641,865 (6%), European Region 11,296,165 (24%), Region of the Americas 20,616,596 (44%), South-East Asia Region 9,305,253 (20%) and Western Pacific Region 738,732 (2%). Among the affected locations, the United States, India, and France have reported over 200,000 new cases in the past seven days. 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) 2 November 2020, a total of 1,803,464 COVID-19 cases and 43,389 deaths (CFR: 2.4%) have been reported in 55 African Union (AU) Member States. This is 4% of all cases reported globally. The majority of countries (41, 75%) are still reporting community transmission. Of the countries actively reporting COVID-19 epidemiologic data, fifteen countries are reporting case fatality rates higher than the global case fatality rate of 2.6%, these include Sahrawi Arab Democratic Republic (7.1%), Chad (6.5%), Sudan (6.0%), Egypt (5.8), Liberia (5.7%), Niger (5.6%), Mali (3.8%), Algeria (3.4%), Gambia (3.2%), Sierra Leone (3.1%), Malawi (3.1%), Zimbabwe (2.9%), Democratic Republic of Congo (2.7%), Burkina Faso (2.7%) and South Africa (2.7%).

For Epi week [3] 44 (26 Oct – 1 November), 74,913 new COVID-19 cases have been reported, which is a 6% increase in the 6% increase in the number of new cases reported compared to compared to Epi week 43. The majority of new COVID-19 cases being reported for this week are from the Northern region (60%) followed by the Southern (20%), Eastern (15%), Western (4%) and Central (1%) regions. Countries reporting the highest incidence (COVID-19 cases per 100,000 population) this week include Tunisia (96), Cabo Verde (75), Libya (73), and Morocco (68).

Table 1 highlights the reported cases and deaths from COVID-19 in all countries in Africa for Epi week 44. 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 15 February to date. During the month of October, there was a slight increase in the number of new cases being reported. For this week, six countries account for approximately 83% of the new COVID-19 cases reported: Morocco (34%), Tunisia (15%), South Africa (15%), Kenya (8%), Libya (7%), and Ethiopia (4%).

Table 1. Confirmed COVID-19 cases, deaths and recoveries [4] reported in Africa for Epi week 44 (26 October – 1 November 2020)

Country

Number of cases

(new)

Percent change in new cases since Epi week 43

Number of deaths (new)

Percent change in new deaths since Epi week 43

Epidemic phase [5]

Central Region

60,806 (1,007)

112%

1,143 (10)

43%

Burundi

589 (32)

113%

1 (0)

NA*

2

Cameroon

22,103 (533)

313%

429 (4)

100%

3

Central African Republic

4,866 (4)

-43%

62 (0)

NA*

3

Chad

1,499 (58)

14%

98 (2)

-33%

3

Congo

5,348 (95)

-2%

92 (0)

NA*

3

Democratic Republic of Congo

11,395 (221)

81%

308 (3)

50%

3

Equatorial Guinea

5,089 (6)

-33%

83 (0)

NA*

3

Gabon

8,968 (49)

29%

55 (1)

NA*

3

Sao Tome and Principe

949 (9)

29%

15 (0)

NA*

2

Eastern Region

215,923 (11,200)

7%

3,981 (178)

11%

Comoros

545 (28)

87%

7 (0)

NA*

3

Djibouti

5,563 (27)

-65%

61 (0)

NA*

2

Eritrea

463 (2)

-78%

(0)

NA*

1

Ethiopia

96,583 (3,240)

-23%

1,478 (52)

-30%

3

Kenya

55,877 (6,156)

27%

1,013 (111)

59%

3

Madagascar

17,111 (143)

-9%

244 (0)

-100%

3

Mauritius

446 (11)

-61%

10 (0)

NA*

1

Rwanda

5,146 (80)

-13%

35 (1)

NA*

2

Seychelles

154 (1)

-75%

(0)

NA*

1

Somalia

3,941 (0)

-100%

104 (0)

-100%

1

South Sudan

2,926 (43)

5%

59 (3)

200%

3

Sudan

13,866 (119)

417%

837 (0)

-100%

3

Tanzania

509 (0)

NA*

21 (0)

NA*

3

Uganda

12,793 (1,350)

58%

112 (11)

175%

2

Northern Region

517,811 (44,497)

12%

14,345 (1,153)

61%

Algeria

57,942 (2,062)

23%

1,964 (57)

-7%

3

Egypt

107,736 (1,196)

7%

6,266 (67)

-15%

2

Libya

62,045 (4,822)

-34%

871 (70)

1%

3

Mauritania

7,703 (40)

-33%

163 (0)

NA*

3

Morocco

222,544 (25,063)

5%

3,762 (461)

24%

2

Tunisia

59,813 (11,314)

96%

1,317 (498)

277%

3

Sahrawi Arab Democratic Republic

28 (0)

NA*

2 (0)

NA*

1

Southern Region

809,140 (15,224)

-13%

20,884 (478)

-12%

Angola

11,035 (1,654)

-6%

286 (18)

-14%

3

Botswana

6,642 (718)

-56%

24 (0)

-100

3

Eswatini

5,925 (71)

-4%

117 (1)

NA*

3

Lesotho

1,953 (13)

-88%

44 (1)

No change

2

Malawi

5,932 (42)

27%

184 (1)

-50%

3

Mozambique

12,988 (1,002)

-11%

93 (7)

-36%

3

Namibia

12,988 (328)

-11%

133 (0)

-100%

3

South Africa

726,823 (10,955)

-9%

19,411 (443)

-11%

3

Zambia

16,480 (343)

21%

349 (1)

-50%

3

Zimbabwe

8,374 (98)

-24%

243 (6)

No change

3

Western Region

190,766 (2,985)

19%

2,771 (39)

34%

Benin

2,683 (126)

107%

41 (0)

NA*

3

Burkina Faso

2,500 (49)

-30%

67 (2)

NA*

3

Cape Verde

8,848 (452)

-30%

95 (1)

-88%

3

Côte d’Ivoire

20,716 (246)

67%

126 (4)

300%

3

Gambia

3,672 (12)

9%

119 (0)

-100%

3

Ghana

48,200 (292)

-21%

320 (2)

-67%

3

Guinea

12,195 (469)

125%

73 (2)

100%

3

Guinea-Bissau

2,413 (10)

-29%

41 (0)

NA*

3

Liberia

1,436 (20)

-49%

82 (0)

NA*

3

Mali

3,565 (75)

-26%

136 (3)

200%

3

Niger

1,221 (6)

20%

69 (0)

NA*

2

Nigeria

62,964 (972)

76%

1,146 (16)

220%

3

Senegal

15,630 (79)

-41%

325 (4)

No change

3

Sierra Leone

2,366 (20)

25%

74 (0)

-100%

3

Togo

2,357 (157)

10%

57 (5)

400%

3

Total

1,794,446 (74,913)

6%

43,124 (1,858)

28%

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

NEW Africa CDC Response Activities:

General:

  1. Africa CDC held its weekly press briefings on Thursday 29 October 2020 at 11 am EAT. The speaker for the week was Dr. John Nkengasong, Director of Africa CDC. 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 in collaboration with the Harvard T.H. Chan School of Public Health launched the Global Nursing Leadership Program that aims to address shortages in human resources for health on the continent.

Healthcare Preparedness and Medical Countermeasures:

Case Management

  1. The Africa CDC Case Management Technical Working Group (TWG) held the 28th clinical webinar titled “Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Kinshasa, DR Congo” and the second session in the “Mental Health Aspects of COVID-19”webinar series on Thursday 29 October 2020. Over 260 participants attended the clinical webinar while over 150 participated in the mental health webinar series. The recordings can be accessed here: https://www.africacdc.training/courses/ccop
  2. Africa CDC is leading the implementation of a COVID-19 vaccine perception study in 15 Member States. Data are currently being analyzed.
  3. The Africa CDC Case Management TWG has facilitated the distribution of dexamethasone tablets to 11 Member States.
  4. This week, the 3rd “Mental Health Aspects of COVID-19” webinar series will be held on Thursday 5 November 2020 at 4pm EAT. Registration link: https://zoom.us/webinar/register/WN_LNL28nAQQvK-rrMLZJ-NKA
  5. A training of trainers on case management will take place in Zambia between 2-4 November 2020.

Infection and Prevention Control (IPC)

  1. The Infection and Prevention Control (IPC) TWG series 4 session 5 webinar titled “Tuberculosis and COVID-19: Risk of delay in TB diagnosis and treatment and IPC overlap” was held on Wednesday 28 October 2020 and 690 participants attended.
  2. This week, the IPC TWG will hold series 4 session 6 webinar titled “IPC for points of entry and transport sectors’’ Tuberculosis and COVID-19: Risk of delay in TB diagnosis and treatment and IPC overlap” in English on Wednesday 4 November 2020 at 1 pm EAT and in French on Friday 6 November 2020 at 1 pm EAT Register here: https://zoom.us/webinar/register/WN_IIC9yfL9QDSyFQmvo61tOw

Laboratory:

  1. Over 18.9 million tests for COVID-19 have been conducted to date with a positivity rate of 9.5% and test per case ratio of 10.5, which is an increase of 3.9% from last week.

Surveillance:

  1. Africa CDC surveillance TWG will hold the third webinar of its 5-part series on “Demography and COVID-19 in Africa: Evidence and Policy Responses to Safeguard the Demographic Dividend” on Wednesday 4 November 2020 at 3 pm EAT. This webinar will include real-time French interpretation. Registration link: https://forms.gle/w4VeWPhUdwqUzSAv6

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/resources/ or at the WHO AFRO link: https://afrolib.afro.who.int/pmb/opac_css/doc_num.php?explnum_id=7728
  2. The Partnership for Evidence-Based Response to COVID-19 (PERC) project has released the latest bi-weekly report discussing the most recent data trends across the continent. This report will be included as an addendum to the Scientific and Public Health Policy Updates as well as the Africa CDC website.

Recommendations for the Member States:

  1. All Member States should continue to enhance their surveillance [6] to include COVID-19 [7] and severe acute respiratory infections (SARI) [8]. 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. [9]
  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.

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.


[1] WHO COVID-19 surveillance guidance and case definition: https://www.who.int/publications/i/item/who-2019- nCoV-surveillanceguidance-2020.7 

[2] WHO coronavirus disease (COVID-19) dashboard: https://covid19.who.int/

[3] Starting this week, Africa CDC is introducing a Monday – Sunday Epi week to standardize all weekly trend analysis and comparisons for all future Africa CDC products.

[4] Data is continuously verified for accuracy and reliability however it may change based on retrospective updates from Member States.

[5] 5 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.

[6] Africa CDC Protocol for enhanced surveillance for COVID-19 in Africa: https://africacdc.org/download/protocol-forenhanced-severe-acute-respiratory-illness-and-influenza-like-illness-surveillance-for-covid-19-in-africa/ 

[7] 7 WHO COVID-19 surveillance guidance and case definition: https://www.who.int/publications/i/item/who-2019- nCoV-surveillanceguidance-2020.7

[8] 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/ 9 Africa CDC Guidance on Contact Tracing for COVID-19 Pandemic: https://africacdc.org/download/guidance-oncontact-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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