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Endemicity of COVID-19 to Sub-Saharan Africa: A Review of the Past, Present and Future Risk
16 Pages Posted: 20 Sep 2021
More...Abstract
Background: The incidence and burden of endemic or potentially endemic infectious diseases (IDs) is highest in Sub-Saharan Africa (SSA) with a new disease to emerge every 8 months on average. The epidemic of preventable IDs becoming endemic to SSA serves as a stack reminder of the region’s systematic failings to health security. It is more important now than ever to evaluate SSA’s vulnerability to COVID-19, a global pandemic becoming endemic to the region after it perhaps gets eliminated from the other world regions.
Method: The International Health Regulations (IHR [2005]) and Global Health Security Index (GHSI) scores for SSA before COVID-19 reached the region were obtained and evaluated to assess its health security preparedness. The number of cases, deaths and stringency measures of the first year of the virus in the region were used to ascertain the possibility of the virus becoming endemic to SSA. By this, COVID-19 confirmed cases and deaths of the region were obtained from the COVID-19 Data Repository by the Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University. The stringency measures put in place by each country were obtained from the Oxford COVID-19 Government Response Tracker (OxCGRT). Data from the Global Infectious Diseases and Epidemiology Online Network (GIDEON) was then used to evaluate the intensity and distribution of endemic or potentially endemic IDs after COVID-19 reached SSA.
Findings: Before the virus reached the region, 31% and 37% of the SSA countries moderately adhered to the IHR and GHSI score respectively. The overall performance of the region in its first year of responding and containing the virus was 56% compared to a global average of 60%. For the first year period of the virus, South Africa with the highest GHSI of 54·8% before the virus reached the region accounted for 55% of the total cases within the first year. Majority of the cases (48%) and deaths (55%) of the first year were recorded in the last three months when values of the stringency measures fell below 50%. For the region, the number of mortalities to cases ratio for the first wave (July 2020) was 1·47:98·53 compared to the second wave (February 2021) of 3·54:96·46. It was also observed that, an average of 222 IDs were endemic or potentially endemic to SSA after COVID-19 reached the region.
Interpretation: It was revealed that there is a high possibility of devastating subsequent waves of COVID-19 and it becoming endemic to the region after assessing the stringency measures that were put in place, relative to the number of cases and deaths over the first year period.
Funding: None to declare.
Declaration of Interest: None to declare.
Keywords: COVID-19, Endemicity, Sub-Saharan Africa, Infectious Diseases
Suggested Citation: Suggested Citation