Since the October 2020 Africa’s Pulse, three salient trends characterize the evolution of the COVID-19 pandemic in Sub-Saharan Africa: a second wave of COVID-19 infections and fatalities, the emergence of new variants of the virus, and the rapid development of vaccines.
Despite the logistical challenges to the rollout of vaccination programs worldwide, the accelerated production of vaccines to immunize populations against COVID-19 has been a positive development.
Yet, new variants of the virus have been circulating across the globe—for example, the South African variant has spread among several Sub-Saharan African countries.
The distribution of vaccines, through the World Health Organization-backed COVAX facility or independent acquisitions, has also been slow and plagued with limited supplies.
So far, the vaccine doses received are insufficient for most countries to reach herd immunity in 2021. This slow rollout may keep mobility restrictions in place and slow the pace of recovery.
While the containment measures adopted by governments have helped curb the second wave for some countries, infections and fatalities are rising in others.
Throughout the first year of the pandemic, best practices and knowledge about the COVID-19 virus accumulated gradually.
Avoiding further infections through the use of masks, handwashing and hand sanitizers, as well as social distance, among others, became more commonly accepted and practiced through a process of learning by doing.
Doctors and nurses researched and identified how to treat COVID-19 patients more effectively. However, relaxing behaviors around stemming the spread of the virus—say, not wearing a mask, not practicing social distancing and exceeding restrictions for gatherings—could accelerate infections in the months ahead.
Consequently, it is critical for African citizens to continue these practices and remain vigilant against the virus to prevent further increases in infections.
Moreover, it is essential for governments to continue running public health campaigns and strengthen public health systems. These responses will militate against further infections— especially those from new virus variants that are found to be more contagious and infect younger populations as well.
The fight against the coronavirus is far from over in the region. The new COVID-19 variants have surged the number of new cases and deaths since the second half of December 2020, and hence fueled the second wave of COVID-19 in SubSaharan Africa.
The B.1.351 variant, first identified in South Africa in mid-December 2020, is believed to be 50 percent more contagious. This variant has been found in some African countries (i.e., Botswana, Comoros, Ghana, Kenya, and Zambia) and non-African countries.
It has accelerated the number of cases in South Africa as well as in other countries in the region.
The number of confirmed cases and deaths in South Africa has increased more than the regional average in this period. For instance, the number of confirmed cases in South Africa increased from 14,109 per million people on December 10, 2020 to a peak of 24,435 per million people on January 30, 2021. Meanwhile, fatalities grew from 384 per million people to 741 per million people over the same time period.
This surge in COVID-19 has translated into an average of more than 12,000 new cases per day (203 per million people) and 416 deaths per day (7 per million people).
The regional average, in terms of cases and deaths, has increased at a much slower pace than in South Africa, from 1,339 per million people and 30 per million people on December 10, 2020 to 2,183 per million people and 54 per million people on January 30, 2021, respectively.
The second wave of COVID-19 infections appears to be worse than the first wave in Sub-Saharan Africa due to new variants of the virus which are spreading worldwide.
The true transmission of the virus—in terms of magnitude and acceleration—is unknown due to low levels of testing in the region.
The evolution of new daily COVID-19 cases and deaths in Sub-Saharan Africa and its subregions clearly illustrates the presence of two distinct waves of infections and deaths.
While East and Southern Africa follows a similar trajectory to that of the entire region (SSA), West and Central Africa exhibits a relatively lower daily rate of infections and deaths. For example, the peak of the first wave (around July 24, 2020) is lower than the peak of the second wave (around January 12, 2021).
The East and Southern Africa subregion shows a steeper increase in new cases and deaths. The number of new daily cases in Sub-Saharan Africa has peaked at 14.5 per million people during the first wave while it has reached a maximum of 23.9 per million people during the second wave (i.e. an increase of 9.4 daily cases per million people).
The second peak of infections in West and Central Africa and East and Southern Africa is higher than the first peak by 14.7 and 1.5 new daily cases per million people, respectively. The peak of COVID-19 deaths takes place with a lag relative to the new daily cases.
The peak in deaths during the second wave (around January 19, 2021) is also higher than that of the first wave (July 28, 2020).
The number of deaths in Sub-Saharan Africa reached a peak of 0.3 per million people in the first wave and 0.65 per million people in the second wave.
The peak of death cases has also increased between the two waves in East and Southern Africa and West and Central Africa by 0.57 and 0.03 new daily deaths per million people, respectively.
The combination of a general relaxation of protective measures7 and the new variants of the virus8 has caused the expansion of the second wave in Sub-Saharan Africa. For instance, community mobility towards places of retail and recreation places increased during the holiday season among Zambians.
On December 28, 2020, community mobility increased by 16.9 percent, reaching even higher levels than the pre-pandemic baseline.
The South African variant of the virus was found to have spread among Zambians during the holiday season, given the close ties between these countries in terms of trade and labour migration.
Community mobility towards places of public transportation also increased during the holiday season in Zambia. It was 26 percent higher than pre-pandemic levels prior to December 25, 2020, and between 6 and 17 percent higher than prepandemic levels between December 28 and 31, 2020.
Zambia has shown a steeper increase in the number of cases and deaths since the beginning of January 2021. For example, the number of cases and deaths increased from 1,127.3 per million people and 21.1 per million people on December 31, 2020 to 1,508.2 per million people and 25.5 per million people, respectively, on January 10, 2021 in Zambia.
The peak of cases in South Africa reached 321.1 per million people (on January 11, 2021) after the emergence of the South African variant. Zambia’s peak reached 76.8 per million people on January 17, 2021 immediately following the expansion in South Africa.
Although the containment measures have reduced the number of new daily cases and deaths in the second wave in some Sub-Saharan African countries, other countries in the region are still facing an upward trend in infections.
Accumulated knowledge from the global context has helped propel targeted containment measures effectively and efficiently during this second wave. Recent containment measures have been less strict than those in the first wave, and yet, ultimately correspond with a decrease in the number of new cases and deaths so far.
While the stringency of containment measures has relatively declined during the second wave, community mobility towards the workplace fell more in the first wave than in the second wave, indicating that the second wave lockdown has been partial or focused to let people return to their workplaces as much as possible.
Accordingly, many countries could implement targeted policies to flatten the curve of COVID-19 infections—for example, by imposing partial and/or focused lockdowns—while minimizing their adverse impact on the economy.
Improved effectiveness and efficiency could be one of the silver linings of the cumulative knowledge on the containment and mitigation measures of the pandemic.
Culled from Africa’s Pulse report released by World Bank in April 2021
