On 1 July, Africa’s third wave surpassed the second-wave peak in daily confirmed cases of Covid-19 – and the numbers continue to climb, though week-on-week growth has seen a slight decline of 0.8 per cent for the first time in two months. The unprecedented surge of this third wave in Africa is largely attributable to the presence of the more transmissible Delta variant, which has been spreading quickly across the continent and is now confirmed in 19 countries, especially in areas where there has been reduced adherence to public-health and social-distancing measures.
Unlike in previous waves, younger populations are this time reporting more symptoms – including those that require hospitalisation – and rural communities are experiencing relatively higher case numbers, indicating dangerous and widespread transmission.
A total of 19 countries have just registered an increase in weekly cases above or equal to 20 per cent, including in Malawi, Mozambique and Zimbabwe, which are experiencing continuing surges, as well as Ethiopia, Nigeria and Senegal, which are seeing escalating community spread.
Some countries that had been facing exponential growth, however, are starting to flatten their curves. Cases in Namibia, Uganda and Zambia surged throughout June with reports of hospitals being stressed beyond capacity, oxygen shortages and morgues quickly filling up. Although daily case numbers are still radically higher than they were in May and the continuing stress on health systems, these countries are reporting a decrease in cases of more than 20 per cent compared to the previous week.
In order to stem transmission, many of these countries have imposed new restrictive measures on their populations.
Figure 1 – Daily new confirmed cases shown incorporating the introduction of lockdown measures
Source: Our World in Data and other media outlets (dates of lockdowns represented are approximate)
To understand the impact of lockdowns on transmission trends, we have conducted high-level analysis of epidemiological curves against the dates on which new measures have been imposed in countries with surges that began in June. We found that while there is evidence from global studies that lockdowns are effective in slowing viral spread, it is difficult to directly attribute decreasing case numbers to restrictions in these particular countries.
Namibia imposed initial restrictions in mid-June that included suspension of in-person classes, a curfew and a limit on public gatherings to ten people. But cases continued to climb so, on 1 July, the country expanded those restrictions by applying a nationwide limit on international and inter-regional air and road travel, restricting alcohol sales and moving the evening curfew from 10pm to an earlier 9pm. Within approximately one week of these additional measures, daily cases in Namibia appear to fall.
In Rwanda, initial restrictions to curb the third wave were implemented around 23 June, including limiting travel between Kigali and the rest of the country and a curfew from 7pm to 4am. Less than a week later, Rwanda’s daily case growth started to slow. Despite this, the country implemented even tougher restrictions on 1 July, including closing schools, prohibiting all inter-regional travel, and barring worship services and social gatherings. Since late June, cases have not climbed but they haven’t significantly declined yet either, plateauing around the 830-mark since 27 June.
Both Zimbabwe and Mozambique have implemented new measures since cases began surging in mid-June, including curfews, stay-at-home orders and limitations on gatherings, yet daily numbers have continued to grow.
Growth and decline in case numbers is therefore attributable to more than just the introduction – and degree – of restrictive measures. Other factors likely at play include:
the success of public-risk communication strategies
type of evidence-based measures implemented
amount of testing conducted
characteristics of the individual variants, particularly the implications of higher transmissibility in local contexts
In deciding to implement lockdown measures, these countries have had the difficult task of balancing lives and livelihoods. Implementing targeted, evidence-based, context-specific restrictions on movement can be effective and may be necessary in certain conditions to stem transmission. Those policies should be considered, however, in combination with stronger public-awareness campaigns, increased mass testing and expanded vaccination programmes.
In short, governments should be taking a holistic approach to flattening the third-wave curve.
Lead Image: Getty Images