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East, Central and Southern Africa Health Community

Issue 4: 21st May to 4th June 2020

Status of COVID-19 in Supported Countries of East, Central and Southern Africa

1 Issue 2: 24th April-7th May

ECSA-HC has continued to monitor the status of COVID-19 in Burundi, Eswatini, Kenya, Lesotho, Malawi,

Mozambique, Mauritius, Rwanda, South Sudan, Tanzania, Uganda, Zambia and Zimbabwe, since March

13th 2020. This is the fourth report on the burden of COVID-19 in those countries. Data were collected

mainly from online public domains, with clarification from in-country focal contacts. This report covers

the period of 21st May to 4th June 2020.

Trend

Kenya reported the highest number of reported confirmed cases of COVID-19 in the region (2340),

followed by Zambia (1089), South Sudan (994) and Uganda (522). Mauritius, reported only 3 more cases,

with a total of 355. Lesotho reported 4 cases. The trend of cases reported is shown in Fig 1. The

distribution of COVID-19 burden in ESA countries is available at:

https://datawrapper.dwcdn.net/NttBg/4/

Fig 1: Reported Confirmed cases of COVID-19 in ESA Countries, 21st May to 4th June 2020

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500

1000

1500

2000

2500

Burundi EswatiniKenya LesothoMalawi MozambiqueRepublic of Mauritius Rwanda

Zambia

South Sudan

Mauritius

Kenya

Tanzania Uganda

2 Issue 2: 24th April-7th May

The number of reported cases of confirmed COVID-19 increased by 84% in the region, compared to

reports of the preceding period. Malawi reported (322, 454%) more cases; Zimbabwe (189, 394%) more;

Kenya had (1311, 127%) more cases, South Sudan had (704, 243%) more and Mozambique (196, 126%)

more reported cases. Lesotho which reported 3 more confirmed cases, had 300% increase. Mauritius

reported only 3 new cases, a 1% increase.

Table 1: Reported confirmed cases and deaths due to COVID-19 in ESA Countries, March 13th-May 20th 2020

Country Reported cases on 4th /JUne Total (New*)

% Increase in cases

Reported cumulative deaths

Recoveries CFR (%)

Burundi 63 (21) 50 1 33 1.6%

Eswatini 300 (83) 38 3 201 1.0%

Kenya 2340(1311) 127 78 592 3.3%

Lesotho 4(3) 300 0 2 0.0%

Malawi 393(322) 454 4 51 1.0%

Mozambique 352 (196) 126 2 114 0.6%

Mauritius 335 (3) 1 10 322 3.0%

Rwanda 410 (96) 31 2 280 0.5%

South Sudan 994 (704) 243 10 6 1.0%

Tanzania 509 (0) 0 21 183 4.1%

Uganda 522 (258) 98 0 82 0.0%

Zambia 1089 (257) 31 7 912 0.6%

Zimbabwe 237 (189) 394 4 31 1.7%

Total 7548 (3443) 84 142 2809 1.9 %

Deaths

Overall, 43% more COVID-19 related deaths occurred between 21st May and 4th June than in the previous

reporting period. No deaths were reported in Lesotho, and Uganda. No new deaths occurred in Burundi,

Eswatini, Mauritius, Tanzania, Zambia and Zimbabwe. The highest increase in deaths was reported in

Kenya, where 28 (56%) more deaths were reported; and South Sudan reported (9, 900%) more deaths.

Malawi had one more death, and Mozambique and Rwanda had 2 each. The case fatality ratio was 1.9%.

Recovery

Out of a 7548 cases that had been cumulatively reported, 142 (1.9%) had died and 1566 (37.2%) been

declared as recovered. Over 61% are therefore still under follow-up and care. Mauritius, reported 2 new

3 Issue 2: 24th April-7th May

imported cases and nearly all identified surviving identified cases (322) have recovered. The pandemic in

Mauritius is fairly well controlled.

Fig 2: Reported cases, deaths and recovery from COVID-19 in ESA Countries 13th March to 4th June 2020

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1000

1500

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2500

Reported cases Reported deaths Recoveries CFR (%)

4 Issue 2: 24th April-7th May

ECSA-HC Support

ECSA-HC has continued to support countries mitigate effects of COVID-19. Due to the prevailing restrictions of travel, much has been provided through online discussions and support and consultation with countries on their needs continues.

Interventions

1. ECSA-HC has continued to hold webinars for health workers in all ESA countries and beyond. Topics discussed include: clinical management of COVID-19; COVID-19 diagnostics—present and future possibilities; infection prevention and control in the context of COVID-19; expansion of diagnostics in the African region; biosafety and biosecurity in the context of COVID-19. IHR (2005) and preparation and deployment of rapid response teams follow.

2. Other training has included: surveillance at Points of Entry, contact tracing, case management and laboratory diagnosis of COVID-19, in Lesotho, Malawi, Zambia and Zimbabwe.

3. In Kenya, the organization has supported capacity building for sub-national rapid response teams and expanding testing capacities—five of the EAPHLNP-supported laboratories (Wajir, Machakos, Malindi, Busia and Kitale) have been designated testing centers for their catchment regions for COVID-19.

4. ECSA-HC is coordinating ministries of health in East Africa to implement a coordinated regional approach to COVID-19 response, with emphasis on Points of Entry.

5. ECSA-HC is in consultation with EAIDSNet and EAC to further support disease surveillance activities with funding from CORDS.

6. ECSA-HC coordinated a meeting between national and cross-border teams of Zambia and Tanzania for the Chirundu, Siavonga (Tanzania) and Hurungwe, Kariba (Zimbabwe) districts. Like in East Africa, participants raised concern about cross-border transmission of COVID-19, and the need to harmonize screening, testing and contact tracing protocols, and improve cross-border sharing of relevant information. Truck drivers and commercial sex workers were noted to be especially a risky population. The team agreed and is working on finalization of the COVID-19 Medical certificate that will facilitate efficient movement of truck drivers carrying essential goods across the border. Contact tracing teams with membership from either side of the border were formulated for real time communication.

7. ECSA-HC is also collaborating with AUDA-NEPAD and other regional and international organizations like ILO to develop Occupational Health and Safety (OHS) guidelines in the context of COVID-19, especially addressing the question of “safe return to work”. Weekly online webinars on OHS in the context of COVID-19 have been conducted where all sectors including mining, retail, education, agriculture, transport have participated.

8. As a member of the Africa CDC COVID-19 surveillance Technical Working Group, ECSA-HC has continued to participate in weekly meetings and contributed to the development of several guidance documents that include the Expansion of Community Health Workers under the Africa

5 Issue 2: 24th April-7th May

union Partnership for Accelerated COVID-19 Testing (PACT) Initiative, Resumption of Air Transport Operations in African Countries: Public Health Key Considerations

Comment

The pandemic is taking different forms in the observed countries. Lesotho just reported the first case.

Kenya and Zambia had an accelerated increase in cases. Mauritius and Tanzania had stagnated in numbers

reported. The overall number of deaths increased too, but two countries (Lesotho and Uganda) had not

reported a COVID-19 related death yet.

The burden of cases under care or follow up is still high—61% of identified cases are still under care or

follow-up, requiring resources that include human resource for health, medical supplies, physical facilities

(for care, isolation and quarantine) and laboratories.. There is still need for continued support to the

region to handle the pandemic.

The progress of the pandemic in the region has been slow in the initial stages, but is now steadily

accelerating. Only Mauritius seems to have flattened the its epi curve. Kenya, Zambia and South Sudan

have shown sharp acceleration. It is not known what shape the curve may take, therefore requiring the

countries to maintain pressure on case identification, contact tracing and isolating cases and quarantining

psossible contacts. The drivers of the pandemic in the region could be associated with special populations.

These should be identified for targeted interventions. More resources for control are needed. Therefore,

ECSA-HC approach to collaborate with partners such as US CDC, Africa CDC, CORDS and others, should be

encouraged and natured. While this burden is getting higher, the countries need to balance it against the

need to open up their economies. There is therefore need to develop containment procedures with

reduced social distancing.

Conclusion

The number of reported confirmed cases of COVID-19 in the region is increasing, in spite of the fear of

under-reporting. The burden of cases under care is getting bigger. At the same time, the governments

wish to open up economies to take care of individual and national economic survival. Generic and targeted

and special populations targeted interventions need to be developed in the context of modified social

distancing mechanisms. Health Partners are needed to offer the needed support with diagnostics, care of

recovering cases, contact tracing and surveillance across countries, taking note of the fluid movement of

people across borders. The region adopting collaborative efforts would therefore be cost-efficient. ECSA-

HC is in pole position to offer this coordination, as exemplified by the non-costly webinar sessions that

have been held since March.