Coronavirus - Africa: Outbreak Brief #41 - Coronavirus Disease 2019 (COVID-19) Pandemic Six countries account for approximately 84% of the new COVID-19 cases reported ADDIS ABABA, Ethiopia, October 28, 2020/APO Group/ -- Outbreak Update: Since the last brief (20 October 2020), 3,025,116 new confirmed [1] coronavirus disease 2019 (COVID-19) cases and 40,780 new deaths have been reported globally. To date, a total of 42,977,875 COVID-19 cases and 1,152,8883 related deaths (case fatality rate (CFR): 2.7%) have been reported from 219 countries and territories. This week, no new country or territory reported its first case. 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 2,499,316 (6%), European Region 9,474,721 (22%), Region of the Americas. Download Document: https://bit.ly/2G6FUmM 19,629,837 (46%), South-East Asia Region 8,924,840 (21%) and Western Pacific Region 711,899 (2%). Among the affected locations, India, the United States, France, Brazil and the United Kingdom have reported over 100,000 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] As of 9 am East African Time (EAT) 27 October 2020, a total of 1,728,682 COVID-19 cases and 41,623 deaths (CFR: 2.4%) have been reported in 55 African Union (AU) Member States. This is 4% of all cases reported globally. Of the countries actively reporting COVID-19 epidemiologic data, thirteen countries are reporting case fatality rates higher than the global case fatality rate of 2.7%, these include Sahrawi Arab Democratic Republic (7.1%), Chad (6.7%), Sudan (6.1%), Liberia (5.8%), Egypt (5.8), Niger (5.7%), Mali (3.8%), Algeria (3.4%), Gambia (3.3%), Sierra Leone (3.2%), Malawi (3.1%), Zimbabwe (2.9%) and Angola (2.8%). For Epi week3 43 (19-25 October), 74,565 new COVID-19 cases have been reported, which is a 12% increase in the number of new cases reported when compared to Epi week 42. The majority of new COVID-19 cases being reported for this week are from the Northern region (55%) followed by the Southern (25%), Eastern (16%), Western (3%) and Central (1%) regions. Countries reporting the highest incidence (COVID-19 cases per 100,000 population) this week include Libya (110), Cabo Verde (107), Morocco (57), Tunisia (49), Botswana (26), South Africa (21) and Namibia (14). Table 1 highlights the reported cases and deaths from COVID-19 in all countries in Africa for Epi week 43. 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. We observed a decline in the daily new cases being reported in Africa during the month of July and August, mostly influenced by South Africa. During the month of October, there has been a slight increase in the number of new cases being reported. For this week, six countries account for approximately 84% of the new COVID-19 cases reported: Morocco (31%), South Africa (18%), Libya (11%), Tunisia (9%), Kenya (7%) and Ethiopia (6%). Table 1. Confirmed COVID-19 cases, deaths and recoveries reported in Africa [3] for Epi week 43 (19-25 October 2020)

Country

Number of cases

(new)

Percent change in new cases since the previous brief

Number of deaths (new)

Percent change in new deaths since the previous brief

Epidemic phase [4]

Central Region

59,777 (453)

-22%

1,133 (7)

-75%

Burundi

557 (15)

-17%

1 (0)

NA*

2

Cameroon

21,570 (129)

-46%

425 (2)

NA*

3

Central African Republic

4,862 (7)

600%

62 (0)

NA*

3

Chad

1,441 (51)

-38%

96 (3)

200%

3

Congo

5,253 (97)

NA*

92 (0)

NA*

3

Democratic Republic of Congo

11,174 (122)

-34%

305 (2)

-93%

3

Equatorial Guinea

5,079 (5)

-38%

83 (0)

NA*

3

Gabon

8,901 (20)

-57%

54 (0)

NA*

3

Sao Tome and Principe

940 (7)

75%

15 (0)

NA*

2

Eastern Region

204,723 (11,994)

28%

3,803 (161)

16%

Comoros

517 (15)

114%

7 (0)

NA*

3

Djibouti

5,536 (84)

115%

61 (0)

NA*

2

Eritrea

461 (9)

-76%

(0)

NA*

1

Ethiopia

93,343 (4,909)

1%

1,426 (74)

14%

3

Kenya

49,721 (5,525)

66%

902 (70)

6%

3

Madagascar

16,968 (158)

72%

244 (6)

500%

3

Mauritius

435 (28)

133%

10 (0)

NA*

1

Rwanda

5,066 (95)

22%

34 (0)

-100%

2

Seychelles

153 (4)

300%

(0)

NA*

1

Somalia

3,941 (77)

NA*

104 (5)

NA*

1

South Sudan

2,883 (66)

2%

56 (1)

NA*

3

Sudan

13,747 (36)

9%

837 (1)

NA*

3

Tanzania

509 (0)

NA*

21 (0)

NA*

3

Uganda

11,443 (988)

25%

101 (4)

No change

2

Northern Region

470,151 (40,620)

9%

13,134 (656)

-7%

Algeria

55,880 (1,687)

49%

1,907 (61)

24%

3

Egypt

106,397 (1,100)

21%

6,187 (67)

-1%

2

Libya

57,223 (8,433)

38%

801 (69)

-22%

2

Mauritania

7,663 (78)

47%

163 (0)

NA*

3

Morocco

194,461 (23,550)

11%

3,255 (327)

1%

2

Tunisia

48,499 (5,772)

-27%

819 (132)

-25%

2

Sahrawi Arab Democratic Republic

28 (0)

NA*

2 (0)

NA*

1

Southern Region

792,922 (18,736)

17%

20,403 (542)

-27%

Angola

9,381 (1,919)

53%

268 (21)

-28%

2

Botswana

4,930 (656)

-38%

21 (0)

-100%

2

Eswatini

5,854 (89)

-20%

116 (0)

-100%

3

Lesotho

1,940 (107)

282%

43 (1)

NA*

2

Malawi

5,890 (38)

6%

183 (2)

100%

3

Mozambique

11,986 (1,279)

48%

86 (11)

175%

3

Namibia

12,660 (397)

11%

133 (2)

-33%

3

South Africa

715,868 (13,737)

21%

18,968 (497)

-28%

3

Zambia

16,137 (348)

-12%

348 (2)

-78%

3

Zimbabwe

8,276 (166)

22%

237 (6)

500%

3

Western Region

187,557 (2,762)

-18%

2,730 (27)

-25%

Benin

2,557 (61)

-28%

41 (0)

NA*

3

Burkina Faso

2,451 (108)

-2%

65 (0)

-100%

3

Cape Verde

8,396 (758)

11%

94 (8)

-27%

2

Côte d’Ivoire

20,470 (169)

No change

122 (1)

No change

3

Gambia

3,660 (11)

-35%

119 (1)

No change

3

Ghana

47,775 (314)

-19%

316 (4)

100%

3

Guinea

11,635 (157)

-66%

71 (1)

NA*

3

Guinea-Bissau

2,403 (14)

250%

41 (0)

-100%

3

Liberia

1,416 (39)

550%

82 (0)

NA*

3

Mali

3,490 (111)

9%

133 (1)

NA*

3

Niger

1,215 (6)

-33%

69 (0)

NA*

2

Nigeria

61,992 (685)

-42%

1,130 (5)

-50%

3

Senegal

15,551 (159)

6%

321 (4)

33%

3

Sierra Leone

2,346 (19)

-21%

74 (1)

No change

3

Togo

2,200 (151)

29%

52 (1)

-50%

3

Total

1,715,130 (74,565)

12%

41,203 (1,393)

-16%

*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 22 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 will hold its webinar series on Mental Health Aspects of COVID-19 titled “Practical Mental Health Considerations for Healthcare Staff during COVID-19” on Thursday 29 October 2020 at 4 pm EAT. Link to register: https://zoom.us/webinar/register/WN_LNL28nAQQvK-rrMLZJ-NKA
  3. Africa CDC held the last in its series of One Health and COVID-19 webinars on Monday, 26 October 2020 at 4 pm EAT. This webinar focused on Africa CDC’s new guidance document, Framework for One Health Practice in National Public Health Institutes: Zoonotic Disease Prevention and Control. Link to the framework: https://africacdc.org/download/framework-for-one-health-practice-in-national-public-health-institutes/
Healthcare Preparedness and Medical Countermeasures: Case Management
  1. The Africa CDC Case Management TWG held the 27th clinical webinar titled “COVID-19 cardiovascular disease considerations” on Thursday 22 October 2020 at 2 pm EAT. There were 250+ participants on the webinar and IWD Facebook page. The recording can be accessed here: https://www.africacdc.training/courses/ccop
Infection and Prevention Control (IPC)
  1. This week, the IPC TWG will hold series 4 session 5 webinar titled “Tuberculosis and COVID-19: Risk of delay in TB diagnosis and treatment and IPC overlap” in English on Wednesday 28 October 2020 at 1 pm EAT. Register here: https://zoom.us/webinar/register/WN_IIC9yfL9QDSyFQmvo61tOw
Laboratory:
  1. Over 17 million tests for COVID-19 have been conducted to date with a positivity rate of 9.5% and test per case ratio of 10.4, which is an increase of 6.9% from last week.
  2. Africa CDC commenced the distribution of RT-PCR testing kits from the Government of German and the European Union (EU) on Saturday 24 October 2020. The testing kits would be distributed to more than 30 Member States.
Surveillance:
  1. Africa CDC surveillance TWG will hold the second webinar of its 5-part series on “Demography and COVID-19 in Africa: Evidence and Policy Responses to Safeguard the Demographic Dividend” on Wednesday 28 October 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
Recommendations for the Member States:
  1. All Member States should continue to enhance their surveillance [5] to include COVID-19 [6] and severe acute respiratory infections (SARI) [7]. 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. [8]
  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.
  4. 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] 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. [5] Africa CDC Protocol for enhanced surveillance for COVID-19 in Africa: https://africacdc.org/download/protocol-for- enhanced-severe-acute-respiratory-illness-and-influenza-like-illness-surveillance-for-covid-19-in-africa/ [6] WHO COVID-19 surveillance guidance and case definition: https://www.who.int/publications/i/item/who-2019- nCoV-surveillanceguidance-2020.7  [7] 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/ [8] Africa CDC Guidance on Contact Tracing for COVID-19 Pandemic: https://africacdc.org/download/guidance-on- contact-tracing-for-covid-19-pandemic/
Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).