Brazzaville — Africa marks six months on 14 August since COVID-19 was first detected on the continent. While the virus has raced through many other regions of the world, the pandemic’s evolution on the African continent has been different.

Preliminary analysis by the World Health Organization (WHO) finds that an exponential surge in cases which peak about two to three weeks later is not occurring in Africa. Instead, many countries are experiencing a gradual rise in COVID-19 cases and it is difficult to discern a specific peak. Transmission patterns also differ between countries, but more importantly within countries.

At the onset, COVID-19 mainly affected capital cities. However, the virus is now moving from high density urban areas to informal settlements and then onward to rural areas that have a lower population density.

“In Africa, curbing COVID-19 is a marathon and not a sprint,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We are observing multiple local outbreaks each with their own infection patterns and peaks. It is by bolstering the response at the community level that we will win this race. The COVID-19 response must be integrated into the fabric of every health district.”

In the past six months, countries have made a lot of progress. Many African governments were quick to impose lockdowns and key public health measures that helped to slow down the virus. Over time preventive, diagnostic and treatment measures have been strengthened. All countries can now diagnose COVID-19, with 14 performing over 100 tests per 10 000 population. Production of oxygen, critical for severely ill COVID-19 patients, has also considerably increased, with the number of oxygen plants in the region rising to 119 from 68 at the onset, while the number of oxygen concentrators has more than doubled to over 6000.

A recent WHO assessment based on self-reporting by 16 countries in sub-Saharan Africa found that the countries improved their capacity to respond to COVID-19. WHO measured countries’ readiness in a range of areas including coordination, surveillance, laboratory capacity, case management, infection prevention and control. Six months ago, the score was 62% and now it is 78%. While much progress appears to have been made at the national level, at the district level countries are generally lagging behind. The scores for coordination (38%), infection prevention and control (46%) and clinical care for patients (47%) are all particularly low at the district level.