Africa’s fight against the Covid-19 pandemic is less effective in the second wave of the outbreak compared to the first wave, a new study has revealed.

The study shows as the second wave of the pandemic sweeps across the continent, African governments have failed to replicate the rapid coordination and effective Covid-19 public health measures rolled out to contain the first wave.

This, combined with the spread of more aggressive variants of the Coronavirus have resulted in increased number of cases.

Despite daily infections being 30% higher during the rise of the continent’s second wave, most countries implemented fewer public health measures, the study published in The Lancet which was led by researchers from the Africa Centres for Disease Control and Prevention (Africa CDC) and the US Centers for Disease Control and Prevention (US CDC), revealed.

The report analyzed data collected between 14^th February and 31^st December 2020.

About 72% of African countries rolled out their first strict Covid-19 control measures approximately 15 days before reporting their first cases.

By the middle of April 2020, 96% of African countries had at least five strict public health and safety measures in place.

The most common of the measures included international travel controls, school closures, cancellation of public events, and restrictions on gatherings.

Gradual relaxation of a lot of these measures began after the end of July when the continent went beyond the peak of the first wave.

But the same rapid and coordinated response was absent as the second wave of the pandemic broke out later in the year.

As of 31^st December 2020, less than 72% of countries were implementing five or more stringent public health, social and safety measures (PHSMs) although cases were up.

Despite facing a second wave of cases and new, more transmissible variants of the virus, many countries had not implemented the same degree of public health and safety measures as they had early on in the pandemic, the study noted.  

“Of the 38 countries that had previously experienced, or were experiencing, a second wave, and recorded PHSMs, almost 45%, had fewer – typically two less – in place during the second wave,” the study found.

This relaxation in Covid-19 containment protocols and a drop in adherence to public health measures after the first wave (probably due to adherence fatigue and economic necessity) are thought to have contributed to the greater impacts observed during the second wave.

“Increasing reports of PHSM adherence fatigue leaves the continent's population at risk and highlights the need to reinvigorate and update existing communication strategies,” the authors wrote.

“These data indicate that member States not only need to remain vigilant in collecting and analysing Covid-19 data to inform PHSM adjustments in place, but they also need to monitor PHSM adherence and ensure public health and case management capacities are sustained as cases rise,” they added.

Way forward

Africa has largely avoided the initial dire predictions that its weak health infrastructure would result in millions of Covid-19 deaths.

As of 22^nd March 2021, the continent had recorded 4.1 million Covid-19 cases, with 109,000 deaths. This represents only about 4% of total world fatalities from the disease.

But the troubling part of the statistics is that more than half of the total deaths have been recorded in the last four months alone.

This means the disease has claimed more lives in Africa over the last four months than the preceding 10 months.  

Director of the Africa CDC Dr John Nkengasong observes “these insights reveal a need to re-emphasise the importance of abiding by measures that aim to strike a fine balance between controlling the spread of Covid-19 and sustaining economies and people’s livelihoods.”

Daniel Otunge of Kenya based Africa Science Media Center (AfriSMC) told Alliance for Science in an interview the study ought to be an eye-opener for African governments which have relaxed Covid-19 control measures against the advice of experts.

He says there is the need to reintroduce tougher containment measures and expand information and education campaigns, as well as behavior change communication on Covid-19.

“I say this because already countries are experiencing the third wave of Covid-19 infections that are more deadly than the first and the second waves. Intensive care units (ICUs) are full to capacity and patients being delicately transported across the country in search of ICU beds. Unfortunately, a number of them die in the process. Therefore, the time to reintroduce the lockdowns and to expand educational activities is now…” Otunge noted.

“The World Health Organization, Africa-CDC and African governments working together with the international community should do everything possible to ensure universal access to Covid-19 vaccines in Africa to avoid an impending disaster of unimaginable proportions," he added.

Dr. Michael Owusu, a virologist and lecturer at the Medical Diagnostic Department of the Kwame Nkrumah University in Ghana in an earlier interview with Alliance for Science cautioned against the re-introduction of lockdowns, but agreed aggressive vaccination is the sure way forward.

“If you weigh the impact of the lockdowns, it has devastated many families. Some have businesses that haven’t survived… and many people in the informal sector are struggling. So, lockdown is not something you want to recommend for different places in Africa. Vaccine is the only way to go…,” he said.