Lockdown measures in response to COVID-19 in nine sub-Saharan African countries

Abstract

Lockdown measures have been introduced worldwide to contain the transmission of COVID-19. However, the term 'lockdown' is not well-defined. Indeed, WHO's reference to 'so-called lockdown measures' indicates the absence of a clear and universally accepted definition of the term 'lockdown'. We propose a definition of 'lockdown' based on a two-by-two matrix that categorises different communicable disease measures based on whether they are compulsory or voluntary; and whether they are targeted at identifiable individuals or facilities, or whether they are applied indiscriminately to a general population or area. Using this definition, we describe the design, timing and implementation of lockdown measures in nine countries in sub-Saharan Africa: Ghana, Nigeria, South Africa, Sierra Leone, Sudan, Tanzania, Uganda, Zambia and Zimbabwe. While there were some commonalities in the implementation of lockdown across these countries, a more notable finding was the variation in the design, timing and implementation of lockdown measures. We also found that the number of reported cases is heavily dependent on the number of tests carried out, and that testing rates ranged from 2031 to 63 928 per million population up until 7 September 2020. The reported number of COVID-19 deaths per million population also varies (0.4 to 250 up until 7 September 2020), but is generally low when compared with countries in Europe and North America. While lockdown measures may have helped inhibit community transmission, the pattern and nature of the epidemic remains unclear. However, there are signs of lockdown harming health by affecting the functioning of the health system and causing social and economic disruption.

Keywords: SARS.

Figure 1

The map with nine countries of sub-Saharan Africa including the number of samples tested in seven countries (location of testing canters and number is shown for Nigeria, Ghana, South Africa, Sudan and Zimbabwe and aggregated national number is shown for Uganda and Zambia) as of 15 May 2020. The data on number of samples tested were collected from researcher (author of this paper) of respective countries. In most of the cases, the source of the number of samples tested were the website of Ministry of Health of the respective country. In some instances, it was through personal communication with the Ministry of Health of respective country.

Figure 2

Different measures of lockdown taken in nine sub-Saharan African countries up until 6 September 2020. The daily reported COVID-19 cases are presented in left-hand y-axis and death cases are at right-hand y-axis. Please notice that axis has different values. Nigeria reported its first COVID-19 case on 27 February is not shown in the graph.