Social distancing policies in 22 African countries during the COVID-19 pandemic: a desk review

Abstract

Introduction: on January 30, 2020, the World Health Organization declared the novel coronavirus outbreak a Public Health Emergency of International Concern. As of October 5, 2020, there were over 34.8 million reported cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and more than 1 million reported deaths from coronavirus disease 2019 (COVID-19), globally. Non-pharmaceutical interventions, such as social distancing policies, hand hygiene, and mask use, are key public health measures to control COVID-19. In response to, or in some cases even before, the first wave of SARS-CoV-2 infections were reported in their countries, policy makers across Africa issued various social distancing policies.

Methods: we describe social distancing policies issued from March 1 to April 24, 2020 in 22 Anglophone countries of sub-Saharan Africa. We reviewed policies identified online.

Results: though all 22 countries closed schools and banned gatherings, they took a variety of approaches to sizes of gatherings banned and to stay-at-home orders, with 13 countries issuing national stay-at-home orders, four issuing subnational stay-at-home orders, and five not issuing stay-at-home orders. Enforcement provisions varied by country, as did funeral and health care exceptions.

Conclusion: movement restrictions, business restrictions, and school closures can have substantial negative impacts on economies, education, nutrition, and routine health care. Yet easing or lifting of COVID-19 social distancing policies can lead to increased transmission. Our review documents a wide variety of policy alternatives used in Africa and can inform future adjustments as countries ease, lift, and reapply measures in response to their evolving epidemics.

Keywords: Africa South of the Sahara; COVID-19; Severe acute respiratory syndrome coronavirus 2; pandemics; public health; public policy.

Figure 1

median percent change in community mobility from pre-COVID-19 baseline (January 3 - February 6, 2020) to study period (March 1 - April 30, 2020) in 12 of 22 African countries (google location data)