COVID-19 cases across Africa have continued to be reported at much lower levels than on other continents. After many African countries took quick action to stop the virus spreading, several have begun easing restrictions.
South Africa has some of the continent's most stringent coronavirus measures, including a ban on cigarette and alcohol sales and a lockdown that allows people out only to get food or medicine. Its government is relaxing restrictions only very gradually.
In contrast, Ghana lifted the lockdown in its capital, Accra, after only three weeks.
“In balancing lives and livelihoods, [African] countries are now looking at easing restrictions. In doing so, we are encouraging countries to adjust measures slowly and in line with the evidence,” Matshidiso Moeti at the World Health Organization told a World Economic Forum virtual meeting on 30 April.
Ghana's first covid-19 cases were reported on 12 March. Before lockdown was imposed on Accra at the end of March, a grace period enabled a “sizeable number” of people carrying the virus to leave for other parts of the country, Kojo Ansah Koram, former director of the Noguchi Memorial Institute for Medical Research in Ghana, told the meeting.
With the lockdown now lifted, Ghana is doing as much testing and tracing as possible – more than 100,000 people have been tested so far. Physical distancing and mask wearing are encouraged.
Koram said that economic voices had won out over scientific advice. While many expected a further three weeks of lockdown, the government had to take into account the large number of people who need to work each day to earn a living.
Modelling by Francesco Checchi at the London School of Hygiene and Tropical Medicine and his colleagues suggests that short lockdowns in African countries can have only “marginal effects”, whereas two-month lockdowns could gain nations an extra three months to prepare and mobilise resources (medRxiv, doi.org/dt95).
South Africa seems better placed to capitalise on this. The country had its first covid-19 case on 5 March and has tested more than 200,000 people. Although 1.5 million people in certain sectors were allowed back to work on 1 May, the initial three-week lockdown has been extended.
The plan now is for testing and tracing, and for lockdown to be relaxed in phases at a regional level. “South Africa has a much more advanced health system and could potentially rely on an exit strategy that mixes distancing with extensive testing and contact tracing plus scaling up of hospitalisation capacity,” says Checchi.
Lockdowns are tough for vulnerable people, says Wafaa El-Sadr at Columbia University in New York, and governments must look to provide food and income support. “If this does not happen, many will suffer and it will compel people to break lockdown measures in order to survive.”