A new report published Wednesday provides guidance to African governments on how to use data to chart a way out of COVID-19 lockdowns. Concerns that the economic impact of stringent stay-at-home orders may become too tough to bear for families has some African countries considering adapting or easing public health restrictions.

Some 69% of people in 28 African cities surveyed for the Responding to COVID-19 in Africa: Using Data to Find a Balance report said that getting adequate food and water would be a problem if they were required to remain home for more than 14 days, and 51% said they would run out of money. In Western and Central Africa, 83% of those surveyed worried about running out of food and water if required to stay home for 14 days. The surveys covered 20 countries. 

Approximately one third of the respondents also said they did not get enough information about the coronavirus, including how it spreads and how to protect themselves. Almost two thirds believed that the pandemic would have a major impact on their countries, but only 44% believed that the virus would be a personal threat. 

“This report highlights the large information gaps on COVID-19 which exist in Africa and threaten response efforts,” said Dr Matshidiso Moeti, World Health Organization Regional Director for Africa. 

“The findings of this report, along with COVID-19 trend data, will help countries make strategic decisions on relaxing their lockdowns. What we’ve learnt from Ebola and other outbreaks is that countries need to decentralize the response to the community level and increase their capacity to identify and diagnose cases.”

The report recommends that governments closely monitor data on how public health measures meet local needs; build capacity to test, isolate and treat while case numbers are low; and engage communities to adapt any public health measures, such as business closures, to the local context.

‘Finding the Balance’ – Special Considerations for Africa

The recommendations are specifically tailored to Africa, where many nations have rapidly responded to early cases by stepping up contact tracing and enacting some of the earliest stay-at-home orders, which have appeared to slow the spread of the virus. However, pre-existing weak social welfare have led to widespread fears that food insecurity and poverty may threaten just as many, if not more people during lockdowns.

Many countries are considering relaxing or adapting lockdown measures as they consider the threat to livelihoods against the threat from COVID-19.

“There are three factors that will be particularly important to weigh in this concept of finding the balance in Africa,” said Tom Frieden, chief executive officer of Resolve to Save Lives and former head of the United States Centers for Disease Control.

“The first is the age structure of population – with fewer elders, there is less risk of widespread illness and death among the elderly population. But still, there is the risk in vulnerable populations and a lack of information by who is most in need,” he added. 

The report found that there was rampant misinformation across the continent. For example, more than 58% of survey respondents believed that taking vitamin C could ward off the virus, and 53% believed that hotter climates could prevent the spread of the virus. While there has been scientific speculation around both of those claims, neither has been proven in peer-reviewed studies. 

“Second,” adds Frieden, “There are limited safety nets. As the report shows, the ability for communities and individuals to thrive and flourish during a lockdown is even less than in many other parts of the world.”

The report found that the lowest-income households expected to run out of food and money in less than a week. Some 42% of non-violent COVID-19 related security incidents, such as peaceful protects, were organized around seeking additional government support during the crisis. Many African nations have had stay-at-home orders in place for more than three weeks now. 

“And finally, there is a critical scarcity of healthcare workers, even before COVID-19, and therefore it’s crucially important that every step is taken to protect those who protect the rest of us, and ensure that healthcare workers and other essential workers are protected,” said Frieden. The global shortage of protective equipment has hit the continent especially hard, with approximately a third of all peaceful protests across the continent organized around demanding protections for healthcare workers, according to the report.

But despite the limitations, communities in cities have largely supported public health and social measures enacted to protect them against the coronavirus.

Over 90% of respondents across all surveyed regions supported halting sporting matches and concerts; and closing schools, restaurants and nightclubs. Around 70% of those surveyed supported halting prayer gatherings, and closing churches and mosques. However, more people opposed transportation shutdowns, closing workplaces, and shutting down markets – activities deemed by many citizens to be essential for their livelihoods.

Gathering such data points is crucial to understanding how public health measures are impacting the general public – and how likely they are to follow guidance. 

“As we prepare for a long term response, there’s too much to be learned about the virus and the impact you have on people, and systems on the continent,” said John Nkengasong, Director of the Africa CDC. “Therefore, we must use evidence to drive decision making, and apply lessons from the past so we can implement the most effective and responsible policies, while protecting lives and livelihoods.”

Along with the public survey conducted in 28 cities across 20 African Union Member States, other indicators of disease transmission, population movement and unrest, were used to inform the report. The final document was produced by the Partnership for Evidence Based Response to COVID-19 (PERC), which consists of the Africa Centres for Disease Control and Prevention; Resolve to Save Lives, an initiative of Vital Strategies; the World Health Organization; the UK Public Health Rapid Support Team; and the World Economic Forum. Private market research and data analytics firms Ipsos and Novetta Mission Analytics also supported the partnership.

Gauri Saxena contributed to this story

Image Credits: WHO African Region, Matshidiso Moeti.