Outbreak Update: Globally, a total of 333,393 coronavirus disease 2019 (COVID-19) confirmed cases[1], and 14,508 (CFR 4%) related deaths have been reported to date. Since the last brief (17 March 2020), 165,803 new COVID-19 cases and 7,900 new deaths have been reported globally. Thirty-five new countries and territories, including 13 African countries, are reporting cases[2], and 40 new countries, including nine African countries, are reporting deaths[3] for the first time. The distribution of cumulative cases (proportion of global cases %) from the WHO reporting regions (excluding Africa) are as follows: Eastern Mediterranean Region 24,854 (7%), European Region 171,401 (51%), Region of the Americas 37,026 (11%), South-East Asia Region 1,775 (0.5%) Western Pacific Region 96,349 (29%). For more detailed information on cases and deaths being reported outside of Africa, refer to the WHO daily situation reports.[4]
As of 24 March 2020, 1,988 total COVID-19 cases and 58 (CFR 3%) deaths have been reported in 43 African countries. Africa CDC is working with all affected countries and is mobilizing laboratory, surveillance, and other response support where requested. See Table 1 for the full list of countries in Africa reporting cases, deaths, and those recovered.
Table 1. Confirmed COVID-19 Cases Reported in Africa[5] 17- 24 March 2020, 12pm CET
| Country | No. of cases (new) | No. of deaths (new) | No. recovered | Transmission Type[6] |
| Algeria | 230 (176) | 17 (14) | 77 | Local transmission |
| Angola | 2 (2) | – | – | Imported cases only |
| Benin | 5 (3) | – | – | Imported cases only |
| Burkina Faso | 114 (87) | 4 (4) | 5 | Local transmission |
| Cameroon | 66 (66) | – | 2 | Local transmission |
| Cabo Verde | 3 (2) | – | – | Imported cases only |
| Central African Republic | 4 (3) | – | – | Imported cases only |
| Chad | 3 (3) | – | – | Imported case only |
| Congo | 4 (3) | – | – | Imported cases only |
| Côte d’Ivoire | 25 (21) | – | 2 | Local transmission |
| Democratic Republic of Congo | 45 (42) | 2 (2) | 1 | Local transmission |
| Djibouti | 3 (3) | – | – | Imported case only |
| Egypt | 366 (200) | 19 (19) | 68 | Local transmission |
| Equatorial Guinea | 9 (8) | – | – | Imported cases only |
| Eritrea | 1 (1) | – | – | Imported cases only |
| Eswatini | 5 (4) | – | – | Imported cases only |
| Ethiopia | 12 (7) | – | 4 | Local transmission |
| Gabon | 6 (5) | 1 (1) | – | Imported cases only |
| Gambia | 2 (2) | 1 (1) | – | Imported cases only |
| Ghana | 27 (21) | 2 (2) | 1 | Local transmission |
| Guinea | 4 (3) | – | – | Imported cases only |
| Kenya | 16 (13) | – | – | Local transmission |
| Liberia | 3 (2) | – | – | Local transmission |
| Madagascar | 12 (12) | – | – | Imported cases only |
| Mauritius | 36 (36) | 2 (2) | – | Imported cases only |
| Mauritania | 2 (1) | – | – | Imported cases only |
| Morocco | 134 (105) | 4 (3) | 3 | Local transmission |
| Mozambique | 1 (1) | – | – | Imported cases only |
| Namibia | 4 (2) | – | – | Imported cases only |
| Niger | 2 (2) | – | – | Imported case only |
| Nigeria | 40 (38) | 1 (1) | 2 | Local transmission |
| Rwanda | 36 (31) | – | – | Local transmission |
| Senegal | 79 (53) | – | 8 | Local transmission |
| Seychelles | 7 (3) | – | – | Imported cases only |
| Somalia | 1 (0) | – | – | Imported cases only |
| South Africa | 554 (492) | – | 12 | Local transmission |
| Sudan | 2 (1) | 1 (0) | – | Imported cases only |
| Tanzania | 12 (11) | – | – | Imported cases only |
| Togo | 18 (17) | – | 1 | Imported cases only |
| Tunisia | 89 (71) | 3 (3) | 1 | Local transmission |
| Uganda | 9 (9) | – | – | Imported cases only |
| Zambia | 3 (3) | – | – | Imported cases only |
| Zimbabwe | 2 (2) | 1 (1) | – | Imported cases only |
| Total | 1,988 (1,566) | 58 (39) | 187 |
Africa CDC Response:
General activities
- Africa CDC activated its Emergency Operations Center and its Incident Management System (IMS) for the COVID-19 outbreak on 27 January 2020. Africa CDC has developed its third Incident Action Plan that covers the period between 16 March to 15 April 2020.
- The Africa Union Ministers of Health gathered in Addis Ababa, Ethiopia, on 22 February for an emergency COVID-19 meeting where they agreed upon a joint continental strategy and guidance for assessment, movement restrictions, and monitoring of people at risk for COVID-19, including people being repatriated from China.
- Africa CDC is holding weekly updates with national public health institutes in Member States and has formed working groups for high priority areas of coronavirus control, including: surveillance; laboratory diagnosis; infection prevention and control; clinical care; and risk communication.
- Three experts each have been deployed to Cameroon and Nigeria and to support COVID-19 outbreak response efforts.
- Response simulation exercises (i.e., ‘table top’ exercises for high-level coordination) are being initiated, including an initial simulation conducted with a group of ~10 West African Countries in partnership with WAHO.
- Africa CDC briefs the permanent council (PRC) and Ambassadors from non-AU states on COVID-19 situation in Africa, Africa CDC responsive activities and recommendation.
- Africa CDC is working to procure emergency medical equipment stockpiles including diagnostics (over 6,000 test kits), PPE, thermal scanners and other critical equipment that can be used to rapidly equip countries in the event of rapid onset of cases.
- Twenty-four volunteers have been recruited to support various response activities with more in-process of recruitment.
- Africa CDC gave an orientation to the African Union Commission staff on the epidemiological situation, Africa CDC efforts, and the precautions that staff members should take to prevent themselves and others from getting infected by COVID-19. A social distancing policy was issued by the African Union Commission to avoid large gatherings and meetings in the AUC facilities.
Surveillance
10. Africa CDC collaborated with the World Health Organization on 22 February 2020 to train in-coming analysts in event-based surveillance using the Epidemic Intelligence from Open Sources platform. These headquarters will be working closely with the Regional Collaborating Centres and Member States to track and verify COVID-19 related events, providing critical information to inform Member States’ response and control efforts.
11. Africa CDC in collaboration with WHO provided two Training of Trainers events for participants from 18 countries: Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Egypt, Ethiopia, Ghana, Kenya, Mauritius, Mauritania, Nigeria, Niger, Zambia, Rwanda, Sao Tome and Principe, South Africa, Tunisia and Zambia to enhance surveillance at points of entry for COVID-19. Additional training is planned for March and April targeting the remaining countries in Africa.
12. Africa CDC in collaboration with the U.S Centers for Disease Control and Prevention will be training 20 countries in event-based surveillance for COVID-19 starting in March 2020. The first training for 7 countries was held in Kampala, Uganda on 2-4 March 2020.
13. Africa CDC supported training of airport staff from the Southern and East African regions, the training was hosted by South African Civil Aviation Authority and ICAO, on preparedness for COVID-19 in the aviation industry. More than 200 participants from 10 Member States (Malawi, Uganda, Zimbabwe, Lesotho, Botswana, Rwanda, Tanzania, Eswatini, Ethiopia and Namibia) were trained.
Laboratory
14. Ethiopian PM Abiy-Jack Ma & Alibaba Foundations initiative provided more than 1 million PCR detection kits to 54 Member States. Africa CDC is coordinating the delivery of the kits to Member States with the Government of Ethiopia, the Foundation and World Food Program.
15. Africa CDC distributed 36,000 tests (TIB Molbiol, German) to 30 Member States.
16. In collaboration with ASLM, a community of practice (online training program) has been arranged for more than 40 laboratories (25 and 30 March 2020).
17. Shipment of ONT equipment and reagents has started to build capacity of seven Member States. Online training will be organized once shipment is completed.
18. Africa CDC is working with other vendors (Roche, Abbott and Cepheid) for alternative testing strategies to expand testing of COVID-19.
19. Supply shortage (viral transport media, swabs and extraction kits) are now the main challenges to expand the testing. Africa CDC is looking for all possible sources for these items and will update the Member States when items are available.
Healthcare Preparedness
20. Africa CDC initiated a continent-wide network of clinicians which met for the first time on 9 March 2020, with a webinar that included ~230 clinicians from across the continent. The next webinar is scheduled for 19 March 2020.
21. Africa CDC initiated design of an online portal with training materials via online courses, online case studies, and social media vignettes to support evidence-based care of COVID-19 patients.
Risk Communication
22. Africa CDC conducted training on risk communication for public health communication officers of 27 countries to manage public information flow for COVID-19 and other public health emergencies.
23. Risk communication training is planned for other countries as soon as the travel restrictions are lifted.
24. Africa CDC has developed and published a number of communication materials on different aspects of COVID-19 preparedness and response to provide information to Member States and the public.
25. Africa CDC has held four press briefings since the outbreak started to provide updates to journalists.
26. Africa CDC has created a risk communication WhatsApp group for the communication officers that were trained to share information and minimize the circulation of rumours.
27. Africa CDC has also created a WhatsApp group with over 100 journalists to share updates about the outbreak in Africa and what Africa CDC and the countries are doing.
28. Africa CDC has started a weekly podcast on the outbreak and is working to produce some documentaries that will provide information to the public on different issues.
Recommendations for Member States:
- All Member States should enhance their surveillance for severe acute respiratory infections (SARI)[7] and to carefully review any unusual patterns of SARI or pneumonia cases. Examples of enhanced surveillance include: a. Adding questions about travel and testing for coronaviruses to existing influenza surveillance systems; b. Notifying healthcare facilities to immediately inform local public health officials about persons who meet the case definition for SARI and/or have recent travel or contact history with someone who has traveled to a country with local transmission.
- Member States that receive direct or connecting flights from affected countries should screen incoming passengers for severe respiratory illness and a history of recent travel to any country/area or territory reporting local transmission. Member States should be prepared to expand questions about recent travel to additional countries as the outbreak evolves.
- Notify WHO and Africa CDC immediately if suspected or confirmed cases of infection with novel coronavirus are identified. Africa CDC should be notified by emailing AfricaCDCEBS@africa-union.org.
- Provide guidance to the general public about seeking immediate medical care and informing healthcare providers about recent travel or contact history in anyone who develops symptoms of severe respiratory illness.
Resources for more information:
Africa CDC Resources
- Africa CDC. http://www.africacdc.org/covid-19-and-resources
- Guidelines http://www.africacdc.org/covid-19-and-resources/guidelines-policies/covid-19-and-resources/guidelines-policies/detail
- Infographics http://www.africacdc.org/covid-19-and-resources/infographics/covid-19-and-resources/infographics/detail
Other Resources
- China CDC. Coronavirus overview. http://www.chinacdc.cn/yyrdgz/202001/t20200109_211159.html
- European Centre for Disease Prevention and Control. Novel coronavirus overview. https://www.ecdc.europa.eu/en/novel-coronavirus-china
- National Health Commission of the People’s Republic of China. http://www.nhc.gov.cn/xcs/yqtb/list_gzbd.shtml
- Shanghai Public Health Clinical Center & School of Public Health. 10 January 2020. Initial genome release of novel coronavirus. http://virological.org/t/initial-genome-release-of-novel-coronavirus/319
- US Centers for Disease Control and Prevention. 14 January 2020. Novel Coronavirus (COVID-19), Wuhan, China. https://www.cdc.gov/coronavirus/novel-coronavirus-2019.html
- WHO. Coronavirus overview. https://www.who.int/health-topics/coronavirus
- WHO. Technical Guidance. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
[1] Per WHO, effective 17 February 2020, ‘confirmed’ cases include both laboratory-confirmed and clinically diagnosed (Hubei province, China only).
[2] Angola, Aruba, Barbados, Bahamas, Cape Verde, Chad, Djibouti, El Salvador, Eritrea, Fiji, Gambia, Greenland, Grenada, Guam, Haiti, Kosovo, Madagascar, Mauritius, Montenegro, Montserrat, Mozambique, New Caledonia, Nicaragua, Niger, Papua New Guinea, Sint Maarten, Syrian Arab Republic, Timor-Leste, Uganda, United States Virgin Islands, Uganda, Uruguay, Uganda, Zambia, Zimbabwe.
[3] Azerbaijan, Bangladesh, Bosnia and Herzegovina, Brazil, Burkina Faso, Chile, Colombia, Costa Rica, Croatia, Cuba, Curacao, Czechia, Democratic Republic of Congo, Dominican Republic, Finland, Gabon, Gambia, Ghana, Guam, Iceland, Israel, Jamaica, Lithuania, Malaysia, Mauritius, Mexico, Nigeria, Pakistan, Paraguay, Peru, Portugal,Puerto Rico, Republic of Moldova, Serbia, Singapore, Slovenia, Tunisia, Turkey, United Arab Emirates, Zimbabwe.
[4] WHO coronavirus disease (COVID-19) situation reports: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
[5] New numbers reported since last weekly brief (17 March 2020)
[6] Local transmission: indicates locations where the source of infection is within the reporting location; Imported cases: only indicates locations where all cases have been acquired outside the location of reporting.
[7] WHO SARI case definition: anyone with an acute respiratory infection with a history of fever (or measured fever of ≥ 38 C°) and cough with symptom onset within the last 10 days that requires hospitalization. https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/