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

Haider, N; Osman, A Y; Gadzekpo, A; Akipede, G O; Asogun, D; Ansumana, R; Lessells, R J; Khan, P; Hamid, M M A; Yeboah-Manu, D; Mboera, L; Shayo, E H; Mmbaga, B T; Urassa, M; Musoke, D; Kapata, N; Ferrand, R A; Kapata, P C; Stigler, F; Czypionka, T; Zumla, A; Kock, R; McCoy, D

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.

Citation

Haider, N., Osman, A. Y., Gadzekpo, A., Akipede, G. O., Asogun, D., Ansumana, R., Lessells, R. J., Khan, P., Hamid, M. M. A., Yeboah-Manu, D., Mboera, L., Shayo, E. H., Mmbaga, B. T., Urassa, M., Musoke, D., Kapata, N., Ferrand, R. A., Kapata, P. C., Stigler, F., Czypionka, T., …McCoy, D. (2020). Lockdown measures in response to COVID-19 in nine sub-Saharan African countries. BMJ Global Health, 5(10), e003319

• Journal Article Type: Article
• Acceptance Date: Sep 11, 2020
• Publication Date: Oct 7, 2020
• Deposit Date: Oct 12, 2020
• Publicly Available Date: Oct 12, 2020
• Journal: BMJ Global Health
• Electronic ISSN: 2059-7908
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 10
• Pages: e003319
• Public URL: https://rvc-repository.worktribe.com/output/1375347
• Publisher URL: https://doi.org/10.1136/bmjgh-2020-003319