Precise analysis of COVID-19 in Africa continues to be hindered by limited testing and reporting of cases. There is a wide variance in testing capacity, commitment to testing, and reporting of coronavirus cases and deaths. As a result, countries that are undertaking the most tests or reporting the highest number of cases may not necessarily match those countries most impacted or at risk from the pandemic.
Recognizing these data limitations, it is noteworthy that the pattern of reported transmissions of the coronavirus in Africa is shifting over time. At the outset of the pandemic, the Africa Center for Strategic Studies mapped out a series of nine risk factors reflecting levels of international exposure, urbanization, demography, fragility, and governance that collectively represent the varied vulnerabilities to the pandemic faced across the continent. In the earliest phase of the pandemic (through May 1), reported cases were most strongly correlated with three primary factors—international exposure, size of urban population, and strength of health sector—underscoring the influence of external contact and ability to test for the virus.
Since that time, and once COVID-19 had emerged in all 54 African countries, the influence of international exposure has slowly diminished, and transmissions have become more dependent on internal risk factors. Presently, the size of urban population, relative age of total population, and level of press freedom have emerged alongside international exposure as the risk factors most closely correlating with reported cases across the continent. As the scatterplots show, South Africa stands out in the number of reported cases with 43 percent of the continental total. Vitally, however, the Africa-wide correlations of key risk factors remain robust even when South Africa is excluded.
The takeaway is that as in-country transmissions grow, each country’s unique risk profile will become increasingly relevant in shaping the course of the pandemic. Recognizing the vulnerabilities—and strengths—that these different risk profiles represent, therefore, is central to mitigating the effects of COVID-19.