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Volume 28, Supplement—December 2022
SUPPLEMENT ISSUE
Surveillance

Comparison of COVID-19 Pandemic Waves in 10 Countries in Southern Africa, 2020–2021

Joshua Smith-SreenComments to Author , Bridget Miller, Alinune N. Kabaghe, Evelyn Kim, Nellie Wadonda-Kabondo, Alean Frawley, Sarah Labuda, Eusébio Manuel, Helga Frietas, Anne C. Mwale, Tebogo Segolodi, Pauline Harvey, Onalenna Seitio-Kgokgwe, Alfredo E. Vergara, Eduardo S. Gudo, Eric J. Dziuban, Naemi Shoopala, Jonas Z. Hines, Simon Agolory, Muzala Kapina, Nyambe Sinyange, Michael Melchior, Kelsey Mirkovic, Agnes Mahomva, Surbhi Modhi, Stephanie Salyer, Andrew S. Azman, Catherine McLean, Lul P. Riek, Fred Asiimwe, Michelle Adler, Sikhatele Mazibuko, Velephi Okello, and Andrew F. Auld
Author affiliations: Public Health Institute/US Centers for Disease Control and Prevention Global Health Fellowship Program, Lilongwe, Malawi (J. Smith-Sreen, B. Miller); Malawi Centers for Disease Control and Prevention, Lilongwe (A.N. Kabaghe, E. Kim, N. Wadonda-Kabondo, A.F. Auld); Angola Centers for Disease Control and Prevention, Luanda, Angola (A. Frawley, S. Labuda); Angola Ministry of Health, Luanda (E. Manuel, H. Frietas); Public Health Institute of Malawi (PHIM), Lilongwe (A.C. Mwale); Botswana Centers for Disease Control and Prevention, Gaborone, Botswana (T. Segolodi, P. Harvey); Botswana Ministry of Health and Wellness, Gaborone (O. Seitio-Kgokgwe); Mozambique Centers for Disease Control and Prevention, Maputo, Mozambique (A.E. Vergara); Mozambique National Institute for Health, Maputo (A.E. Vergara, E.J. Gudo); Namibia Centers for Disease Control and Prevention, Windhoek, Namibia (E.J. Dziuban); Namibia Ministry of Health and Social Services, Windhoek (N. Shoopala); Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia (J.Z. Hines, S. Agolory); Zambia National Public Health Institute (ZNPHI), Lusaka (M. Kapina, N. Sinyange); Zimbabwe Centers for Disease Control and Prevention, Harare, Zimbabwe (M. Melchior, K. Mirkovic); Zimbabwe Office of the President and Cabinet, Harare (A. Mahomva); US Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Modi, S.J. Salyer, C. McLean); Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia (S.J. Salyer, L.P. Riek); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (A.S. Azman); Lesotho Centers for Disease Control and Prevention, Maseru, Lesotho (F. Asiimwe); Eswatini Centers for Disease Control and Prevention, Lobamba, Swaziland (M. Adler, S. Mazibuko); Eswatini Ministry of Health, Lobamba (V. Okello); The Global Fund, Geneva, Switzerland (A.F. Auld)

Main Article

Table 5

Public health and social measure comparison across COVID-19 pandemic waves for 10 countries in southern Africa, January 1, 2020–September 19, 2021*,

Country and wave Average index number throughout entire wave
 No. stringent containment measures‡ in place†
Stringency index‡ Government response index§ Containment index¶ Economic support index# Beginning of wave Peak of wave End of wave Entire wave
Angola
1 69.7 50.88 56.22 13.49 8 8 8 8
2 49.5 43.53 49.74 0.00 8 5 7 5
3 56.9 48.01 54.86 0.00 7 Unknown 7 7
Overall
 57.1
 42.79
 48.31
 12.67
NA
 NA
 NA
 NA
Botswana
1 57.5 49.75 51.03 40.79 8 7 7 7
2 59.2 51.60 57.94 7.14 7 7 7 7
3 60.3 58.08 65.22 8.13 7 7 4 0
Overall
 54.7
 46.97
 50.52
 22.15
NA
 NA
 NA
 NA
Eswatini
1 72.9 54.39 58.58 25.00 8 8 8 8
2 67.6 59.52 60.17 55.00 7 8 7 7
3 63.7 64.42 73.32 2.27 8 8 8 8
Overall
 59.1
 50.93
 53.99
 29.50
NA
 NA
 NA
 NA
Lesotho
1 62.6 49.28 49.86 45.17 7 8 7 6
2 62.7 49.24 56.27 0.00 7 6 8 6
3 54.2 50.18 57.35 0.00 5 6 6 5
Overall
 53.3
 42.99
 46.98
 13.91
NA
 NA
 NA
 NA
Malawi
1 59.8 51.42 51.11 53.57 6 6 6 6
2 49.0 49.08 50.17 41.45 5 6 5 4
3 40.5 48.04 51.42 24.33 4 6 4 4
Overall
 44.8
 42.97
 43.99
 35.83
NA
 NA
 NA
 NA
Mozambique
1 70.5 55.22 63.11 0.00 8 8 6 5
2 56.5 48.16 55.04 0.00 5 7 7 5
3 52.2 47.63 54.43 0.00 6 7 6 5
Overall
 52.9
 43.76
 50.01
 0.00
NA
 NA
 NA
 NA
Namibia
1 54.4 49.31 53.05 23.13 7 7 6 5
2 38.8 38.75 44.48 0.00 6 5 6 4
3 57.4 56.26 64.20 0.69 7 8 6 4
Overall
 46.6
 43.25
 48.23
 8.96
NA
 NA
 NA
 NA
South Africa
1 79.4 74.51 77.12 56.21 8 8 7 7
2 53.2 63.18 61.49 75.00 5 8 7 5
3 52.7 60.73 62.22 50.18 6 8 7 3
Overall
 54.0
 57.53
 58.14
 53.19
NA
 NA
 NA
 NA
Zambia
1 49.1 43.76 46.44 25.00 6 6 6 5
2 41.8 38.25 42.27 10.06 6 6 4 3
3 45.7 42.87 46.44 17.86 3 5 4 1
Overall
 40.6
 36.60
 39.56
 15.88
NA
 NA
 NA
 NA
Zimbabwe
1 77.8 58.05 62.77 25.00 8 8 8 8
2 80.3 61.45 66.96 2.86 8 8 6 6
3 67.0 55.20 63.08 0.00 5 6 8 5
Overall
 2.9
 48.78
 53.88
 13.06
NA
 NA
 NA
 NA
Total averages per wave
1 65.4 53.66 56.93 30.74 7.4 7.5 6.9 6.5
2 55.9 50.27 54.45 21.15 6.4 6.6 6.4 5.2
3 55.1 53.14 59.25 10.35 5.8 6.7 6.0 4.2
Overall 52.6 45.76 49.36 20.51 NA NA NA NA

*Public health and social measures, as defined and measured by Oxford COVID-19 Government Response Tracker (OxCGRT; https://www.bsg.ox.ac.uk/research/research-projects/covid-19-government-response-tracker), accessed 2021 Sep 20. OxCGRT collects publicly available information on 23 indicators of government response. The data from these indicators is aggregated into a set of common indices, reporting a number between 1 and 100 to reflect the level of government action in 4 specific areas. This is a measure of how many of the relevant indicators a government has acted upon, and to what degree. A higher number reflects more government action. NA, not applicable. †For this analysis, we focused on 8 indicators of stringent containment measures, which record information on containment and closure policies such as school closures and restrictions in movement. If any containment measure related to that indicator was in place at the time of the wave that is indicated, the measure was counted. ‡Stringency index records the strictness of ‘lockdown style’ policies that primarily restrict residents’ behavior. It is calculated using all ordinal containment and closure policy indicators, plus an indicator recording public information campaigns. §Overall government response index records how the response of governments has varied over all indicators in the database, becoming stronger or weaker over the course of the outbreak. It is calculated using all ordinal indicators. ¶Containment and health index combines ‘lockdown’ restrictions and closures with measures such as testing policy and contact tracing, short term investment in healthcare, as well investments in vaccines. It is calculated using all ordinal containment and closure policy indicators and health system policy indicators. #Economic support index records measures such as income support and debt relief. It is calculated using all ordinal economic policies indicators.

Main Article

Page created: July 12, 2022
Page updated: December 11, 2022
Page reviewed: December 11, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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