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

Type Journal Article Author Najmul Haider Author Abdinasir Yusuf Osman Author Audrey Gadzekpo Author George O. Akipede Author Danny Asogun Author Rashid Ansumana Author Richard John Lessells Author Palwasha Khan Author Muzamil Mahdi Abdel Hamid Author Dorothy Yeboah-Manu Author Leonard Mboera Author Elizabeth Henry Shayo Author Blandina T. Mmbaga Author Mark Urassa Author David Musoke Author Nathan Kapata Author Rashida Abbas Ferrand Author Pascalina-Chanda Kapata Author Florian Stigler Author Thomas Czypionka Author Alimuddin Zumla Author Richard Kock Author David McCoy URL https://gh.bmj.com/content/5/10/e003319 Rights © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Volume 5 Issue 10 Pages e003319 Publication BMJ Global Health ISSN 2059-7908 Date 2020/10/01 Extra Publisher: BMJ Specialist Journals Section: Analysis PMID: 33028699 DOI 10.1136/bmjgh-2020-003319 Accessed 2020-10-26 08:05:05 Library Catalog gh.bmj.com Language en 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.