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

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...

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Main Authors: Richard John Lessells, David McCoy, Alimuddin Zumla, Leonard Mboera, Palwasha Khan, Thomas Czypionka, Richard Kock, Blandina T Mmbaga, David Musoke, Elizabeth Henry Shayo, Najmul Haider, Abdinasir Yusuf Osman, Audrey Gadzekpo, George O Akipede, Rashid Ansumana, Muzamil Mahdi Abdel Hamid, Dorothy Yeboah-Manu, Mark Urassa, Nathan Kapata, Rashida Abbas Ferrand, Pascalina-Chanda Kapata, Florian Stigler
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/10/e003319.full
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author Richard John Lessells
David McCoy
Alimuddin Zumla
Leonard Mboera
Palwasha Khan
Thomas Czypionka
Richard Kock
Blandina T Mmbaga
David Musoke
Elizabeth Henry Shayo
Najmul Haider
Abdinasir Yusuf Osman
Audrey Gadzekpo
George O Akipede
Rashid Ansumana
Muzamil Mahdi Abdel Hamid
Dorothy Yeboah-Manu
Mark Urassa
Nathan Kapata
Rashida Abbas Ferrand
Pascalina-Chanda Kapata
Florian Stigler
author_facet Richard John Lessells
David McCoy
Alimuddin Zumla
Leonard Mboera
Palwasha Khan
Thomas Czypionka
Richard Kock
Blandina T Mmbaga
David Musoke
Elizabeth Henry Shayo
Najmul Haider
Abdinasir Yusuf Osman
Audrey Gadzekpo
George O Akipede
Rashid Ansumana
Muzamil Mahdi Abdel Hamid
Dorothy Yeboah-Manu
Mark Urassa
Nathan Kapata
Rashida Abbas Ferrand
Pascalina-Chanda Kapata
Florian Stigler
author_sort Richard John Lessells
collection DOAJ
description 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.
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spelling doaj-art-87e093ccd65c4923a99097cf22a646eb2025-08-20T02:50:02ZengBMJ Publishing GroupBMJ Global Health2059-79082020-10-0151010.1136/bmjgh-2020-003319Lockdown measures in response to COVID-19 in nine sub-Saharan African countriesRichard John Lessells0David McCoy1Alimuddin Zumla2Leonard Mboera3Palwasha Khan4Thomas Czypionka5Richard Kock6Blandina T Mmbaga7David Musoke8Elizabeth Henry Shayo9Najmul Haider10Abdinasir Yusuf Osman11Audrey Gadzekpo12George O Akipede13Rashid Ansumana14Muzamil Mahdi Abdel Hamid15Dorothy Yeboah-Manu16Mark Urassa17Nathan Kapata18Rashida Abbas Ferrand19Pascalina-Chanda Kapata20Florian Stigler21Department of Pubic Health, University of KwaZulu-Natal, Durban, South AfricaCentre for Primary Care and Public Health, Queen Mary University London, London, UKDivision of Infection and Immunity, University College London Medical School, London, UKSACIDS Foundation for One Health, Sokoine University of Agricultue, Morogoro, TanzaniaDepartment of Clinical Research, London School of Hygiene and Tropical Medicine, London, UKHealth Economics and Health Policy, Institute for Advanced Studies, Vienna, AustriaPathobiology and Population Science, The Royal Veterinary College, London, UKKilimanjaro Clinical Research Institute, Moshi, Tanzania3 School of Public Health, Makerere University College of Health Sciences, Kampala, UgandaHealth Systems, Policy and Translational Reseach Section, National Institute for Medical Research, Dar es Salaam, Tanzania, United RepublicPathobiology and Population Science, The Royal Veterinary College, London, UKPathobiology and Population Science, The Royal Veterinary College, London, UKDepartment of Communication Studies, University of Ghana, Legon, GhanaCollege of Medicine, Ambrose Alli University, Ekpoma, Nigeria and Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, NigeriaNjala University, Bo, Sierra LeoneDepartment of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, SudanNoguchi Memorial Institute for Medical Research, University of Ghana, Legon, GhanaNational Institute for Medical Research Mwanza Research Centre, Mwanza, TanzaniaZambia National Public Health Institute, Lusaka, ZambiaBiomedical Research and Training Institute, Harare, ZimbabweMinistry of Health, Lusaka, ZambiaAustrian Sickness Fund, Vienna, AustriaLockdown 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.https://gh.bmj.com/content/5/10/e003319.full
spellingShingle Richard John Lessells
David McCoy
Alimuddin Zumla
Leonard Mboera
Palwasha Khan
Thomas Czypionka
Richard Kock
Blandina T Mmbaga
David Musoke
Elizabeth Henry Shayo
Najmul Haider
Abdinasir Yusuf Osman
Audrey Gadzekpo
George O Akipede
Rashid Ansumana
Muzamil Mahdi Abdel Hamid
Dorothy Yeboah-Manu
Mark Urassa
Nathan Kapata
Rashida Abbas Ferrand
Pascalina-Chanda Kapata
Florian Stigler
Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
BMJ Global Health
title Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
title_full Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
title_fullStr Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
title_full_unstemmed Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
title_short Lockdown measures in response to COVID-19 in nine sub-Saharan African countries
title_sort lockdown measures in response to covid 19 in nine sub saharan african countries
url https://gh.bmj.com/content/5/10/e003319.full
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