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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 2

Testing, illness, death, and vaccination comparison across 3 COVID-19 pandemic waves for 10 countries in southern Africa, March 5, 2020–September 19, 2021*

Country and wave 7-day averages and peaks
 Peak Rt Average CFR, % Total vaccinated/100 pop Total fully vaccinated/100 pop 7-d average no. vaccinations/1 million pop
Average no. tests/1 million pop† Average test positivity, % Peak test positivity, % Average no. tests/case Average no. cases/1 million pop† Peak no. cases/1 million pop Average no. deaths/1 million pop† Peak no. deaths/1 million pop
Angola‡
1 56.6 8.0 28.8 23.6 2.3 7.7 0.05 0.1 1.3 3.5 NA NA NA
2 70.4 8.5 34.0 16.8 5.1 8.6 0.11 0.3 1.2 2.3 2.8 1.6 421.6
3 85.9 6.5 17.2 20.8 4.9 9.5 0.18 0.3 1.2 2.5 5.4 2.9 455.3
Total
 70.3
 7.5
 34.0
 20.6
 2.8
 9.5
 0.07
 0.3
 1.3
 3.7
 5.4
 2.9
 392.6
Botswana§
1 NA NA NA NA 27.5 124.8 0.08 0.3 1.2 0.5 NA NA NA
2 NA NA NA NA 112.6 201.1 2.33 5.1 1.3 1.0 2.1 NA 597.5
3 NA NA NA NA 397.7 946.6 5.25 16.0 1.4 1.5 15.3 9.3 1,751.2
Total
 NA
 NA
 NA
 NA
 132.3
 946.6
 1.83
 16.0
 1.4
 1.6
 15.3
 9.3
 1,403.7
Eswatini§
1 NA NA NA NA 24.7 77.3 0.49 2.0 2.0 1.6 NA NA NA
2 NA NA NA NA 87.7 205.9 4.40 14.0 1.8 3.1 NA NA NA
3 NA NA NA NA 289.6 649.6 5.67 10.2 1.7 2.9 17.1 16.5 1,964.3
Total
 NA
 NA
 NA
 NA
 70.1
 649.6
 1.85
 14.0
 2.0
 2.5
 17.1
 16.5
 1161.2
Lesotho§
1 NA NA NA NA 5.9 18.7 0.13 0.7 1.3 2.4 NA NA NA
2 NA NA NA NA 46.0 180.7 1.36 4.8 1.5 2.0 NA NA NA
3 NA NA NA NA 16.7 49.8 0.36 1.6 1.2 2.8 3.3 1.5 1,250.9
Total
 NA
 NA
 NA
 NA
 13.6
 180.7
 0.38
 4.8
 1.5
 2.5
 3.3
 1.5
 743.3
Malawi¶
1 17.6 8.9 24.8 22.3 1.9 5.6 0.06 0.3 1.8 2.7 NA NA NA
2 58.0 13.1 37.8 14.7 10.7 50.6 0.37 1.7 2.1 3.1 1.4 NA# 358.5
3 70.8 13.3 25.8 14.2 12.2 37.8 0.50 1.3 1.8 3.4 3.8 2.4 280.5
Total
 37.9
 9.2
 37.8
 31.8
 5.9
 50.6
 0.22
 1.7
 2.1
 3.5
 3.8
 2.4
 266.9
Mozambique
1 31.7 5.6 15.5 30.8 2.1 6.7 0.02 0.1 1.5 0.7 NA NA NA
2 60.4 16.3 33.6 9.8 11.7 29.7 0.15 0.5 1.7 1.1 0.2 NA# 169.7
3 97.0 18.6 35.9 11.0 20.7 58.9 0.28 0.8 1.8 1.2 5.8 4.9 702.2
Total
 51.6
 11.2
 35.9
 20.6
 8.6
 58.9
 0.11
 0.8
 1.8
 0.9
 5.8
 4.9
 488.0
Namibia
1 368.7 10.0 19.4 12.4 36.1 99.4 0.37 1.4 1.6 0.8 NA NA NA
2 590.1 13.6 25.7 10.3 88.2 185.6 0.98 2.4 1.5 1.0 NA NA NA
3 871.3 22.9 50.9 6.3 232.8 694.8 8.43 30.7 1.4 2.1 9.0 5.5 998.8
Total
 549.0
 12.7
 50.9
 23.9
 88.9
 694.8
 2.43
 30.7
 1.6
 1.3
 9.0
 5.5
 776.5
South Africa
1 392.8 12.5 27.8 14.9 63.3 209.6 1.55 5.0 1.5 1.9 NA NA NA
2 618.3 16.1 32.6 8.6 109.9 317.1 4.31 9.6 1.5 2.9 0.2 0.2 83.5
3 792.5 18.1 29.4 7.0 153.8 332.4 3.73 7.0 1.4 3.1 19.3 13.2 1,814.2
Total
 519.3
 13.1
 32.6
 13.2
 85.6
 332.4
 2.55
 9.6
 2.6
 2.6
 19.3
 13.2
 1,205.7
Zambia
1 107.5 9.9 30.1 32.5 6.1 15.9 0.13 0.7 1.1 2.4 NA NA NA
2 348.8 6.6 16.9 40.3 25.4 74.6 0.31 0.9 1.7 1.5 0.2 NA 85.1
3 387.3 11.0 26.0 21.3 48.6 147.5 1.00 3.2 1.8 1.6 1.6 1.5 227.2
Total
 242.3
 7.5
 30.1
 44.0
 20.2
 147.5
 0.35
 3.2
 1.8
 1.9
 1.6
 1.5
 213.6
Zimbabwe
1 52.7 6.5 21.3 37.3 3.7 13.3 0.11 0.4 1.8 2.4 NA NA NA
2 174.4 11.0 28.7 18.6 22.2 63.4 1.08 2.9 1.7 3.4 0.2 NA 118.8
3 411.1 11.2 22.8 14.2 55.7 156.1 1.86 5.2 1.9 3.5 19.5 13.7 2,437.0
Total
 161.3
 6.9
 28.7
 40.5
 15.5
 156.1
 0.56
 5.2
 1.9
 4.4
 19.5
 13.7
 1,527.4
All#
1 146.8 8.8 24.0 24.8 17.4 209.6 0.30 5.0 1.5 1.9 NA NA NA
2 274.3 12.2 29.9 17.0 51.9 317.1 1.54 14.0 1.6 2.1 NA 0.9 262.1
3 388.0 14.5 29.7 13.5 123.3 946.6 2.73 30.7 1.6 2.5 10.0 7.1 1,087.9
Total 243.9 10.0 35.7 28.3 44.8 322.7 1.05 8.7 1.8 2.5 10.8 8.1 832.3

*Source (5); accessed 2021 Sep 20. CFR, case-fatality ratio; NA, not available (either in the original dataset nor based on supplemental information) for this indicator in the given period; pop, population; Rt, effective reproduction number. †Variables on which a 1-way analysis of variance test was performed, and a significant difference in means was found between waves at α = 0.05 at a country level and across all countries. ‡Third wave was ongoing in Angola at the time of data extraction during epidemiologic week 90 (ending September 19, 2021). §These countries had no testing data in OWID. ¶These countries had no testing data in OWID, but testing data was provided by US Centers for Disease Control and Prevention collaborators, on the basis of nationally reported, publicly available aggregate data. #Regional averages for testing indicators were computed based on data from only 7 countries, excluding those for which testing data was not available (Botswana, Lesotho, Eswatini).

Main Article

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