Coronavirus - Africa: Update on the ongoing Novel Coronavirus (COVID-19) Global Epidemic, Brief 13 ADDIS ABABA, Ethiopia, April 14, 2020/APO Group/ -- Outbreak Update: Since the last brief (7 April 2020), 562,026 new confirmed¹ coronavirus disease 2019 (COVID-19) cases and 44,014 new deaths have been reported globally. This is a 46% increase in cases reported. To date, a total of 1,773,987 COVID-19 cases and 111,680 (CFR: 6%) related deaths have been reported worldwide. Two new countries and territories² are reporting cases and five new countries and territories³, including four African countries, are reporting deaths for the first time this week. The distribution of cumulative cases (proportion of global cases %) from the WHO reporting regions (excluding Africa) are as follows: Eastern Mediterranean Region 94,995 (5%), European Region 913,349 (52%), Region of the Americas 610,742 (34%), South-East Download document - Africa CDC COVID-19 Brief 14 APRIL 20: https://bit.ly/34FC1xc Download document - COVID-19 Scientific and Public Health Policy Update – (14 April 2020): https://bit.ly/2V7iwu4 Asia Region 16,883 (1%), and Western Pacific Region 122,138 (7%). For more detailed information on cases and deaths being reported outside of Africa, refer to the WHO daily situation reports⁴. As of 9 am EAT 14 April 2020, a total of 15,284 COVID-19 cases and 816 (CFR: 5%) deaths have been reported in 52 African countries. Out of 52 Member States that have reported cases, six have community transmission, 44 have local transmission and two have imported cases only. Since the last brief, the number of COVID-19 cases has increased by 52% (5,198 cases). The five countries in Africa with the highest cumulative number of cases (proportion of reported cases in Africa) are South Africa (2,272; 15%), Egypt (2,190; 14%) Algeria (1,914; 13%), Morocco (1,763; 12%) and Cameroon (820; 5%). When population is taken into consideration, Djibouti (30.2), Mauritius(25.5), Seychelles (11.2), Tunisia (6.1), and Morocco (4.8) are reporting the most cases per 100,000 population within the continent. Fifteen countries are reporting case fatality rates higher than the global case fatality rate of 6%. See Table 1 for the full list of countries in Africa reporting cases, deaths, and COVID-19 recoveries in addition to transmission type being reported. Africa CDC is working with all affected countries and is mobilizing laboratory, surveillance, and other response support where requested. Table 1. Confirmed COVID-19 Cases Reported in Africa⁵ 7-14 April 2020, 9 am EAT

Country	No. of cases (new)	No. of deaths (new)	No. of recovered	Transmission Type⁶
Central Region	1,274 (324)	39 (6)	170
Burundi	5 (2)	1 (1)	-	Local
Cameroon	820 (170)	12 (3)	130	Local
Central African Republic	11 (2)	-	4	Local
Chad	23 (14)	-	2	Local
Congo	74 (25)	5 (0)	10	Local
DRC	241 (61 )	20 (2)	20	Local
Equatorial Guinea	21 (5)	-	3	Local
Gabon	75 (45 )	1 (0)	1	Local
Sao Tome and Principe	4 (4)	-	-	Under Investigation
Eastern Region	1,377 (516)	32 (14)	232
Djibouti	298 (208)	2 (2)	41	Local
Eritrea	34 (3)	-	-	Local
Ethiopia	74 (30)	3 (1)	14	Community

Kenya	208 (50)	9 (3)	40	Local
Madagascar	108 (27)	-	21	Local
Mauritius	324 (80)	9 (2)	42	Local
Rwanda	127 (22)	-	25	Local
Seychelles	11 (0)	-	-	Local
Somalia	60 (43)	2 (2)	2	Local
South Sudan	4 (3)	-	-	Local
Sudan	29 (17)	4 (2)	5	Local
Tanzania	46 (22)	3(2)	7	Local
Uganda	54 (2)	-	18	Community
Northern Region	6,625 (2,138)	619 (252)	1,336
Algeria	1,914 (491)	293 (120)	591	Community
Egypt	2,190 (868)	164 (90)	488	Local
Libya	25 (7)	1 (0)	9	Local
Mauritania	7 (1)	1 (0)	2	Local
Morocco	1763 (643)	126 (46)	203	Local
Tunisia	726 (130)	34 (12)	43	Community
Southern Region	2,434 (636)	37 (20)	455
Angola	19 (3)	2 (0)	2	Imported
Botswana	13 (7)	1 (1)	-	Local
Eswatini	15 (5)	-	8	Local
Malawi	16 (11)	2 (2)	-	Local
Mozambique	20 (10)	-	2	Local
Namibia	16 (5)	-	3	Local

South Africa	2,272 (604)	27 (15)	410	Community
Zambia	45 (6)	2 (1)	30	Local
Zimbabwe	17 (7)	3 (2)	-	Local
Western Region	3,574 (1,582)	89 (32)	702
Benin	35 (9)	1 (1)	5	Local
Burkina Faso	515 (170)	28 (10)	170	Local
Cape Verde	10 (4)	1 (0)	1	Local
Côte d’Ivoire	626 (381)	6 (3)	89	Local
Gambia	10 (6)	1 (0)	2	Imported
Ghana	566 (279)	8 (3)	4	Local
Guinea	319 (198)	-	17	Local
Guinea-Bissau	40 (22)	-	-	Local
Liberia	59 (45)	6 (3)	4	Local
Mali	126 (79)	10 (5)	26	Local
Niger	544 (291)	13 (3)	86	Local
Nigeria	343 (105)	10 (5)	91	Community
Senegal	291 (64)	2 (0)	178	Community
Sierra Leone	10 (4)	-	-	Local
Togo	77 (19)	3 (2)	29	Local
Total	15,284 (5,198)	815 (27)	2,895

NEW Africa CDC Response Activities: Surveillance:

AFTCOR’s weekly surveillance technical working group met on 1 April 2020 to strategize on innovative ways to provide remote technical capacity and improved policy recommendations to Member States, backed up by Member State data, in this era of closed borders and restricted movement.
Africa CDC will start holding weekly disease surveillance webinars on priority topics, like early detection and containment of COVID-19 cases, to support technical teams within the AU Member States’ ministries and governments. The English and French Webinar were launched on Wednesday (8 April) and Tuesday (14 April), respectively.
Africa CDC will host the second weekly disease surveillance webinar on "Understanding the WHO First Few Cases (FFX) protocol and the Case record form (“know your epidemic”)” and “How to use Go data” on Wednesday 15 April 2020 for English speaking countries and Friday 17 April 2020 for French speaking countries at (16:00-17:00 hours EAT).

Healthcare Preparedness 1. Africa CDC initiated a continent-wide network of 300 clinicians from across the continent to discuss COVID-19 clinical management and is holding weekly webinars. The next webinar is scheduled for 16 April 2020 to discuss management of frontline healthcare workers. Recommendations for Member States:

All Member States should enhance their existing surveillance⁷ to include COVID-19⁸ and severe acute respiratory infections (SARI)⁹ or pneumonia cases. Examples of enhanced surveillance include:
1. Adding questions about travel, contact history, and testing for coronaviruses to existing influenza surveillance systems;
2. Notifying healthcare facilities to immediately inform local public health officials about persons who meet the case definition for COVID-19, SARI and/or have recent travel to a country with local transmission or history of contact with a case.
Member States should continue to enhance surveillance at the borders to screen incoming travelers for severe respiratory illness and a history of recent travel to affected countries or territories reporting local or community transmission. Member States should
Member States should perform contact tracing of confirmed cases based on transmission type and country capacity.¹⁰
Notify WHO and Africa CDC immediately if suspected or confirmed cases of infection with novel coronavirus are identified. Africa CDC should be notified by emailing AfricaCDCEBS@africa-union.org.
Provide guidance to the general public about seeking immediate medical care and informing healthcare providers about recent travel or contact history in anyone who develops symptoms of severe respiratory illness.

¹ Per WHO, effective 17 February 2020, ‘confirmed’ cases include both laboratory-confirmed and clinically diagnosed (Hubei province, China only).
² Yemen and Saint Pierre and Miquelon
³ Burundi, Djibouti, Malawi, Malta, Slovakia and Somalia
⁴ WHO coronavirus disease (COVID-19) situation reports: https://www.who.int/emergencies/diseases/novel- coronavirus-2019/situation-reports
⁵ New numbers reported since last weekly report (7 April 2020)
⁶ Definitions modified from WHO for clarity in the African context: Community transmission: indicates countries experiencing large outbreaks of local transmission defined through an assessment of factors including, but not limited to: large numbers of cases not linkable to transmission chains, large numbers of cases from sentinel lab surveillance, multiple unrelated clusters in several areas of the country; Local transmission: indicates that the source of infection is within the country; Imported cases: indicates that all cases being reported by country have been acquired outside of the country
⁷ Africa CDC Protocol for enhanced surveillance for COVID-19 in Africa: https://africacdc.org/download/protocol- for-enhanced-severe-acute-respiratory-illness-and-influenza-like-illness-surveillance-for-covid-19-in-africa/
⁸ WHO COVID-19 surveillance guidance and case definition: https://www.who.int/emergencies/diseases/novel- coronavirus-2019/technical-guidance/surveillance-and-case-definitions
⁹ WHO SARI case definition: anyone with an acute respiratory infection with a history of fever (or measured fever of ≥ 38 C°) and cough with symptom onset within the last 10 days that requires hospitalization. https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/
¹⁰ Africa CDC Guidance on Contact Tracing for COVID-19 Pandemic: https://africacdc.org/download/guidance-on- contact-tracing-for-covid-19-pandemic/ Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).