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COVID-19 Results Briefing The African Region November 3, 2021
Transcript of COVID-19 Results Briefing The African Region November 3, 2021
covid19.healthdata.org 1 Institute for Health Metrics and Evaluation
COVID-19 Results Briefing
The African Region
November 3, 2021 This document contains summary information on the latest projections from the IHME model on COVID-19 in the African Region. The model was run on November 2, 2021, with data through November 1, 2021.
While trends in daily reported cases, reported deaths, and hospitalizations continue to decline, there are early indications that this trend may soon reverse. Daily infections increased by 11% this week, and 19 countries, primarily concentrated in a band across the Sahel from Mauritania in the west to Eritrea in the east, have an effective R greater than 1, indicating rising transmission. We expect that reported cases will begin to increase, with daily deaths starting to increase in mid-November. The increases are due in large part to mobility levels 18% higher than the pre-pandemic baseline; continually low levels of mask use, particularly in west, central, and parts of east Africa; waning immunity; and the world’s lowest levels of vaccination. Ongoing global vaccine inequity remains a major threat to the African region. This week, we have extended our projections to March 1, 2022. In our reference scenario, we project 170,000 cumulative reported deaths on March 1, representing an additional 20,000 lives lost between November 1 and March 1. Our reference scenario suggests that the African region’s fourth wave of the COVID-19 pandemic will peak in mid-February. Many factors can influence the magnitude and timing of the next peak. First, we have not yet incorporated waning immunity into our projections; we expect the next release of our models will factor this in. Second, the pace at which vaccination is scaled up will impact transmission potential across the region in the coming months. With only 5% of the population currently fully vaccinated and 43% previously infected, more than half of the population in the African region remains highly vulnerable while vaccine coverage remains low. Third, the extent to which mask use is expanded – 75% percent of the lives expected to be lost in our reference scenario between November 1 and March 1 could be saved if universal mask use were achieved. Given the number of factors at play, as well as questions surrounding the speed at which infection-derived immunity wanes, what happens to vaccine-derived immunity for hospitalization and deaths after six months, and the emergence of a new variant with increased transmissibility or considerable immune escape, the magnitude and timing of peaks in the next several months is uncertain. It is, however, clear that the notion that the COVID-19 pandemic is over is very unlikely to be true. The main strategies to manage the pandemic at this stage include rapid scale-up of vaccination, continued efforts to dispel vaccine misinformation and stimulate vaccine uptake, and promotion of mask use to mitigate surges in the coming months and prevent additional stress on health systems.
Current situation • Daily infections in the last week increased to 339,500 per day on average compared to
306,000 the week before (Figure 1.1). Daily hospital census in the last week (through November 1) decreased to 17,900 per day on average compared to 20,800 the week before.
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• Daily reported cases in the last week decreased to 2,600 per day on average compared to 3,000 the week before (Figure 2.1).
• Reported deaths due to COVID-19 in the last week decreased to 94 per day on average compared to 120 the week before (Figure 3.1).
• Total deaths due to COVID-19 in the last week decreased to 860 per day on average compared to 1,100 the week before (Figure 3.1). This makes COVID-19 the number 9 cause of death in the African Region this week (Table 1). Estimated total daily deaths due to COVID-19 in the past week were 9.2 times larger than the reported number of deaths.
• No locations had daily reported COVID-19 death rates greater than 4 per million (Figure 4.1).
• The daily rate of total deaths due to COVID-19 is greater than 4 per million in Congo, Gabon, and Mauritius (Figure 4.2).
• We estimate that 43% of people in the African Region have been infected as of November 1 (Figure 6.1).
• Effective R, computed using cases, hospitalizations, and deaths, is greater than 1 in 19 countries. (Figure 7.1).
• The infection-detection rate in the African Region was close to 1% on November 1 (Figure 8.1).
• Based on the GISAID and various national databases, combined with our variant spread model, we estimate the current prevalence of variants of concern (Figure 9.1). We estimate that the Beta variant is circulating in 2 countries, that the Delta variant is circulating in 41 countries, and that the Gamma variant is circulating in 14 countries.
Trends in drivers of transmission • Mobility last week was 18% higher than the pre-COVID-19 baseline (Figure 11.1).
Mobility was near baseline (within 10%) in 45 countries. Mobility was lower than 30% of baseline in no locations.
• As of November 1, in the COVID-19 Trends and Impact Survey, 44% of people self-report that they always wore a mask when leaving their home, the same as last week (Figure 13.1).
• There were 14 diagnostic tests per 100,000 people on November 1 (Figure 15.1).
• As of November 1, 2 countries have reached 70% or more of the population who have received at least one vaccine dose and 1 country has reached 70% or more of the population who are fully vaccinated (Figure 17.1).
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• In the African Region, 59.4% of the population that is 12 years and older say they would accept or would probably accept a vaccine for COVID-19, the same as last week. Note that vaccine acceptance is calculated using survey data from the 18+ population. The proportion of the population who are open to receiving a COVID-19 vaccine ranges from 31% in Botswana to 74% in Ghana (Figure 19.1).
• In our current reference scenario, we expect that 179.4 million people will be vaccinated with at least one dose by March 1 (Figure 20.1). We expect that 10% of the population will be fully vaccinated by March 1.
• Based on the estimate of the population that have been infected with COVID-19 and vaccinated to date, combined with assumptions on protection against infection with the Delta variant provided by either natural infection, vaccination, or both, we estimate that 33% of the region is immune to the Delta variant. In our current reference scenario, we expect that by March 1, 44% of people will be immune to the Delta variant (Figure 21.1). These two calculations do not take into account waning of natural or vaccine-derived immunity.
Projections • In our reference scenario, which represents what we think is most likely to happen,
our model projects 170,000 cumulative reported deaths due to COVID-19 on March 1. This represents 20,000 additional deaths from November 1 to March 1. Daily reported deaths will rise to 350 by February 18, 2022 (Figure 22.1).
• Under our reference scenario, our model projects 1,216,000 cumulative total deaths due to COVID-19 on March 1. This represents 209,000 additional deaths from November 1 to March 1 (Figure 22.1).
• If universal mask coverage (95%) were attained in the next week, our model projects 15,000 fewer cumulative reported deaths compared to the reference scenario on March 1.
• Under our worse scenario, our model projects 177,000 cumulative reported deaths on March 1, an additional 6,800 deaths compared to our reference scenario. Daily reported deaths in the worse scenario will rise to 490 by February 14, 2022 (Figure 22.1).
• Daily infections in the reference scenario will rise to 1,019,000 by January 25, 2022 (Figure 22.3). Daily infections in the worse scenario will rise to 1,416,290 by January 25, 2022 (Figure 22.3).
• Daily cases in the reference scenario will rise to 12,900 by February 5, 2022 (Figure 22.4). Daily cases in the worse scenario will rise to 18,600 by February 2, 2022 (Figure 22.4).
• Daily hospital census in the reference scenario will rise to 57,720 by February 8, 2022 (Figure 22.5). Daily hospital census in the worse scenario will rise to 80,140 by February 7, 2022 (Figure 22.5).
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• Figure 23.1 compares our reference scenario forecasts to other publicly archived models. Forecasts are widely divergent.
• At some point from November through March 1, 12 countries will have high or extreme stress on hospital beds (Figure 24.1). At some point from November through March 1, 35 countries will have high or extreme stress on intensive care unit (ICU) capacity (Figure 25.1).
African Region
Model updatesNo model updates.
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African Region
Figure 1.1. Daily COVID-19 hospital census and infections
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Figure 2.1. Reported daily COVID-19 cases, moving average
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Table 1. Ranking of total deaths due to COVID-19 among the leading causes of mortality this week,assuming uniform deaths of non-COVID causes throughout the year
Cause name Weekly deaths RankingNeonatal disorders 14,422 1Lower respiratory infections 12,732 2HIV/AIDS 12,224 3Malaria 11,351 4Diarrheal diseases 11,088 5Ischemic heart disease 8,306 6Stroke 8,063 7Tuberculosis 7,097 8COVID-19 6,008 9Congenital birth defects 3,721 10
Figure 3.1. Smoothed trend estimate of reported daily COVID-19 deaths (blue) and total daily deaths dueto COVID-19 (orange)
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Daily COVID-19 death rate per 1 million on November 1, 2021
Figure 4.1 Daily reported COVID-19 death rate per 1 million
<1
1 to 1.9
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>=8
Figure 4.2 Daily total COVID-19 death rate per 1 million
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Cumulative COVID-19 deaths per 100,000 on November 1, 2021
Figure 5.1 Reported cumulative COVID-19 deaths per 100,000
<50
50 to 99
100 to 149
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Figure 5.2 Total cumulative COVID-19 deaths per 100,000
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100 to 149
150 to 199
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250 to 299
300 to 349
350 to 399
>=400
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 6.1. Estimated percent of the population infected with COVID-19 on November 1, 2021
<10
10−19.9
20−29.9
30−39.9
40−49.9
50−59.9
60−69.9
70−79.9
80−84.9
85−89.9
90−94.9
>=95
Figure 7.1. Mean effective R on October 21, 2021. Effective R less than 1 means that transmission shoulddecline, all other things being held the same. The estimate of effective R is based on the combined analysisof deaths, case reporting, and hospitalizations where available. Current reported cases reflect infections 11-13days prior, so estimates of effective R can only be made for the recent past.
<0.52
0.52−0.63
0.64−0.75
0.76−0.87
0.88−0.99
1−1.11
1.12−1.23
1.24−1.35
1.36−1.47
>=1.48
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African Region
Figure 8.1. Percent of COVID-19 infections detected. This is estimated as the ratio of reported dailyCOVID-19 cases to estimated daily COVID-19 infections based on the SEIR disease transmission model. Dueto measurement errors in cases and testing rates, the infection-detection rate can exceed 100% at particularpoints in time.
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Region of the Americas
South−East Asia Region
European Region
Eastern Mediterranean Region
Western Pacific Region
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Estimated percent of circulating SARS-CoV-2 for primary variant families on November 1, 2021
Figure 9.1 Estimated percent Alpha variant
0%
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10−24%
25−49%
50−74%
75−89%
90−100%
Figure 9.2 Estimated percent Beta variant
0%
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10−24%
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50−74%
75−89%
90−100%
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 9.3 Estimated percent Delta variant
0%
1−9%
10−24%
25−49%
50−74%
75−89%
90−100%
Figure 9.4 Estimated percent Gamma variant
0%
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10−24%
25−49%
50−74%
75−89%
90−100%
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African Region
Figure 10.1. Infection-fatality rate on November 1, 2021. This is estimated as the ratio of COVID-19 deathsto estimated daily COVID-19 infections.
< 0.2%
0.2% to 0.39%
0.4% to 0.59%
0.6% to 0.79%
0.8% to 0.99%
> 1%
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African Region
Critical driversTable 2. Current mandate implementation
Prim
ary
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ders
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ll no
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side
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Indi
vidu
al m
ovem
ents
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ted
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few
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ness
esIn
divi
dual
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few
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indo
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0 ou
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10
indo
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5 ou
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athe
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limit:
25
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limit:
50
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limit:
100
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or, 2
50 o
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esta
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ars
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bars
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taur
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/ ba
rs c
urbs
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s, p
ools
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isur
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osed
Non
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Non
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ial r
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lyN
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clos
edS
tay
hom
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der
Sta
y ho
me
fine
Mas
k m
anda
teM
ask
man
date
fine
ZimbabweZambia
United Republic of TanzaniaUganda
TogoSouth SudanSouth AfricaSierra Leone
SeychellesSenegal
Sao Tome and PrincipeRwandaNigeria
NigerNamibia
MozambiqueMauritius
MauritaniaMali
MalawiMadagascar
LiberiaLesotho
KenyaGuinea−Bissau
GuineaGhana
GambiaGabon
EthiopiaEswatini
EritreaEquatorial Guinea
Democratic Republic of the CongoCôte d'Ivoire
CongoComoros
ChadCentral African Republic
CameroonCabo Verde
BurundiBurkina Faso
BotswanaBenin
AngolaAlgeria
Mandate in placeMandate in place(imposed this week)Mandate in place(updated from previous reporting)
No mandateNo mandate(lifted this week)No mandate(updated from previous reporting)
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African Region
Figure 11.1. Trend in mobility as measured through smartphone app use, compared to January 2020baseline
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obili
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Region of the Americas
South−East Asia Region
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Western Pacific Region
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 12.1. Mobility level as measured through smartphone app use, compared to January 2020 baseline(percent) on November 1, 2021
=<−50
−49 to −45
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African Region
Figure 13.1. Trend in the proportion of the population reporting always wearing a mask when leaving home
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Figure 14.1. Proportion of the population reporting always wearing a mask when leaving home on November1, 2021
0%
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covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 15.1. Trend in COVID-19 diagnostic tests per 100,000 people
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Figure 16.1. COVID-19 diagnostic tests per 100,000 people on November 1, 2021
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African Region
Table 3. Estimates of vaccine efficacy for specific vaccines used in the model at preventing disease andinfection. The SEIR model uses variant-specific estimates of vaccine efficacy at preventing symptomaticdisease and at preventing infection. We use data from clinical trials directly, where available, and makeestimates otherwise. More information can be found on our website.
Vaccine
Efficacy atpreventing disease:
ancestral andAlpha
Efficacy atpreventing infection:ancestral and Alpha
Efficacy atpreventing disease:Beta, Delta, &
Gamma
Efficacy atpreventing infection:
Beta, Delta, &Gamma
AstraZeneca 90% 52% 85% 49%CoronaVac 50% 44% 43% 38%Covaxin 78% 69% 68% 60%Johnson &Johnson
86% 72% 60% 56%
Moderna 94% 89% 94% 80%Novavax 89% 79% 79% 69%Pfizer/BioNTech 94% 86% 85% 78%Sinopharm 73% 65% 63% 56%Sputnik-V 92% 81% 80% 70%TianjinCanSino
66% 58% 57% 50%
Othervaccines
75% 66% 65% 57%
Othervaccines(mRNA)
91% 86% 85% 78%
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African Region
Percent of the population having received at least one dose (17.1) and fully vaccinated against SARS-CoV-2(17.2) by November 1, 2021
Figure 17.1 Percent of the population having received one dose of a COVID-19 vaccine
0%
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Figure 17.2 Percent of the population fully vaccinated against SARS-CoV-2
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African Region
Figure 18.1. Trend in the estimated proportion of the population that is 12 years and older that has beenvaccinated or would probably or definitely receive the COVID-19 vaccine if available. Note that vaccineacceptance is calculated using survey data from the 18+ population.
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Figure 19.1. Estimated proportion of the population that is 12 years and older that has been vaccinatedor would probably or definitely receive the COVID-19 vaccine if available. Note that vaccine acceptance iscalculated using survey data from the 18+ population.
0%
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covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 20.1. Percent of people who receive at least one dose of a COVID-19 vaccine and those who arefully vaccinated
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Figure 21.1. Percentage of people who are immune to non-escape variants and the percentage of peoplewho are immune to escape variants
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Projections and scenariosWe produce three scenarios when projecting COVID-19. The reference scenario is our forecast of what wethink is most likely to happen:
• Vaccines are distributed at the expected pace. Brand- and variant-specific vaccine efficacy is updatedusing the latest available information from peer-reviewed publications and other reports.
• Future mask use is the mean of mask use over the last 7 days.• Mobility increases as vaccine coverage increases.• Governments adapt their response by re-imposing social distancing mandates for 6 weeks whenever
daily deaths reach 8 per million, unless a location has already spent at least 7 of the last 14 days withdaily deaths above this rate, and not yet re-imposed social distancing mandates. In this case, thereference scenario assumes that mandates are re-imposed when daily deaths reach 15 per million.
• Variants Alpha, Beta, Gamma, and Delta continue to spread regionally and globally from locationswith sufficient transmission.
The worse scenario modifies the reference scenario assumption in four ways:
• 100% of vaccinated individuals stop using masks.• Mobility increases in all locations to 25% above the pre-pandemic winter baseline, irrespective of vaccine
coverage.• Governments are more reluctant to re-impose social distancing mandates, waiting until the daily death
rate reaches 15 per million, unless a location has already spent at least 7 of the last 14 days with dailydeaths above this rate, and not yet re-imposed social distancing mandates. In this case, the referencescenario assumes that mandates are re-imposed when daily deaths reach 38 per million. In either case,we assume social distancing mandates remain in effect for 6 weeks.
• Variants Alpha, Beta, Gamma, and Delta spread between locations twice as fast when compared withour reference scenario.
The universal masks scenario makes all the same assumptions as the reference scenario but assumes alllocations reach 95% mask use within 7 days.
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African Region
Daily COVID-19 deaths until March 01, 2022 for three scenarios
Figure 22.1 Reported daily COVID-19 deaths per 100,000
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Figure 22.2 Total daily COVID-19 deaths per 100,000
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Figure 22.3. Daily COVID-19 infections until March 01, 2022 for three scenarios
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Figure 22.4. Daily COVID-19 reported cases until March 01, 2022 for three scenarios
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African Region
Figure 22.5. Daily COVID-19 hospital census until March 01, 2022 for three scenarios
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Hos
pita
l cen
sus
Hospital census per 100,000 population
Reference scenario
Universal mask use
Worse
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 23.1. Comparison of reference model projections with other COVID modeling groups. For thiscomparison, we are including projections of daily COVID-19 deaths from other modeling groups whenavailable, last model update in brackets: Delphi from the Massachusetts Institute of Technology (Delphi)[November 3, 2021], Imperial College London (Imperial) [October 27, 2021], the SI-KJalpha model fromthe University of Southern California (SIKJalpha) [November 3, 2021]. Daily deaths from other modelinggroups are smoothed to remove inconsistencies with rounding. Regional values are aggregates from availablelocations in that region.
0
500
1,000
1,500
Nov 2
1
Dec 2
1
Jan
22
Feb
22
Mar
22
Date
Dai
ly d
eath
s
Models
IHME (reported deaths)
Delphi
Imperial
SIKJalpha
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 24.1. The estimated inpatient hospital usage is shown over time. The percent of hospital bedsoccupied by COVID-19 patients is color-coded based on observed quantiles of the maximum proportion ofbeds occupied by COVID-19 patients. Less than 5% is considered low stress, 5-9% is considered moderatestress, 10-19% is considered high stress, and 20% or greater is considered extreme stress.
eSwatiniZimbabwe
ZambiaUganda
TogoThe Gambia
TanzaniaSão Tomé and PrÍncipe
South SudanSouth AfricaSierra Leone
SeychellesSenegalRwandaNigeria
NigerNamibia
MozambiqueMauritius
MauritaniaMali
MalawiMadagascar
LiberiaLesotho
KenyaGuinea−Bissau
GuineaGhanaGabon
EthiopiaEritrea
Equatorial GuineaDR Congo
Côte d'IvoireCongo (Brazzaville)
ComorosChad
Central African RepublicCape Verde
CameroonBurundi
Burkina FasoBotswana
BeninAngolaAlgeria
Mar
20
May
20
Jul 2
0
Sep 2
0
Nov 2
0
Jan
21
Mar
21
May
21
Jul 2
1
Sep 2
1
Nov 2
1
Jan
22
Mar
22
Stress level
Low
Moderate
High
Extreme
All hospital beds
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
Figure 25.1. The estimated intensive care unit (ICU) usage is shown over time. The percent of ICU bedsoccupied by COVID-19 patients is color-coded based on observed quantiles of the maximum proportion ofICU beds occupied by COVID-19 patients. Less than 10% is considered low stress, 10-29% is consideredmoderate stress, 30-59% is considered high stress, and 60% or greater is considered extreme stress.
eSwatiniZimbabwe
ZambiaUganda
TogoThe Gambia
TanzaniaSão Tomé and PrÍncipe
South SudanSouth AfricaSierra Leone
SeychellesSenegalRwandaNigeria
NigerNamibia
MozambiqueMauritius
MauritaniaMali
MalawiMadagascar
LiberiaLesotho
KenyaGuinea−Bissau
GuineaGhanaGabon
EthiopiaEritrea
Equatorial GuineaDR Congo
Côte d'IvoireCongo (Brazzaville)
ComorosChad
Central African RepublicCape Verde
CameroonBurundi
Burkina FasoBotswana
BeninAngolaAlgeria
Mar
20
May
20
Jul 2
0
Sep 2
0
Nov 2
0
Jan
21
Mar
21
May
21
Jul 2
1
Sep 2
1
Nov 2
1
Jan
22
Mar
22
Stress level
Low
Moderate
High
Extreme
Intensive care unit beds
covid19.healthdata.org Institute for Health Metrics and Evaluation
African Region
More informationData sources:
Mask use and vaccine confidence data are from the The Delphi Group at Carnegie Mellon University andUniversity of Maryland COVID-19 Trends and Impact Surveys, in partnership with Facebook. Mask use dataare also from Premise, the Kaiser Family Foundation, and the YouGov COVID-19 Behaviour Tracker survey.
Genetic sequence and metadata are primarily from the GISAID Initiative. Further details available on theCOVID-19 model FAQ page.
A note of thanks:
We wish to warmly acknowledge the support of these and others who have made our COVID-19 estimationefforts possible.
More information:
For all COVID-19 resources at IHME, visit http://www.healthdata.org/covid.
To download our most recent results, visit our Data downloads page.
Questions? Requests? Feedback? Please contact us at https://www.healthdata.org/covid/contact-us.
covid19.healthdata.org Institute for Health Metrics and Evaluation