Brazzaville – Southern Africa is facing an upsurge in COVID-19 cases for the third consecutive week as the winter season in the region approaches. The uptick has broken a two-month-long decline in overall infections recorded across the continent.

The sub-region recorded 46 271 cases in the week ending on 8 May 2022, marking a 32% increase over the week before. The increase is largely driven by a spike in South Africa where weekly recorded cases have quadrupled in the past three weeks. Deaths have, however, not climbed as quickly. South Africa recorded 376 deaths in the past three weeks, twice as many compared with the previous three weeks.

Although cases have risen, hospitalization in South Africa remains low, with the number of patients currently admitted testing positive for COVID-19 at around 20% of the late December 2021 peak. In Gauteng and KwaZulu-Natal provinces, where the latest wave was first detected, both hospitalizations and in-hospital deaths increased by 90-100% in the past two weeks over the previous fortnight.

The current surge is being fuelled by the Omicron variant amid relaxed public health and social measures. Since the beginning of April, South Africa alone has recorded 1369 cases of the Omicron sub-variant BA.2, 703 cases of sub-variant BA.4, and 222 cases of sub-variant BA.5. However, BA.4 and BA.5 remain the most concerning because the two sub-variants contain the largest number of mutations, and it still unclear how they affect immunity.

In addition to South Africa, Eswatini and Namibia have also recorded an increase in cases, with both reporting 50% more new cases in the past two weeks compared with the previous two weeks.

Africa’s past four pandemic waves have occurred around mid- and end-year and mostly driven by new COVID-19 variants, winter seasons and high population movement during these holiday periods. In 2021, the Delta-fuelled mid-year surge began round May and in late November with the emergence of Omicron.

“This uptick in cases is an early warning sign which we are closely monitoring. Now is the time for countries to step up preparedness and ensure that they can mount an effective response in the event of a fresh pandemic wave,” said Dr Abdou Salam Gueye, Director of Emergency Preparedness and Response at World Health Organization (WHO) Regional Office for Africa.

Over the past two years African countries have greatly improved COVID-19 response, with key aspects such as surveillance, testing and treatment bolstered. It is vital that these measures are maintained and quickly scaled up should COVID-19 cases surge further and across many countries.

The continent has also ramped up genomic sequencing. Between January and April 2021, African laboratories reported about 9000 sequences. This has risen over four times to nearly 40 000 over the same period this year.

However, with the decline in cases earlier this year, countries have rolled back public health measures, including surveillance. Testing has also decreased. Between March and May 2022, only 30% of countries reporting testing data met the WHO benchmark of carrying out 10 tests per 10 000 people per week. This is down from 40% in the months between the waves driven by Delta and Omicron in 2021.

“With the experience gained over the past two years, we must do all it takes to curb the adverse impacts of a new pandemic wave by stepping up vaccination and the measures to detect and prevent the spread of the virus as well as treat patients,” Dr Gueye said. “To beat this pandemic, we must stay vigilant. The harsh reality is that complacency comes at a high price.”

So far, Africa has reported 11.7 million cases and around 253 000 deaths. The continent recorded 52 878 cases in the week ending on 8 May, a rise of 38% from the week before. 

WHO held a virtual press conference today led by Dr Gueye and facilitated by APO Group. He was joined by             Professor Placide Mbala, Head of Epidemiology Department and Head of the Genomic Pathogens Laboratory, National Institute for Biomedical Research, Democratic Republic of the Congo, and Dr Kerrigan McCarthy, Specialist Pathologist, National Institute for Communicable Diseases, South Africa.

Also on hand from the WHO Regional Office for Africa to respond to questions were Dr Thierno Balde, Regional COVID-19 Incident Manager, Dr Nicksy Gumede-Moeletsi, Regional Virologist, Dr Mory Keita, Incident Manager for Ebola outbreak response in the Democratic Republic of the Congo, and Zora Machekanyanga, Communications Officer, Vaccine Preventable Diseases, WHO Intercountry Support Team for Eastern and Southern Africa.