# A comparative analysis of infection and mortality in reassessing africa’s COVID-19 dynamic using time-varying tests

## TL;DR

This study shows Africa experienced similar infection surges and death increases as other regions during the pandemic, once testing differences are accounted for.

## Contribution

A novel metric to correct for time-varying test volumes reveals accurate infection and mortality dynamics in Africa.

## Key findings

- Africa had infection surges with magnitude and frequency matching other regions.
- Mortality increases in Africa followed infection surges with a ten-week lag.
- Infection acceleration in Africa correlated with that in the Americas.

## Abstract

It is commonly believed that Africa largely evaded the worst of the COVID-19 pandemic, with fewer cases than other continents. However, regional comparisons that ignore differences in testing intensity may misrepresent dynamics. Studying the spread and case-fatality relationship during COVID-19 across WHO regions requires explicitly adjusting for time-varying test volumes.

We build a weekly panel dataset spanning May 2020 to December 2021 for the WHO regions: Africa, Eastern Mediterranean, South-East Asia, the Americas, Western Pacific, and Europe. Data on tests, confirmed cases, and COVID-19-attributed deaths were sourced from Our World in Data. We apply a novel metric that corrects for fluctuating test volumes to quantify week-to-week acceleration in infections and in mortality. We then compare the frequency, magnitude, and timing of these acceleration episodes across regions.

Accounting for testing dynamics, we show that Africa exhibits multiple infection-acceleration episodes whose magnitude and frequency match those in other regions. Mortality accelerations in Africa closely follow infection surges, with an average lag of ten weeks. A positive correlation between infection acceleration in Africa and the Americas further indicates synchrony. These findings hold when using a larger secondary dataset of 140 countries.

Contrary to prevailing assumptions, Africa was not spared from the pandemic’s severe dynamics. Infection surges were on par with those elsewhere and were followed by mortality accelerations. These results underscore that accounting for testing variability is essential to accurately assess pandemic progression, and they highlight the urgent need to strengthen surveillance and healthcare capacity across all regions.

It is commonly believed that Africa was less affected by COVID-19 than other parts of the world because it reported fewer cases. However, differences in how much testing was done can make such comparisons misleading. In this study, we used a new measure that accounts for changes in testing levels to examine how quickly infections and deaths increased over time. We analyzed weekly data from May 2020 to December 2021 across World Health Organization regions. Our findings show that Africa experienced several infection surges similar in size and frequency to those in other regions, followed about ten weeks later by increases in deaths. Considering testing differences in surveillance and healthcare systems is crucial for accurately assessing the pandemic’s course worldwide.

Luchini et al., correct for time-varying tests to quantify week-to-week acceleration in COVID-19 infection and mortality from May 2020 to December 2021 in WHO regions. Africa exhibits infection-acceleration episodes whose magnitude and frequency match those in other regions, and that are followed by mortality accelerations about ten weeks later.