Most African states swiftly implemented public health and social measures (PHSMs) to contain Covid-19 and limited the spread of the virus, with caseloads in Africa remaining lower than projected.

As governments now loosen restrictions, new research from the Partnership for Evidence-Based Covid-19 Response (PERC) highlights the indirect burdens of the virus across Africa and offers recommendations to governments.

The report, “Responding to Covid-19 in Africa: Using Data to Find a Balance”, compiles data from over 24 000 adults in 18 AU member states who provide insight into indirect impacts of the virus. The report was developed by Africa CDC, the WHO, Ipsos, Vital Strategies’ Resolve to Save Lives initiative, the UK Public Health Rapid Support Team, Novetta Mission Analytics and the World Economic Forum.

Key findings in the report include:

* 44% respondents in need of health care said they or someone in their household had skipped or delayed needed services, and 45% respondents in need of medicine reported the same for accessing medication.

* 70% of people reported problems accessing food, mainly due to lost income or higher food prices.

* 70% of survey respondents reported earning less money compared to the same time last year.

* Lower income families were more likely to experience a decline in income. About 80% of households with less than $100 in monthly income saw their income fall, compared to 60% of households with at least $500 in monthly income.

* Six in 10 respondents agreed that the economy needs to be reopened, and that the health risks of Covid-19 are minimal if social distancing rules are followed.

* 85% of respondents reported wearing a face mask in public in the previous seven days, but as expected given recent relaxing of some PHSMs, a lower share (60%) said they avoided religious gatherings and only half reported staying home instead of going to work, school or other regular activities.

* While more than two-thirds of respondents agreed that many people in their country would be affected by Covid-19, less than one-third (29%) believed their own personal risk of infection was high.

* While most respondents indicated basic knowledge of Covid-19, misinformation about the virus is common, particularly those positing foreign interference in treatments and vaccines. About one in three survey respondents agreed with the assertion that foreigners were discrediting African medicines and testing vaccines on Africans.

Recommendations include that governments:

* Prioritise “boxing in” the virus, by ensuring an adequate supply of testing kits and reagents to identify positive cases, tracing their close contacts, and isolating cases, rather than relying on wide-scale lockdowns.

* Make it as easy as possible for communities to adhere to low-cost personal protective measures, “the 3 W’s” – wearing a mask, washing hands, and watching distance.

* Protect health care workers by establishing Covid-19 protocols, increasing availability of personal protective equipment and training on infection prevention and control; then encourage people to seek care for health services unrelated to Covid-19 by engaging community leaders.

* Prioritise evidence-based measures to increase food security and economic recovery, including cash transfers and direct food support, with a focus on the lowest income households and vulnerable populations.

* Address misinformation by sharing consistent, evidence-based messages with trusted community members as messages messengers.

* Invest in data collection, analysis and reporting, including core indicators about cases and the public health response, rapid mortality surveillance, data about Covid-19 infections among health workers, and data on utilisation of health services.