Does sub-Saharan Africa truly defy the forecasts of the COVID-19 pandemic? Response from population data

IntroductionSince its identification, the COVID-19 infection has caused substantial mortality and morbidity worldwide, but sub-Saharan Africa seems to defy the predictions. We aimed to verify this hypothesis using strong statistical methods. MethodsWe conducted a cross-sectional study comparing the projected and actual numbers as well as population proportions of COVID-19 cases in the 46 sub-Saharan African countries on May 1st, May 29th (4 weeks later) and June 26th (8 weeks later). The source of the projected number of cases was a publication by scientists from the Center for Mathematical Modeling of Infectious Diseases of the London School of Hygiene & Tropical Medicine, whereas the actual number of cases was obtained from the WHO situation reports. We calculated the percentage difference between the projected and actual numbers of cases per country. Further, "N-1" chi-square tests with Bonferroni correction were used to compare the projected and actual population proportion of COVID-19 cases, along with the 95% confidence interval of the difference between these population proportions. All statistical tests were 2-sided, with 0.05 used as threshold for statistical significance. ResultsOn May 1st, May 29th and June 26th, respectively 40 (86.95%), 45 (97.82%) and 41 (89.13%) of the sub-Saharan African countries reported a number of confirmed cases that was lower than the predicted number of 1000 cases for May 1st and 10000 for both May 29th and June 26th. At these dates, the population proportions of confirmed Covid-19 cases were significantly lower (p-value <0.05) than the projected proportions of cases. Across all these dates, South-Africa always exceeded the predicted number and population proportion of COVID-19 infections. ConclusionSub-Saharan African countries did defy the dire predictions of the COVID-19 burden. Preventive measures should be further enforced to preserve this positive outcome.