The COVID-19 pandemic in Africa’s Island Nations: A descriptive study of the course of the COVID-19 outbreaks and the national response plans

Introduction: The main objective is to present an overview of the evolution of the COVID-19pandemic in the six African island nations: Cabo Verde, Comoros, Madagascar, Mauritius, SãoTomé e Príncipe and Seychelles, up until 29 November 2020. The relevance of studying theoutbreak in these countries is their distinct geography, which may facilitate rapid closure andcontrol of their international borders. Here, we investigate whether this geography may haveled to an effective response and management of their respective COVID-19 epidemics.Methods: A literature review and analysis of national public health reports, officialcoronavirus websites and previously published research in each of the studied countries fromthe start of the pandemic through 29 November 2020 was performed. Data on metrics on thecountry-specific progression of COVID-19, the level of strictness of the governmental policies,the testing practices, as well the national healthcare systems, the description and the state ofhealth of the populations in the African island nations were reported.Results: Five out of six countries controlled their respective COVID-19 epidemics at an earlystage in the context of the total number of confirmed cases and deaths. In Cabo Verde, therewas an increasing number of cases as of 29 November 2020, when 10,526 total cases and 104total deaths were reported nationally. All six nations maintained a case fatality rate (CFR)lower than the global average, estimated between 2 - 3% in previously published research.Among the island nations, Mauritius had the highest CFR of 2%.Discussion: African island nations have different demographic, socioeconomic, and healthcareprofiles. However, their shared geographic characteristics likely played a role in limiting thespread of the infection. Furthermore, data from these nations support the idea that theimplementation of strict restrictions at an early stage, such as border closure and lockdowns,was crucial for the epidemic response.