First wave of the COVID-19 pandemic in Africa’s island nations: A descriptive study of the variation in the disease burden

Motivated by the idea that island nations might respond differently to non-island countries in handling pandemic situations, we aimed to study the first wave of COVID-19, along with the potential reasons behind the variation in disease burden, across the six African island nations: Cabo Verde, Comoros, Madagascar, Mauritius, São Tomé e Príncipe, and Seychelles. We analysed the publicly available COVID-19 data on confirmed cases and deaths from the beginning of the pandemic through 29 November 2020, to give an overview of the course of the pandemic in these nations. To understand the variation in disease burden across nations, we first explored their economic statuses, healthcare expenditures and facilities, ranging from the numbers of hospital staff to the PCR tests performed, and the main health risk factors. We further examined the age and sex distributions and densities of the overall and urban populations, along with analyzing the main industries in these countries. We also reviewed the non-pharmaceutical response measures implemented nationally. By presenting a comprehensive picture of the healthcare, socioeconomic, and demographic situation and describing the control measures taken by the governments, we aimed to evaluate the possible determinants of the variation in COVID-19 disease burden across the islands.