Pan-African evolution of within- and between-country COVID-19 dynamics

Significance We created a strategy for understanding the evolution of the COVID-19 pandemic throughout the African continent. Because high-quality mobility data are challenging to obtain across Africa, the approach provides the ability to distinguish cases arising from within a country or from its neighbors. The results further show how testing capacity and social and health policy contribute to the dynamics of cases, and generate short-term prediction of the evolution of the pandemic on a country-by-country basis. This framework improves the ability to interpret and act upon real-time complex COVID-19 data from the African continent. These findings emphasize that regional efforts to coordinate country-specific strategies in transmission suppression should be a continental priority to control the COVID-19 pandemic in Africa. The coronavirus disease 2019 (COVID-19) pandemic is heterogeneous throughout Africa and threatening millions of lives. Surveillance and short-term modeling forecasts are critical to provide timely information for decisions on control strategies. We created a strategy that helps predict the country-level case occurrences based on cases within or external to a country throughout the entire African continent, parameterized by socioeconomic and geoeconomic variations and the lagged effects of social policy and meteorological history. We observed the effect of the Human Development Index, containment policies, testing capacity, specific humidity, temperature, and landlocked status of countries on the local within-country and external between-country transmission. One-week forecasts of case numbers from the model were driven by the quality of the reported data. Seeking equitable behavioral and social interventions, balanced with coordinated country-specific strategies in infection suppression, should be a continental priority to control the COVID-19 pandemic in Africa.