I raised this question on Twitter the other day, because I continue to follow the COVID-19 numbers coming out of the Sahelien countries, and I’ve been struck by those out of Burkina Faso. (I mostly rely on the daily counts posted by the journalist Dieudonné Lankoande). After a period where new case counts were negligible, my impression was that numbers jumped a bit recently. Others weighed in to basically confirm that impression, with Louis Audet-Gosselin pointing to a recent pocked of cases discovered in Bobo-Dioulasso, Burkina Faso’s second most populous city and its key economic hub (see here for more).
A quick glance at Google’s figures reinforces the sense that compared to many of its neighbors, and especially its two Sahelian neighbors Mali and Niger, Burkina Faso’s official confirmed case count is relatively high.
|Country||Reported COVID Case Sept. 8-21||Total Country Population (2018)|
|Burkina Faso||444||19.8 million|
|Cote d’Ivoire||619||25 million|
What these numbers mean is above my pay grade. There has been a wide-ranging debate about what seems to be a markedly low case rate in Africa. The Washington Post‘s Karen Attiah weighed in eloquently on that debate recently, noting Western media’s superficial coverage of the issue: “It’s almost as if they are disappointed that Africans aren’t dying en masse and countries are not collapsing.” And I have gone back, several times, to George Kibala Bauer’s post at Africa Is A Country, in which he argues, in part, “COVID-19 is a powerful reminder that we must reclaim African reality in all its forms in order to adequately define and respond to the challenges we face and imagine African futures, which transcend the Western gaze.”
How should one explain, moreover, substantial variation not just within Africa but within a single region or sub-region? Population size seems to matter but obviously does not tell the whole story. Does the explanation for the variation involve a lack of testing in some countries – more sophisticated testing infrastructure in Ghana than in, say, Niger? Or are the levels of actual outbreak markedly different, due to population density and movement, or levels of precaution and preparedness, or some other factor?
Those questions operate at the country level, too: the clusters in Burkina in recent days appear to have been in Bobo-Dioulasso and in the capital Ouagadougou, but also (to a lesser extent) in the western town of Houndé (map) and the southern town of Gaoua (map). These two towns are much smaller than Ouagadougou and Bobo-Dioulasso, with roughly 50,000 people in Houndé and over 30,000 in Gaoua, according to the outdated estimates found on Wikipedia. That there would be more testing capacity in the major cities makes sense, and that there would be some testing in other parts of the country also makes sense – but does this mean that there are no outbreaks, or simply no testing, in the conflict zones in the north and east? Or are there cases there, in small or large numbers, that are escaping detection? Figures for excess deaths, meanwhile, might help settle these questions, but are not easily accessible from what I can tell.
A COVID-19 spike would be bad news, obviously, for Burkina Faso, with the country and its neighbors having eased key restrictions in July and August, with elections approaching in November, and with mass violence continuing in parts of the north and east.