Thread by @MartinKGHI

#COVID_SSA Update #Ethiopia - 13 weeks into their 2nd wave. 7,107 new cases last week, one-third⬇️on week 60. So it could be peaking🙏but caution indicated THREAD 1/8 @EPHIEthiopia @abebawfekadu @EthiopianNomad

Caution 1 - cases are falling in Ethiopia, but so are the number of tests performed. The test +ve proportion (>20%) remains much too high overall 2/8

Caution 2 - regional data issued by @EPHIEthiopia (latest to 18/4/21) indicates that while incidence *may* have peaked in #Addis it is rising in most other regions (having taken off later) 3/8

Caution 3 - test +ve proportions are a good indicator of suppression of transmission & testing sufficiency (when <5%). But TPPs are high AND rising. Only in #Addis & #Oromia have TPPs flattened. #Sidama #Somali #Harari regions & #DireDawa look particularly worrying 4/8

Caution 4 - @WHO advises 1,000 tests/million pop'n for surveillance during suppression. Other than 'COMBAT' surge testing in 8/20 #Ethiopia has struggled to do this - excepting #Addis where tests are concentrated. But recent⬆️in #Oromia #DireDawa #Gambella #Somali #SNNPR 4/8

Caution 5 - @EPHIEthiopia commented on burn out among regional response teams. Perhaps partic. evident in contact tracing, which despite increases in past few weeks, is still only identifying 4 contacts for every 10 new cases (compared with 3 contacts per new case in Wave 1) 5/8

In common with other sub-Saharan African countries the 2nd wave in #Ethiopia has led to more cases & deaths than the 1st. It's by no means over yet (see health system burden indicators👇). #Ethiopia faces unique infrastructural challenges with its huge population & land mass 6/8

Despite this, #Ethiopia's achievements (e.g. scaling up regionalized testing from zero) are extraordinary. It needs more support now with test kits & vaccines. It's already delivered most of its initial allocation of #COVAX vaccines, leading the way with #Nigeria