Fight or Flight Response: Using Air Travel History to Determine COVID-19 Import Risk across Sub-Saharan Africa

Abstract

The coronavirus epidemic, COVID-19, has threatened the work and very existence of health systems, but the extent of its damage in the global scale has yet to be fully comprehended. Many of the initial recorded cases and mortalities have been in higher income and higher latitude countries, including China, European countries, and the United States. However, the spread of COVID-19 to lower latitude, lower middle income countries (LMICs) was not a question of if, but when. The potential outbreak seemed less severe in 2020 for lower latitude, LMICs, but recent data has suggested the trajectory of the epidemic to escalate. The eventual spread in these countries could result in higher cases and mortality than what is seen thus far, as these countries, especially those in Sub-Saharan Africa, are dependent upon the limitations of existing medical infrastructure and resources to support the response. Although a history of epidemics has bolstered healthcare capabilities, providing a wealth of reusable and adaptable facilities, potential development is hampered by the lack of knowledge about this current epidemic. Collecting arrival data to international airports in Sub-Saharan Africa allows analyzing risk and predicting countries of high case concentration to guide where resource interventions should be localized. In order to achieve this, this study compiled the amount of arrivals and analyzed the level of risk based on the coronavirus case reports in countries of origin at a given time. Furthermore, to account for the risk that is determined by the current infrastructure in place, the model developed by flight data would be compared to the actual infection rate and spread. While this is a necessary and initial step in preventative study, further research is needed to supplement current records and extend intervention plans to outbreak mitigation, especially when considering the intense diversity of factors in the Sub-Saharan Africa region.