COVID-19 and the Motorcycle Taxi Sector in Sub-Saharan African Cities: A Key Stakeholders’ Perspective

This article assesses the impact of the COVID-19 outbreak on the urban motorcycle taxi (MCT) sector in Sub-Saharan Africa (SSA). MCT operators in SSA provide essential transport services and have shown ingenuity and an ability to adapt and innovate when responding to different challenges, including health challenges. However, policymakers and regulators often remain somewhat hostile toward the sector. The article discusses the measures and restrictions put in place to reduce the spread of COVID-19 and key stakeholders’ perspectives on these and on the sector’s level of compliance. Primary data were collected in six SSA countries during the last quarter of 2020. Between 10 and 15 qualitative interviews with key stakeholders relevant to the urban MCT sector were conducted in each country. These interviews were conducted with stakeholders based in the capital city and a secondary city, to ensure a geographically broader understanding of the measures, restrictions, and perspectives. The impact of COVID-19 measures on the MCT and motor-tricycle taxi sector was significant and overwhelmingly negative. Lockdowns, restrictions on the maximum number of passengers allowed to be carried at once, and more generally, a COVID-19-induced reduction in demand, resulted in a drop in income for operators, according to the key stakeholders. However, some key stakeholders indicated an increase in MCT activity and income because of the motorcycles’ ability to bypass police and army controls. In most study countries measures were formulated in a non-consultative manner. This, we argue, is symptomatic of governments’ unwillingness to seriously engage with the sector.

Wastewater sequencing reveals early cryptic SARS-CoV-2 variant transmission.

As SARS-CoV-2 continues to spread and evolve, detecting emerging variants early is critical for public health interventions. Inferring lineage prevalence by clinical testing is infeasible at scale, especially in areas with limited resources, participation, or testing and/or sequencing capacity, which can also introduce biases1-3. SARS-CoV-2 RNA concentration in wastewater successfully tracks regional infection dynamics and provides less biased abundance estimates than clinical testing4,5. Tracking virus genomic sequences in wastewater would improve community prevalence estimates and detect emerging variants. However, two factors limit wastewater-based genomic surveillance: low-quality sequence data and inability to estimate relative lineage abundance in mixed samples. Here we resolve these critical issues to perform a high-resolution, 295-day wastewater and clinical sequencing effort, in the controlled environment of a large university campus and the broader context of the surrounding county. We developed and deployed improved virus concentration protocols and deconvolution software that fully resolve multiple virus strains from wastewater. We detected emerging variants of concern up to 14 days earlier in wastewater samples, and identified multiple instances of virus spread not captured by clinical genomic surveillance. Our study provides a scalable solution for wastewater genomic surveillance that allows early detection of SARS-CoV-2 variants and identification of cryptic transmission.

Atypical Presentations among Older Adults with COVID-19 Disease: A Need for Broadening the Differential Diagnosis.

Typical presenting symptoms of COVID-19 have been reported to be common in older adults. Current guidelines by the World Health Organization (WHO) and Centers for Disease Control (CDC) for testing and diagnosis are based on the presence of these typical symptoms. Several older adults seen at our hospital have presented atypically with symptoms such as delirium, falls, increasing the need for attention to diagnostic protocols since this has significant implications for early detection and patient outcomes, infection control and promotion of safety among healthcare providers. With the increased risk of fatality among older adults with COVID-19, appropriate diagnostic protocols are needed to ensure early diagnosis and management. Recognizing these atypical presentations in nursing homes would also facilitate early screening and cohorting in these congregate living facilities where older adults have had disproportionately high morbidity and mortality rates. We present two patients who presented with delirium and falls, found to have COVID-19 infection.