COVID-19 in Ethiopia:A contextual approach to explaining its slow growth

The COVID-19 pandemic is a time of many predictions and rapid learning. Early on, the World Health Organization (WHO) identified Ethiopia as one of thirteen countries in Africa as a top priority for COVID-19 preparedness [1]. Surprisingly and thankfully, while an early catastrophic outbreak was feared, the rise in COVID-19 cases in Ethiopia has continued to be slow, with few significant health systems impacts or changes in the patterns of morbidity and mortality [2]. Despite its high-risk status, over four months after is first confirmed case, Ethiopia, with a population of 110 million, reported only 8181 cases of COVID-19 on July 15th, 2020, or 74.37 cases per 1 million people [2]. In comparison, the United States, with a population three times that of Ethiopia, had over 2 million cases within four months of its first case [3]. Brazil, with a population twice the size of Ethiopia, had over 1 million cases within four months of its first case, and South Africa, with a population half that of Ethiopia, had over 150 000 cases within four months of its first case [3].