The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Work-life, diversity and intersectionality: a critical review and research agenda

Work-life issues have important implications at both organizational and individual levels. This paper provides a critical review of the work-life literature from 1990 onwards through the lens of diversity, with a particular focus on disparities of power induced by methodological and conceptual framings of work and life. The review seeks to answer the following questions: What are the gaps and omissions in the work-life research? How may they be overcome? To answer these questions, the review scrutinizes blind spots in the treatment of life, diversity and power in work-life research in both positivist and critical scholarship. In order to transcend the blind spots in positivist and critical work-life research, the review argues the case for an intersectional approach which captures the changing realities of family and workforce through the lens of diversity and intersectionality. The theoretical contribution is threefold: first, the review demonstrates that contemporary framing of life in the work-life literature should be expanded to cover aspects of life beyond domestic life. Second, the review explains why and how other strands of diversity than gender also manifest as salient causes of difference in experiences of the work-life interface. Third, the review reveals that social and historical context has more explanatory power in work-life dynamics than the micro-individual level of explanations. Work-life literature should capture the dynamism in these contexts. The paper also provides a set of useful recommendations to capture and operationalize methodological and theoretical changes required in the work-life literature