Nigeria is currently the worst COVID-19 affected country in West Africa in terms of morbidity and mortality amid ECOWAS’s recent proclamation of the country as the region’s COVID-19 Response Champion. It is against this background that this paper analysed the geographical distribution of confirmed COVID-19 cases and fatalities in West Africa, with a view to understanding why Nigeria is at the heart of the pandemic in the sub-continent. The research relied on COVID-19 data and other health, demographic, transport, economic indicators from published sources. Pearson correlation technique and simple linear regressions were useful in discerning associations between COVID-19 and explanatory factors in West Africa. In order of importance, Nigeria, Ghana and Senegal were the top three on the morbidity list while Nigeria, Mali and Niger had the largest number of fatalities as at June 11, 2020. Results show that the population size and air traffic had significant impact on both COVID-19 morbidity and mortality in West Africa. In addition, Nigeria’s large population size and high air traffic volume did not only increase its susceptibility to the viral infection but also accounted for its being an outlier in the sub-continent. The study recommends that a cautious and gradual reopening of the borders should be considered by member states of the sub-region while behavioural avoidance measures are being enforced till a vaccine is found. Electronic supplementary material The online version of this article (10.1007/s41324-020-00371-5) contains supplementary material, which is available to authorized users.

The poverty-as-a-vaccine hypothesis came to light following the wide circulation of the controversial British Broadcasting Corporation (BBC) World Service post on the internet and social media. It was a theoretical response to what this paper has termed as “the African COVID-19 paradox” or what some have characterised as the “African COVID-19 anomaly” whose thesis is though Africa is the poorest continent in the world, yet it has some of the lowest COVID-19 infection and mortality rates globally. This paradoxical profile apparently contradicts earlier and grim projections by several international bodies on the fate of Africa in this global health crisis. Given this background, we specifically tested the validity of the hypothesis from a geographic perspective within the spatial framework of Africa. Data came from secondary sources. Evidence truly points out a significant negative relationship between COVID-19 and poverty in Africa and thus statistically supports the poverty-as-a-vaccine hypothesis. However, this does not confirm that poverty confers immunity against COVID-19 but it implicitly shows there are complex factors responsible for the anomaly. The main conclusion of the paper is that poverty has no protective immunity against COVID-19 in Africa and is therefore not tenable.

Clinical evidence shows the incidence of novel coronavirus is associated with pre-existing medical conditions. Thus, people with pre-existing medical conditions are more likely to be infected with COVID-19. In light of this, this paper examined the extent to which pre-existing medical conditions are related to COVID-19 incidence and mortality in Nigeria from a geographical perspective. We used the geographically weighted regression (GWR) to determine the effect and extent to which pre-existing medical conditions affect COVID-19 incidence in Nigeria. Our findings show that besides the remarkable spatial variation in COVID-19 incidence and mortality, obesity was a significant predictor of COVID-19 with its effect strongest in southwest Nigeria and other parts of the country. The conclusion of the paper is that areas with high prevalence of pre-existing medical conditions coincide with areas with high COVID-19 incidence and fatality. We recommended that there should be a spatially explicit intervention on the reduction of exposure to COVID-19 among states with high prevalence of pre-existing medical conditions through vaccination.