The study characterized the transmission of COVID-19 in Ghana by estimating the time-varying reproduction number (Rt) and exploring the effect of various public health interventions at the national and regional levels. The median Rt for Ghana and six out of sixteen regions dropped from greater than 1 in March 2020 to less than 1 in September but increased above 1 in January 2021. The relaxation of movement restrictions and religious gatherings were not associated with increased Rt in the regions with lower case burdens. However, Rt increased in most regions after schools were reopened in January 2021. In a regression analysis, we estimated that the per-capita cumulative case count increased with population size. Findings indicated the public health interventions reduced the Rt at the national level while at the regional levels, the Rt fluctuated, and the extent of fluctuation varied across regions.
Transmission dynamics of COVID-19 in Ghana and the impact of public health interventions