The COVID-19 pandemic curve in Africa has lagged behind that of Europe. The first case of SARS-CoV-2 in Malawi was confirmed on 2 April.1 Malawi closed schools and airports, but no ‘lockdown’ was enforced in recognition of the risk to a population vulnerable to economic and health service disruption.2 Although overall ascertainment was low, detection of cases nationwide confirmed community transmission by July. Nonetheless, the number of acute cases presenting to hospital remained less than expected. The current total number of confirmed COVID-19 cases nationwide is just over 60001 with Blantyre district contributing one-third of the nationwide total.3more