Ciaran Burks (4 Min Read)
COVID-19 in South Africa: The main issues
First, we should highlight the main issues surrounding this pandemic. The primary concern is, or at least should be, the preservation of human lives in this outbreak. The main issue is that the virus requires, in a large proportion of cases, the use of ventilators typically located in intensive care units (ICUs). Thus, the rapid spread of the virus will leave those in need of ventilators without access to them, and over 70% of people in this situation will die in this circumstance (van den Heever, 2020). How do we prevent this outcome? By reducing the infection rate to a point where we “flatten the curve” enough so that all those who need a ventilator get one, we can prevent deaths as far as possible.
Reducing the infection rate is achieved most effectively with a vaccine, but we are at least a year away (and probably more) from a large-scale vaccine. Social distancing and quarantines also slow the infection rate. We have seen the emergence of two responses internationally (van den Heever, 2020).
First, prepared countries have implemented testing, tracing, and selective quarantines. This is possible only in a situation where the government and health system have the resources to carry out many tests for the virus, trace infections reliably, and put selective groups into lockdown. The South African health system (both private and public) cannot support many tests, which presents a significant complication. Since testing was only conducted for people with severe symptoms and contact with an international traveller, we have no data on if the virus is present in communities that have not had direct contact with international travellers. Since a large portion of the South African population resides in densely populated communities, the spread of the virus in these situations will be rapid. In summary, the South African government cannot make good decisions because it does not have good data (van den Heever, 2020).
Poor health infrastructure will reduce the ability of South Africa (and all emerging countries) to deal with the economic fallout of the crisis. The South African Reserve Bank estimates that South Africa’s economy will contract 6% or more in 2020, with job losses exceeding 350,000, with higher rates of unemployment expected in the informal sector (Magubane & Omarjee, 2020).
COVID-19 in South Africa: Have we contained the crisis?
South Africa went into a stringent national lockdown at the end of March, and the data look promising. It seems that the lockdown has drastically reduced the number of new infections, evident in figure 2.
The number of new infections per day is still increasing at around 5% per day, which could cause a real health emergency if the rate does not continue to fall. Additionally, the real rate is likely to be far higher, given the limits on testing. This rate still presents a problem, but it is a huge improvement on the rates we saw before the lockdown.
COVID-19 in South Africa: What next?
The spread of the virus from relatively affluent communities to the general population of South Africa may make the lockdown strategy far less effective. It is almost certain that this will occur, and it is unlikely that a lockdown will prove effective in very densely populated areas. The South African government can, and probably will, continue to use lockdowns to limit the spread of the virus. The other option is to implement mass testing and tracing, while still implementing social distancing, but allowing travel to restart the economy. In the absence of an effective healthcare response, which, the only tool at the government’s disposal is mass lockdown (van den Heever, 2020).
A reopening of the economy will likely see a resurgence in cases that will prompt another – much longer – lockdown at the end of May. The only sustainable option for South Africa, and every country in this crisis, is to roll out mass testing and selective quarantines. The only other tool at the disposal of government is a protracted lockdown, likely to have economic impacts so severe that they could match the direct health impacts of the virus itself.
Summary
The COVID-19 pandemic is global, highly infectious, and deadly. The crisis is largely unprecedented, at least in living memory and most governments, including the South African government, have been caught woefully unprepared. South Africa is in a state of lockdown, which has already been extended once at the time of writing (21 April 2020). The South African response has been commendable, and the data seem to show that the lockdown has reduced the spread of the virus. This is a positive first step, and we should take heart from it, but it is hardly the end. The COVID-19 pandemic is a problem with many moving parts, and in a globalised world, South Africa cannot move them alone. What is next for South Africa?
References
Centers for Disease Control and Prevention (CDC). (2020).https://www.cdc.gov/coronavirus/2019-ncov/index.html.Retrieved from CDC: https://www.cdc.gov/coronavirus/2019-ncov/communication/graphics.html
Magubane, K., & Omarjee, L. (2020, April 19). Covid-19 | Govt’s economic rescue plan a race against time. Retrieved from https://www.fin24.com/Economy/South-Africa/covid-19-govts-economic-rescue-plan-a-race-against-time-20200419:
van den Heever, A. (2020, April 20). Toward a risk-based strategy for managing the COVID-19 epidemic: A modelling analysis. Retrieved from Daily Maverick: https://www.dailymaverick.co.za/article/2020-04-20-toward-a-risk-based-strategy-for-managing-the-covid-19-epidemic-a-modelling-analysis/
Worldometer. (2020, March 16). COVID-19 CORONAVIRUS OUTBREAK. Retrieved from Worldometer: https://www.worldometers.info/coronavirus/