South Africa needs to move to the next phase of its coronovirus battle plan – namely focusing on active case finding, and dealing with hotspot areas, instead of subjecting the entire country to the same lockdown conditions.
This is the plea and recommendation from several analysts, economists and business people in unaffected areas, speaking to the City Press and sister paper, Rapport.
Minister of Health Dr Zweli Mkhize announced on Saturday (9 May) that there are now 9,420 confirmed cases of coronavirus in South Africa – an increase of 525 from the 8,895 cases reported on Friday. The total number of deaths has increased by eight, to 186.
The number of new cases is increasing in-line with a jump in the number of daily tests being conducted: a total of 324,079 tests have been conducted at the time of reporting, up from the total of 307,752 conducted the day before.
This is also true in South Africa’s hardest-hit province, the Western Cape, where daily tests increased to 8,322 (compared to 6,110 in Gauteng) – however, the province’s infection rate is still far higher than anywhere else in the country.
The infection rate per 1 million people sits at 12.9 – while Gauteng (the second-hardest hit) sits at 1.2. A total of 56,986 tests have been conducted in the Western Cape, vs 92,272 in Gauteng.
Not all affected
While the Western Cape is clearly the epicentre of infection in South Africa, residents in smaller towns in the country are pleading to government not to paint all areas with the same brush.
Speaking to Rapport, residents of Kuruman in the Northern Cape pointed out that their small town – where approximately 13,000 people live – has so far been untouched by the coronavirus, yet they are subject to the same level 4 restrictions as the rest of the country.
The closest town where infections have been confirmed is 170km away, where 10 cases have been found.
In areas like this, hundreds if not thousands of workers are being kept from returning to work because of lockdown restrictions, even though the risk of infection is low to nil.
Several economists, speaking to the City Press, said that it was time for government to shift its focus to hotspot areas in the country, allowing the economy to open up in areas that are low-risk, while ramping up testing and treatment in areas that are most vulnerable.
Ahead of moving South Africa down to lockdown level 4 at the start of the month, government said that it intended to treat different districts, metropolitan areas and provinces differently in terms of restrictions, depending on the rate of infection in each area.
However, it has fallen silent on this strategy, since.
Stephan Malherbe, chief executive of Genesis Analytics, said that South Africa has been successful in easing lockdown restrictions in most of the areas identified by the World Health Organistion, but has failed to take a logical approach in opening up the economy.
Here, he said, a differentiated approach with the lockdown to various areas was very important.
Data published this week pointed to the damage being done to the economy as a result of the umbrella lockdown approach, including projections of GDP decline between 6% and 16%, job losses between 1 million and 7 million people, and a potential loss in tax revenue as high as R285 billion.
Shift in strategy
Actuarial data shows that South Africa is yet to hit its peak of infections, but the damage done to the economy could be far worse.
Public health specialists speaking to the City Press said that it is time for government to move on from the surveillance phase of the pandemic and focus on hotspot areas – which means intervening in cluster outbreaks and the areas hardest-hit by the virus.
Dr Mkhize himself admitted as much on Saturday, saying there are a number of areas with cluster outbreaks. The minister suggested stricter restrictions would need to be put in place in these areas.
This means it’s going to require that these areas will need stricter restrictions.
— Dr Zweli Mkhize (@DrZweliMkhize) May 9, 2020
This would mean stage five of the eight-stage response plan outlined by government in April.
- Stage 1: Preparation, including community education, establishing lab capacity and surveillance of the virus.
- Stage2: Primary prevention, including social distancing and hand-washing, closing schools, reducing gatherings, and closing borders and international travel.
- Stage 3: Lockdown
- Stage 4: Active case-finding, a unique measure in South Africa, where healthcare workers are being sent out to test vulnerable communities.
- Stage 5: Finding hotspots, including surveillance and interventions, monitoring of new cases and other outbreak investigations.
- Stage 6: Medical care for the peak, including managing case load capacity, healthcare staff exposure and infection, building field hospitals and expanding ICU and ventilator numbers.
- Stage 7: Dealing with the Aftermath, including expanding burial capacity, regulating funerals, and managing the psychological and social impact of the epidemic.
- Stage 8: Ongoing vigilance – keeping one step ahead of the virus and infections.