South Africa fourth wave predicted as Covid-19 cases rise

South African coronavirus cases are beginning to climb, the positivity rate of tests is increasing and an analysis of wastewater shows that the disease is once again becoming more prevalent in some areas.

On 20 November, the number of confirmed cases over a 24-hour period rose to 887, the highest since 14 October, and on 21 November, 3.4% of tests returned a positive result, according to government data. If maintained over a seven-day period, that would be the highest proportion of people testing positive since the week ended 26 September.

The rise in cases comes days after the National Institute for Communicable Diseases said that the incidence of Covid-19 was increasing in wastewater samples of some areas of Gauteng, the most populous province.

South African Medical Research Council data show that excess deaths, the number of deaths over an historical average, have been rising in recent weeks.

There has been a rise in the number of people testing positive in Gauteng, particularly in the Tshwane municipal area that includes the capital Pretoria, the NICD said in a later statement on Monday.

“Localized increases in case numbers (clusters) are not unexpected,” Adrian Puren, the NICD’s acting executive director said in the statement. “However, it is hard to say whether the increases indicate the start of a widespread resurgence.”

Scientists working with the government have predicted that a fourth wave of coronavirus infections could begin in December.

Still, they said it will likely be less severe than previous resurgences because about a third of South African adults are fully vaccinated and between 60% and 70% of the population may have already been infected.

The number of confirmed daily infections peaked at almost 20,000 in July, during the third and most severe wave the country has experienced.

Return of patients 

South African hospitals are seeing a return of patients who don’t require treatment for Covid-19, though said a faster vaccination rate may be needed to ensure a fourth wave doesn’t lead to a large surge in admissions.

Operators lead by Mediclinic International,  Life Healthcare, and Netcare are starting to work through a lengthy backlog of elective surgeries, the companies said during a recent round of earnings reporting.

“In South Africa, the third wave was a big and tough one and lot of elective work wasn’t done,” Mediclinic chief executive Ronnie van der Merwe said in an interview.

“That work will start flowing through and the first target is to get back to pre-pandemic levels of normality.”

The country’s most recent Delta-driven surge was the most severe yet, though a major slump during September gave way to weeks of minimal case numbers.

Positivity is now starting to pick up again, albeit off a low base, but only about 35% of adults are fully vaccinated. Inoculations have helped to reduce admissions in countries with more advanced rollout programs.

“We are seeing a return to non-Covid activity. But how long will it last?” Netcare chief executive Richard Friedland said Monday. “We live under the spectre of another outbreak or flare-up until we’re in an endemic situation, not a pandemic.”

Getting as many people vaccinated as soon as possible is imperative, he said, adding that South Africa remains short of adequate safety levels.


Read: Regulator to consider use of Pfizer booster shots in South Africa

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South Africa fourth wave predicted as Covid-19 cases rise