President Cyril Ramaphosa addresses a media briefing at the Union Buildings in Tshwane. Picture: GCIS
President Cyril Ramaphosa addresses a media briefing at the Union Buildings in Tshwane. Picture: GCIS

One million South Africans could contract Covid-19 within just 40 days, unless the government takes drastic action to avoid the country reaching a tipping point of 100 locally acquired cases, according to a team of researchers at Wits university.

Their modelling work shows aggressive containment is essential for slowing the spread of the virus and keeping the numbers to a more manageable level.

Their projections come as the government weighs up further restrictions on travel, mass gatherings and social interaction to try to slow transmission of the virus, and grapples with the trade-off between limiting the effect of the disease on SA’s health system, and the economic and social fallout of the measures it imposes.

President Cyril Ramaphosa met business leaders on Sunday and then convened a meeting of the National Command Council to consider his next steps after last week’s declaration of a national disaster and sweeping measures to try to curb SA’s outbreak.

Containment

At issue now is whether to impose a staged lockdown, including tighter measures on the movement of people, such as restrictions on public transport and a ban on domestic travel ahead of the Easter weekend.

The Wits group has also modelled the impact of containment measures, drawing on the experience of several European countries, and found that the growth in the epidemic could be slowed significantly.

As of Sunday the total number of confirmed cases in SA stood at 274, an increase of 34 since Saturday, according to a brief statement from health minister Zweli Mkhize.

The number of local transmissions stood at 15 on Saturday, but increased by 11 on Sunday, bringing the total to 26.

"The spread of the virus is exponential without containment. With containment it becomes close to linear," said Wits professor Bruce Mellado, who is also a senior researcher at iThemba LABS.

SARS-CoV-2 emerged in China in December and has raced around the world in three months, sickening more than 316,650 people and killing about 13,600 by Sunday, according to the Johns Hopkins tracker.

Several hard-hit European countries have implemented the most stringent limits on people’s movement since World War 2 in their efforts to contain the virus.

Mellado said that the latest modelling work indicated the measures imposed in countries such as France, Italy and Spain had borne fruit, as their initially exponential growth in new infections slowed to a more linear trajectory after they imposed restrictions on people’s movement. "These results are very encouraging in that the situation would be much worse without the containment measures," he said.

Ramaphosa, cabinet ministers and senior government officials were on Sunday locked in discussions around the legal, logistical and political dimensions of a lockdown.

If this route is chosen, then it is likely the government will opt for provisions in the Disaster Management Act that allow for control over the movement of goods and people and allow the government to take any steps to prevent escalation.

The University of Cape Town’s head of public health and family medicine, Landon Myer, warned that SA would pay a high economic price for the restrictions already in place and questioned the benefit of containment measures at this point. If there was already undetected sustained local transmission, a lockdown would have a limited health effect but would take a devastating toll on people’s livelihoods, he said.

"The epidemic is likely to be over in several months, but the economic impact will last for another two to three years."

The Reserve Bank cut interest rates last week and said the economy would contract 0.2% in 2020, a forecast some economists said would probably prove to be too optimistic.

The government is under pressure to come up with potential remedies for businesses and workers as the virus collapses demand. However, its options are constrained by a fiscal situation that may see SA lose its remaining investment-grade rating as soon as March.

A key concern among health professionals is that exponential growth would overwhelm the health system. The Actuarial Society has warned that if only 40% of the population is infected and 5% require hospitalisation, 1-million hospital admissions would be necessary.

Both the Western Cape and Gauteng health departments have begun reducing the number of patients in their hospitals in anticipation of a surge in Covid-19 cases.

Elective surgery has been postponed, extra prescriptions are to be provided to stabilise chronic patients to reduce repeat visits to pharmacies, and visiting hours have been slashed.

• With Claudi Mailovich

kahnt@businesslive.co.za