EDITORIAL: Screening for Covid-19 is welcome news

Last week’s announcement by President Cyril Ramaphosa to deploy a 10,000-strong force of fieldworkers to visit homes across the country to screen people for symptoms of Covid-19, a respiratory disease caused by the SARS-CoV-2 coronavirus, is welcome news.

The field workers will send those with signs of the illness for testing at local hospitals and mobile testing labs. People found to be positive with mild symptoms will be quarantined either at home or in government facilities, and those who are seriously ill will be hospitalised.

Alongside the stay-at home order, which entered its second week on Friday, and social distancing guidelines, testing should be at the heart of the efforts to contain and control the pandemic, which has taken a huge toll on the fragile economy, epidemiologists say.

We agree.

On Sunday, the number of people infected by the novel coronavirus, traced to China’s central province of Hubei in December 2019, topped 1.2-million, according to data compiled by Johns Hopkins University in the US. Though SA accounted for less than 1% of that total with nearly 1,600 confirmed cases, the country remains the hardest hit in Sub-Saharan Africa.

South Korea is perhaps the most striking example of how a combination of social distancing and efforts to test as many people as possible should be the backbone of any plan to bring the pandemic under control. South Korea quickly slowed the rate of new infections thanks to mass testing at clinics, hospitals and in unorthodox places such as drive- and walk-through booths.

Even as China emerges from one of the biggest human lockdowns in history and eases restrictions on movement, testing remains an important aspect of its efforts to keep the virus suppressed. As the numbers of patients have plummeted, temporary hospitals have closed, but isolation wards and quarantine sites remain open, international travellers face mandatory quarantine periods, and testing labs are still running.

No wonder the World Health Organisation (WHO) is pleading with every country to include testing in any measures to fight the pandemic. “We have a simple message for all countries: test, test, test,” Tedros Adhanom Ghebreyesus, director-general of the WHO, told a virtual media conference last week.

The reasons for large-scale testing are straightforward. First, Ramaphosa’s Covid-19 command team can easily identity those with the disease, isolate them and get them medical care. It doesn’t take experts in the WHO to work out that preventing confirmed cases from coming into contact with others will slow the rate of transmission.

The other purpose of testing is for the team led by health minister Zweli Mkhize, who has been consistently telling South Africans that the current rate of infections is  the “calm before a heavy and devastating storm”,  to have a better idea of the prevalence of the disease.

To date SA has tested nearly 50,000 people. That the bulk of those cases have been done in private labs suggests that the National Health Laboratory Service has not exactly swung into action. In a statement posted on its website, the government agency expects to process roughly 36,000 tests a day by the end of April.

It is also good to hear that team has approached cellphone companies to help identify, trace and test every person who an infected person has interacted with. It would be a much tougher tracing job if the team were to wait any longer because tracing contacts of contacts of contacts will make the job almost impossible.

Even if that job could be done effectively, our hospitals, both private and public, will be overrun by those needing 24-hour care, and 37 quarantine sites will prove inadequate when the virus runs amok.  

And self-quarantining at home will be a sad joke for most South Africans, whose shacks are barely a metre apart in urban land-hungry squatter camps, while government-subsidised RDP houses end up being home to more people than they are intended to be.

There’s a lot we don’t know about how the trajectory of the epidemic will unfold and the terrible toll it will take on human life and the economy, but we fully agree with epidemiologists that large-scale testing, isolation and contact tracing can mean the difference between suppressing the outbreak and losing control.