Gauteng health department officials collect samples during a door-to-door Covid-19 testing drive in Yeoville, Johannesburg. Picture: AFP/MARCO LONGARI
Gauteng health department officials collect samples during a door-to-door Covid-19 testing drive in Yeoville, Johannesburg. Picture: AFP/MARCO LONGARI

The data paints a frightening picture: SA’s Covid-19 infection rate has doubled from 100,000 to 205,721 in just two weeks. The country’s daily new cases are so high, it is now fourth in the world, lagging only the US, India and Brazil.

In another day or two, total Covid-19 infections in Gauteng will overtake the Western Cape. Already, Gauteng’s daily new cases far exceed anything the Western Cape has seen. In fact, with over 4,000 daily cases recorded, the province is on par with countries such as Pakistan, Peru and Saudi Arabia.

So alarmed are authorities in SA’s most populous province that debate has turned to the reimposition of lockdown level 5.

But what good will a lockdown really do, now that community transmission is well entrenched? And what can it do to help a health-care system that is already close to reaching its bed capacity?

Prof Salim Abdool Karim, chair of the government’s Covid-19 ministerial advisory committee, believes it’s still possible to bring the epidemic under control – without the imposition of a harder lockdown. And if SA is able to do that, he thinks there will be time to avoid the fate of countries such as Italy and the US.

During a presentation for aid organisation Muslims for Humanity on Saturday, Abdool Karim said: “We are no longer treating this epidemic like a sprint. We are treating it like a marathon. We understand that we are going to live with this viral threat for a long time to come.”

Abdool Karim described Johannesburg as SA’s “New York equivalent”. The virus spread is being aided by population density, where distancing is sometimes impossible. SA, he says, is in a bind: the country is easing lockdown restrictions at a time when the cases are growing exponentially.

“We are doing things that don’t make sense,” he says — like opening places of worship, which brings far too many people together under one roof.

Nonetheless, Abdool Karim believes SA has no option but to open the economy. A lockdown cannot be sustained, as people need to go back to work and children return to schools.

At this point, it seems Gauteng isn’t going to be subjected to another level 5 lockdown. President Cyril Ramaphosa this week emphasised that a repeat of the hard lockdown isn’t on the cards, partly because the government is so concerned by the number of jobs that will be lost.

It means that the responsibility to slow the growth in cases now rests with individuals. And if behaviour doesn’t change fast – including wearing masks, better hygiene practices and social distancing (including, importantly, avoiding gatherings) – SA will have what Abdool Karim describes as “a very, very serious epidemic”.

The case for a return to level 5

Gauteng health MEC Bandile Masuku told the Sunday Times that the province wants the national coronavirus command council to allow it to reintroduce hard lockdown regulations, for up to two weeks at a time, to contain the infection rate.

During this proposed lockdown, movement would be restricted, and weddings, protests and church gatherings banned. The number of people who attend funerals would be cut from 50 to 20. Alcohol sales for offsite consumption would be allowed only once a week.

“The option of intermittent lockdown gives us the option of shutting down everything. So at least there is predictability and you can control infections in that way,” he said.

By Monday, however, Masuku appeared to have backtracked. He told EWN that a hard lockdown would not be implemented because of the dire implications it has for the economy.

But what has 100 days of the lockdown really achieved?

Abdool Karim says the province was able to keep a lid on new infections very effectively during levels 4 and 5. Cases doubled every 21 days. However, under level 3, cases in Gauteng are doubling every nine days.

But the spotlight also has to fall on the province’s use of the lockdown to prepare the health-care system. And on that account, its officials have very serious questions to answer. In a hard-hitting editorial, the Sunday Times suggests Gauteng may have squandered the time that the lockdown provided.

“When the country’s richest and best-resourced province is signalling that it is not ready and that only the bluntest of blunt instruments, a lockdown, will suffice, then one may wonder what can be done in two weeks or a month that couldn’t be achieved in the 100 days that have already passed.”

Personal accounts from doctors and patients suggest hospitals are already full, even though private hospital groups have said they still have some space.

Either way, as Abdool Karim says, we need to learn to coexist with the virus. A vaccine is still at least 18 months away. Interdependence is central, which means people need to accept responsibility for the own health by better embracing methods that can limit the spread.

If that fails, and habits don’t change, this province’s health-care system is unlikely to cope.​

* Munshi is News & Fox editor of the FM​

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