Tuesday, 28 April 2020

Pretoria: South Africa’s prudent decision to institute a countrywide lockdown has circumvented an exponential explosion of cases of the worldwide COVID-19 pandemic within the borders of the country, the Department of Health said on Tuesday.

The Minister of Health, Dr Zweli Mkhize, said while the lockdown will not spell the end of new infections, it has, however, significantly delayed the peak of the virus. This has bought the country precious time to beef up its response, and prepare health facilities for the management and treatment of those infected with COVID-19.

As of Tuesday, 28 April, the country had 4 996 confirmed COVID-19 cases, with 93 deaths.

Mkhize revealed that from 6 March, the country has conducted 185 497 tests. During this period, over six million people have been screened for symptoms and have had temperature checks. During this process, 11 000 were referred for COVID-19 tests.

Between 6 and 12 March, the country had done 413 tests. The tests doubled the following week, steadily increasing over the subsequent weeks to the extent of 25 000 tests done in the past week.

The Western Cape, with 1 870 cases, has become the country’s epicentre of the outbreak. Gauteng and KwaZulu-Natal follow with 1 387 and 919 cases, respectively. With 616 cases, the Eastern Cape follows. While the Free State has 113 confirmed cases, the remaining provinces all have less than 40 cases each.

Speaking extensively on the impact of the lockdown, which came into effect on 27 March (and was extended by a further two weeks on 9 April), Mkhize said this intervention stopped an exponential increase in cases. Furthermore, South Africa has announced an elaborate, phased easing of the lockdown, which is categorised according to risk levels. This, President Cyril Ramaphosa has said, will allow the country to resume economic activity, while safeguarding human life.

In dealing with the lockdown, the Health Department’s epidemiologists considered three scenarios, which included “nothing being done”. Under this scenario, the virus would have peaked in July. With a three-week lockdown, the virus would have peaked in August. With a five-week lockdown, the experts say the peak has been staved off until September.

“This lockdown stopped a huge movement of people and stopped an exponential rise [in cases].

“Because people were congregating, they were close to one another… in big meetings, sport gatherings, trains, taxis and so on. That would have actually made the outbreak rise pretty fast. In this case, we were able to delay it,” said Mkhize.

Mkhize said the department is pleased with the development and is confident that its duration is sufficient to flatten the curve of infection.

“The [epidemiologists’] model shows that even if we made the lockdown longer, it would have not put down the curve further than what it is,” said Mkhize.

The lockdown, he said, is being eased based on scientific projections and calculations stating that a Level 5 lockdown would be of no further benefit.

Risk factors

The Minister said a trend has emerged of fatalities mostly having the underlying challenge of comorbidities. These include hypertension, diabetes, obesity, asthma and lung diseases.

However, Mkhize pointed out that South Africa has a unique challenge that is not as prevalent in other countries that have combatted the virus.

The Minister said a study by the University of the Witwatersrand revealed that approximately one-third of South Africans suffer from hypertension – the highest prevalence in southern Africa. In addition, the country has millions of people with diabetes.

“Over 4.5 million people in South Africa have diabetes. Over 70% of women and 40% of men are overweight or obese,” Mkhize said.

All these factors, the Minister said, are important to take into account, as they are considered in the COVID-19 infection.

“We still have unknown factors when it comes to HIV and Aids, and tuberculosis. Unfortunately, South Africa has the largest numbers and therefore not in a position to learn from other countries because they have less of a challenge than us,” he said.

The country, unlike some countries in Western Europe, was fortunate that the mortality rate has stayed at a low 1.9%.

This, he said, could be attributed to that most of the country’s infections were among mostly healthy people. “That tends to make them recover pretty quickly.”

Mkhize said testing can be classified into three groups i.e. tests conducted at private facilities, public hospitals, as well as public screening campaigns.

A departmental analysis, he said, has revealed that tests have increased between 6 and 26 March.

“From then on, the rate of numbers in positive tests started to decline, but it has remained constant among those who have been referred to hospital because of their symptoms,” he said.

The rate of positive cases from those identified in public screenings was between 3% and 3.8%.