latest: coronavirus in South Africa
Throughout the coronavirus crisis and the lockdown period, the Mail & Guardian will be updating this page several times a day with the latest information and advice from government and healthcare experts around the world.
We understand our readers’ need for accurate and timely information, and will be keeping our essential coronavirus coverage free for all throughout the crisis.
Entering phase three
On 24 May, President Ramaphosa confirmed that the country will be entering Phase 3 of lockdown on 1 June. That means public servants must return to work, and most retail can re-open. Restaurants, bars, accommodation and air travel remain restricted, but people can now exercise any time of the day. Alcohol will be sold for home consumption, but tobacco remains banned. Hotspots – where the infection rate is higher than 5 people per 100 000 population – till receive be subject to extra monitoring and support.
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When should you seek medical attention?
The NICD has advised that if a person develops symptoms of Covid-19, and they have reason to believe they have been in contact with someone who has the virus, they are to self-isolate immediately and implement measures to prevent transmission.
A toll-free public hotline (0800 029 999) has been set up for people who feel sick with a fever, cough or have difficulty breathing.
Tests are only available if you are referred by a health professional. In the first instance, you should contact your GP. Public sector testing is free of charge.
“In cases where it is difficult to assess the onset of symptoms, for example in young children or the elderly, self-quarantine for 14 days after return from international travel may be considered as a precautionary measure,” the NICD’s website notes.
Screening versus testing
Health workers are currently going door-to-door screening residents for symptoms (ie. a temperature or cough). If concerned, they will prescribe a full test, which usually involves taking a swab from the nose.
According to the NICD, treatment for Covid-19 is “supportive”: there is no specific antiviral treatment available. Antibiotics do not treat viral infections, but they may be required if a bacterial secondary infection develops.
Should you wear a mask?
The current regulations say that yes, you should wear a mask when you go outside of your home. You should, however, opt for a simple cloth mask and not an N95 medical mask, supplies of which should be reserved for health professionals.
The key purpose of wearing a mask is not to prevent you catching the disease: it’s to stop you spreading it. Studies are starting to show that infected people can spread the disease when they are asymptomatic – in other words, before they start coughing.
Why not make your own mask?
What does a “national state of disaster” actually mean?
In response to the Covid-19 outbreak President Cyril Ramaphosa announced a “national state of disaster”.
Section 27 of the Disaster Management Act allows Minister Nkosazana Dlamini-Zuma (the minister designated by the president) to declare a “national state of disaster” if other laws are not adequate to deal with a situation effectively.
The Act also allows the government — under section 27(2) — to make regulations to swiftly authorise the release of resources and personnel to help to deal with the disaster.
Regulations may also be passed to control the movement of people to and from the “disaster-stricken area or threatened area”.
There is also a catch-all power, allowing the government to take “other steps that may be necessary to prevent an escalation of the disaster, or to alleviate, contain and minimise the effects of the disaster”.
The Act says that these powers given to government may be used as far as is necessary to assist, protect and give relief to the public, protect property, prevent disruption and deal with the effects of the disaster.
Unlike a state of emergency, the declaration of a disaster does not need to be passed by an Act of Parliament. It also lasts longer: a state of emergency lasts 21 days but under the Disaster Management Act, a national state of disaster only lapses three months after it has been declared, and the minister may extend or shorten it by notice in the Government Gazette.
Are we “flattening the curve”?
It’s hard to argue that South Africa is “flattening the curve”, indeed, the graph of daily infections (at the top of this page and here) looks a lot like a traditional exponential curve of the type it was hoped we would avoid. It’s worth looking a bit deeper than that, however.
A pessimistic interpretation is that the number of cases recorded directly correlates with the number of tests completed. As the graph below shows, the more tests we do, the more cases we find. As we ramp up testing, we see a correlated rise in the number of cases discovered. If we increase testing exponentially, it might be that we would see an exponential increase in the number of positive results.
On the other hand, in the UK, around 30% of tests come back positive, right now in South Africa, fewer than 4% do. What seems to be happening is that South Africa’s “rate of reproduction” – the number of people one carrier subsequently infects – is, for the time being, being contained. In other words, there’s probably a lot of cases out there undetected, but the overall infection rate may be lower than other countries.
The other notable local feature is that our fatality rate is unusually low – just over 200 deaths have so far been reported, and it’s unlikely there are thousands of unreported fatalities – South Africa’s mortality rate is much lower than usual for this time of year, unlike countries where the coronavirus has really taken hold.
Whatever the case, government and its top advisor Professor Salim Abdool Karim have repeatedly warned that even in the best case scenario, South Africa is likely only delaying a wider outbreak and buying itself time to prepare with more testing facilities and treatment centres. Until a vaccine or cure is developed, the threat of a sudden rapid in cases is always going to be there.
What’s it looking like in the rest of the world?
The total number of confirmed Covid-19 cases reached four million on 9 May. The number of recoveries passed one million on May 1.
The US has the highest absolute number of cases, at over 1 350 000. Qatar has one of the highest known infection rates – over eight thousand cases per million people. Luxembourg follows at over 6 100/million. The UK has confirmed infection rates over 3 000 per million people, while China’s total rate is less than 60 people per million. South Africa is at 160/million.
So how do you protect yourself?
On its website, the WHO notes that: “The disease can spread from person to person through small droplets from the nose or mouth, which are spread when a person with Covid-19 coughs or exhales. Other people then catch Covid-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch Covid-19 if they breathe in droplets from a person with Covid-19 who coughs out or exhales droplets.”
This is why it is important to stay more than one metre away from a person who is sick, the organisation advises.
WHO lists a number of measures that can be taken to reduce your risk of infection. These include:
- Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water;
- Maintain at least a one metre distance between yourself and anyone who is coughing or sneezing;
- Avoid touching eyes, nose and mouth;
- Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately; and
- Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance.
People who are infected may show no symptoms, so it is advised that people avoid crowds during the outbreak.