/ 13 May 2021

South Africa not yet in a third wave, says health department

South African President Ramaphosa Visits Aspen Plant In Gqeberha
President Cyril Ramaphosa speaks during his oversight visit to the Aspen Pharmacare sterile manufacturing facility on March 29, 2021 in Gqeberha. (Photo by Lulama Zenzile/Die Burger/Gallo Images via Getty Images)

Despite a department of health seven-day average finding that South Africa had recorded a 46% increase in Covid-19 infections in all provinces, the country is not yet in a third wave. 

In a statement released by the department on Wednesday, the daily surveillance system reported an increase in positive cases from 8 593 to 12 531 between 3 to 9 May. 

At 68%, the Northern Cape has shown the highest increase, followed by Gauteng at 63%. Nationwide, 24 healthcare workers tested positive for the virus.

South Africa’s cumulative fatality rate is just over 3%. Although new coronavirus deaths increased in the past seven days — from 269 to 318 — the 14-day comparison shows a decrease. 

Despite rising Covid-19 infections and more variants being detected in South Africa, the department’s resurgence dashboard “still shows that we have not as a country reached a resurgence threshold, though some districts in the country are fast approaching the threshold”, according to the statement. 

The department said it was on high alert as it monitored the “main drivers” of the new wave, which were described as the “resurgence of new variants and/or the fatigue from adherence to non-pharmaceutical interventions”. 

The department released its statement shortly after reports surfaced of health minister Zweli Mkhize warning of a third wave. On Wednesday, News24 ran with the headline: “We are in the 3rd wave. Buckle up.”

The media house quotes communication from Mkhize it says was widely distributed on Wednesday, in which the minister warns: “Kindly note that the Covid-19 positive cases are rising rapidly. For all intents and purposes, we are in [a] third-wave even if not fitting in [the] technical definition. The numbers will no longer go down other than if we start intensive containment measures.” It is unclear if this was internal communication. 

Soon afterwards, the department said there was not yet a third wave, “however we are at risk and we hence need to be on heightened vigilance as a country.”

How severe will a third wave be? 

South Africa’s second wave peaked in mid-January, with a seven-day average of almost 18 000 cases a day. Experts argue that a third wave will not be as severe as the second, and will look somewhat different. 

“The reality is that a much higher proportion of the population have been infected now. And so as we believe that the immunity from 501.Y.V.2 [the so-called South African variant] gives at least for a period of time good protection against reinfection and infection,” said Dr Richard Lessells, an infectious diseases specialist at the KwaZulu-Natal Research Innovation and Sequencing Platform. 

“We may see this kind of different pattern in some provinces, but not as much in others. We may see … smaller rises in infection and then not really taking off into a full kind of resurge. We are in a different phase of the epidemic and it may not be as straightforward as just going into a national third wave.”

Professor of vaccinology at the University of the Witwatersrand, Shabir Madhi agrees with Lessells: “If the virus remains relatively stable and doesn’t develop more mutations, which makes it even more resistant to the immune responses that been induced by past infection, then I expect the next wave to be different and less severe.” 

He added that a number of hospital admissions and deaths are expected. 
On Wednesday South Africa recorded 2 759 new Covid-19 cases, an increase of 1 211 since the previous day.