/ 9 July 2020

People’s behaviour stoking Gauteng pandemic

Covid 19 Emergency Beds At Nasrec
Up to one in five people can get long COVID — a condition in which someone keeps on feeling ill for months after their initial symptoms have cleared up. (Paul Botes)

As many as 11 000 people in Gauteng may die of Covid-19 with the disease on its current trajectory, amid warnings that each infected person is spreading the disease to up to four other people.

Experts note a rapid increase in the number of infections and a drop in people’s vigilance in terms of compliance with basic precautions such as physical distancing and wearing masks in public.

Earlier in the pandemic the Covid-19 Modelling Consortium produced a projection that by November this year, between 8 000 and 11 000 Gautengers may have succumbed to the disease.

But the rate at which the disease is spreading in the province appears to be accelerating. The consortium predicted that 342 residents would die in July, whereas the current projection is 700.

South Africa has 114 000 active cases — the fifth largest tally in the world.

Gauteng has the highest number of active cases in South Africa, with more than 55 000 people currently infected. It has more active cases than Egypt, which has seven times the population.

The province’s active coronavirus cases have also surpassed countries such as Argentina, Belgium and the Philippines. 

The majority of the infections in Gauteng are in densely populated areas such as the centre of Johannesburg, Sandton, Alexandra and parts of Soweto. In the coming weeks, based on models presented, the province could see more than 200 000 active cases and more than 700 deaths. 

More than 400 people have died in the province.

According to the head of the vaccine trials in the country, Dr Shabir Madhi, densely populated areas see one person spread the virus to up to four others, leading to an exponential rise in cases. 

(John McCann/M&G)

This increase will also put pressure on hospital capacity in the province. As of July 8, Gauteng has the highest number of people in intensive care and on ventilators than anywhere else in the country.

More than 2 100 people are in 83 health facilities in the province. More than 360 people are in an intensive care unit and 166 are on ventilators.

The actual number could be higher because only 22% of public hospitals report this information to the National Institute for Communicable Diseases. All private hospitals are reporting their statistics. 

Said Madhi: “The reproductive rate of the virus is also largely dependent on people adhering to non-pharmaceutical interventions. If people don’t wear face masks, choose to go into crowded areas, sit in taxis that are 100% occupied, it all lends itself to an escalating rate of infection. 

“It doesn’t come as a surprise to me because, unfortunately, the majority of people simply do not take the virus seriously enough.” 

He added that people’s behaviour has a major role to play in controlling the virus. 

Bruce Mellado, a physicist at the University of the Witwatersrand and a member of the Gauteng Premier’s advisory team, said numerous reports were being received from clinical workers and other members of the team that there is a “seriously concerning” relaxation among Gauteng residents in the observance of basic disease precautions.

“There is a concern that this underlies the recent surge in the number of cases that we’ve had in the province. Scientifically and mathematically we know that the more people who adhere to social distancing whenever they can, the lower the numbers are going to be. There is a clear correlation between adherence and the number of people infected,” Mellado said.

Gauteng community health care workers on the front line told the Mail & Guardian that there is little to no compliance with Covid-19 health protocols in the areas where they work. 

The health workers were appointed by the Gauteng health department in March to help the department in spreading awareness of the virus, for contact tracing and to conduct screenings. 

Patricia Makhubu has been working as a community health care worker at the Eden Park clinic since 2015. 

The clinic is located in the Ekurhuleni municipality, which has been identified as one of Gauteng’s hotspot areas, having recorded more than 10 000 cases this week alone. 

Makhubu said many residents in the area only began to adhere to Covid-19 health guidelines once they were personally affected by the coronavirus and had seen saw that Covid-19 numbers are rapidly increasing there. 

Sisanda Kulima works at Finetown clinic, south of Johannesburg. She said people are more likely to change their behaviour and “to follow the rules when they see others do so”.

Some people also believe that the virus is a hoax, she said. Conspiracy theories about the virus being spread by 5G technology are still believed because of viral videos on social media. 

Kulima has lost two relatives who lived in the Eastern Cape to the virus. She said she often tells the story of how her relatives succumbed to Covid-19 to people to encourage them to “take corona seriously”.

She added: “Even though people wear face masks, there is no social distancing when people go outside or when they are with their friends and family.”

Meanwhile, the department of health is pushing for stricter policing of the level 3 regulations, with the provincial command council recommending to the National Command Council that the trade in alcohol should be controlled in the province. 

If accepted, the proposal will see Gauteng residents limited in terms of the amount of alcohol that may be sold per customer, or even a restriction in the number of days and hours when alcohol may be traded. 

Gauteng provincial spokesperson Thabo Masebe said the police and South African National defence Force would be roped in to ensure compliance with the regulations in certain areas, including workplaces and shopping centres. 

Gauteng residents can also expect to see more enforcement at roadblocks. “It doesn’t mean that because we are under level 3 we should not ask people where they are going,” Masebe said. 

Instead of leaving their homes to attend to business and work, collect essential items or go to schools, Masebe complained that “people are now visiting friends family, which is not allowed under level 3”. 

“There has also been an increase in marches and demonstrations. It’s almost as if things are back to normal and there is no lockdown. [The problem is] that enforcement is not where it used to be [under level 4 and 5].” 

(John McCann/M&G)

There have been calls for the province to return to a hard lockdown to contain the virus, but experts insist that this would be futile and dangerous. 

Madhi, one of the global leaders in the vaccine field, said: “The single most important intervention government can make is to make it compulsory for everyone to wear a face mask. If people don’t wear masks, there should be penalties,” he said.

The argument made by Madhi and others, such as pubic health medicine specialist Dr Atiya Mosam, is that because Gauteng is the economic hub of South Africa and even Africa, a prolonged lockdown would be damaging. 

It would need to be maintained until a vaccine becomes available — perhaps two years’ time. 

“This is a very difficult situation and people are finding it hard to be constantly vigilant , especially those who do not have all the resources, such as running water and sanitisers,” Mosam said. 

“But it is not feasible to have a perpetual lockdown. But people must also bear in mind that just because the economy has opened up it doesn’t mean that the risk is reduced.

“If anything, because we have opened up the economy the risk is even higher. The government must have a much more coherent message about this.”