Putting out the small flames: South Africa’s approach to combating

 
Код статьиS032150750009552-9-1
DOI10.31857/S032150750009552-9
Тип публикации Статья
Статус публикации Опубликовано
Авторы
Аффилиация:
Название журналаАзия и Африка сегодня
ВыпускВыпуск №5
Страницы58-62
Аннотация

Although the COVID-19 pandemic started only recently, and the epidemiological situation in Africa and worldwide changes rapidly and sometimes unexpectedly, a preliminary analysis of the South African experience in handling the outbreak can be illuminating. Within the two months since the first confirmed case was reported in South Africa, the government took comprehensive measures to combat the new coronavirus. These measures displayed patterns and attitudes that will probably persist and determine the government’s response to the COVID-19 crisis.

‘Putting out the small flames to avoid a raging fire’ has been the main principle of the government’s strategy. The anticipatory action includes community screening and testing, using some of the experience that South African health professionals acquired in containing the HIV/AIDS pandemic. By minimising or preventing community transmission in high-risk areas they have succeeded in maintaining a comparatively low infection rate.

South African policymakers have displayed flexibility in response to the demands of the population and the business community. The full lockdown has been replaced with the so-called ‘shielding’ approach, protecting the most vulnerable residents while allowing the rest of the people to engage in their normal activities, with mandatory precautions.

The government has also shown its resolve to salvage the South African economy by reallocating a large part of the budget and securing loans from international financial institutions, such as the New Development Bank (BRICS), for a stimulus package that amounts to 10% of the country’s GDP.

Ключевые словаSouth Africa, coronavirus, pandemic, COVID-19, Africa
Дата публикации23.06.2020
Кол-во символов17242
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1 The fight against the new coronavirus in Africa began only a few months ago, and the epidemiological situation has been changing. The approaches to handling the COVID-19 emergency have been evolving as both governments and healthcare professionals obtain new information on the virus, its fatality and recovery rates.
2 This process is also taking place in South Africa, where the COVID-19 pandemic has been recognised as the greatest health crisis since the outbreak of Spanish flu a century ago. President Cyril Ramaphosa even stated that his country ‘has never had to deal with a public health emergency of this magnitude’ [1]. Under these circumstances, it is too early to evaluate the efficiency of the measures taken against the pandemic in that country. However, these measures have displayed certain characteristics that can be identified in order to understand how South African policymakers would view new developments and respond to them.
3

IMPOSITION OF A LOCKDOWN

4 A confirmed COVID-19 case in South Africa was first reported on 5 March, 2020. Ten days later, President Ramaphosa declared a national state of disaster. There were just sixty confirmed cases of COVID-19 countrywide and no confirmed deaths, but community transmission of the virus had already started. Epidemiological projections indicated that 40% of the South African population would be infected and over 350,000 of those would die from the coronavirus unless its spread was arrested [2]. South Africans, with their immunity compromised by high rates of HIV and tuberculosis, were deemed particularly vulnerable to the infection [3].
5 South Africa became one of the first countries on the continent to impose a countrywide lockdown. From 27 March most South Africans were prohibited from leaving their homes except for necessary trips, such as buying groceries or seeking medical help. All shops and companies were closed except those providing essential goods and services. Liquor and cigarettes were not regarded as essential goods, so their sale was stopped. The expected reduction in alcohol-related cases was meant to enable hospitals to keep more beds ready for COVID-19 patients.
6 The mandatory social distancing and other emergency measures introduced by the government helped to forestall the spread of infection [4]. Although the number of COVID-19 cases in South Africa was expected to grow exponentially, the curve proved to be flatter than was the case in the US and many countries of Western Europe. The pattern of the infection in March and April resembled that of South Korea [5].
7

LESSONS LEARNT FROM THE HIV/AIDS PANDEMIC

8 Since the imposition of the lockdown, the daily number of new confirmed COVID-19 cases had a tenfold reduction. It had been growing by 41% on the average, but, during the lockdown the number was rising by only 4% [6].
9 South African epidemiologists have used their experience of the HIV/AIDS pandemic. Given that the country has the largest number of confirmed HIV cases in the world, the government cannot afford to let their nation fall victim to another dangerous virus, which is why they have consistently taken the advice of medical experts.
10 Another lesson from the HIV pandemic has been ‘putting out the small flames to avoid a raging fire’ is an appropriate strategy of managing the outbreak [5]. To identify COVID-19 cases and minimise community transmission, mobile testing units and thousands of health workers, some already employed in HIV- or tuberculosis prevention, are deployed in areas with the highest population density and, correspondingly, the highest risk of infection. Residents showing coronavirus symptoms are identified and treated, and their contacts quarantined.
11 However, the comparatively low number of confirmed COVID-19 cases in South Africa has also been attributed to insufficient testing [7]. By 28 April, for every thousand residents, South Africa had conducted 10 times fewer tests than Italy or Spain, and 7 times fewer than Russia. Still, South Africa, with its 3.1 tests per thousand residents, was second only to Ghana (3.2) among the African countries with a population of two million and more. South Africa also outperformed its BRICS partners: India (0.5) and Brazil (1.6) [8].
12 During the lockdown, the National Health Laboratory Service aspired to raise the daily number of COVID-19 tests to 35,000. The inefficiency of the public healthcare system, the lack of testing kits and testing sites as well as the lengthy processing of samples hindered the progress [7; 9; 10]. At the end of April, nearly 10,000 tests were carried out in South Africa every day. Although it represented a threefold increase from the beginning of the month, the goal was not reached [11].
13

THE LOCKDOWN ENDS

14 By the end of April, over 5000 confirmed cases of the new coronavirus had been reported [12]. South Africa found itself among the three countries with the highest COVID-19 infection rate on the African continent, the others being Egypt and Morocco (which conducted significantly fewer tests per thousand residents). It also had the largest number of confirmed COVID-19 cases south of the Sahara.

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