As predicted by many analysts at the beginning of the pandemic, South Africa is the country most affected by the SARS-COV-2 virus in Africa. The good news is that the “Rainbow Nation” is the African country with the most testing facilities and the best-equipped hospitals across the continent. As of April 07 2020, South Africa had 1,686 confirmed cases of the novel coronavirus disease, COVID-19, with more than 50,000 tests conducted since 5 March, when the country’s first case was confirmed. All nine South African provinces have recorded cases of COVID-19, however a large number of the confirmed infections are in Gauteng, the richest and most densely inhabited province in South Africa, that stretches from the administrative capital Pretoria to the commercial hub Johannesburg.
The numbers of confirmed cases and related deaths in South Africa are after all much lower than elsewhere in the world. However, without swift intervention from the government, which imposed a travel ban from the most affected countries and a 21-day nationwide lockdown until 16 April, the death toll could have reached dramatic proportions. According to the economic modelling by scientists Warwick McKibbin and Roshen Fernando, the virus could have led to between 75,000 and 337,000 fatalities in South Africa.
A study from the European Respiratory Journal shows that COVID-19 fatalities are highest among those who have comorbidities. South Africa has 7.7 million people living with HIV and 301,000 suffering from tuberculosis. It is likely that those living with tuberculosis and/or HIV could be at a higher risk from the more severe complications of COVID-19, given that they compromise the lungs and the broader immune system.
Additionally, South Africa is exposed to medical supply chain disruptions, given its high demand for tuberculosis and HIV medications and the closure of several China-owned pharmaceutical factories. Pretoria imports 60% of its antiretrovirals for HIV treatment largely from India and China.
As the Minister of Health confirmed the first cases in densely populated areas such as Mitchell’s Plain and Khayelitsha in Cape Town and Alexandra in Johannesburg, South African President Cyril Ramaphosa announced in a television address the launch of a new phase to fight the spread of the SARS-COV-2 virus. The government will be rolling out a screening, testing, tracing and monitoring programme. A total of 10,000 field workers will visit homes around the country, scanning people for COVID-19 symptoms. People with moderate symptoms will be treated at home or at COVID-19 facilities, while those with serious symptoms will be transferred to hospitals. Ramaphosa said a mobile tracing system to track those who had come into contact with infected people and to monitor new cases would have been set up in April.
The national lockdown is President Ramaphosa’s most decisive act since taking office in 2019. He acted swiftly without minimizing the virus threat, fully aware that an increasing number of cases would stretch the country health’s facilities beyond their capabilities. “Never before in the history of our democracy has our country been confronted with such a severe situation,” said Ramaphosa in his first television speech on 15 March. Opposition parties and detractors inside the divided ruling party buried the hatchet and showed solidarity and unity behind Ramaphosa’s stringent measures to curb the spread of the virus and convince those sections of the population who were underestimating the potential disruption of what in the first weeks was labelled the “white virus”, due to the fact that the first cases were all white South Africans who had travelled overseas for tourism or business.
Unlike his predecessor, the former President Jacob Zuma, Ramaphosa coordinated his actions and consulted all stakeholders to set up a National Council. For the first time in democratic South Africa, the head of state wore a military uniform to show the nation the harsh times ahead.
Almost 18,000 security personnel between police and soldiers have been deployed to enforce the lockdown. Despite the president’s recommendation not to use violence towards citizens, some members of the army and the police have used force against people who failed to comply with lockdown regulations: security forces claimed that this kind of action was permitted during the national lockdown, and that they were following orders from “the top”. In this respect, Ramaphosa conceded in his latest television address that mistakes had been made in how the lockdown has been implemented.
South Africans will have to wait until 16 April to see if the stringent measures adopted by the government have had an effect. What is certain is the economic impact of the COVID-19 pandemic on a country that was already in recession. According to Efficient Group chief economist Dawie Roodt, the South African economy would have grown by around 0.5% in 2020 without the COVID-19 crisis. “The second quarter is when we are really going to feel the impact and I expect a significant contraction of between 5% and 6%,” Roodt said. The decision by the Moody’s ratings agency to downgrade South Africa’s credit rating to junk status further deteriorated the economic outlook and the local currency, the rand, hit a record low against the US dollar, trading at $18. Ramaphosa reacted overnight with a stimulus package that aims to get more money into the hands of households and provide some relief to small and medium-sized enterprises. In South Africa 8 million people are part of the informal labour sector and they are likely to be the hardest hit by this crisis. Excluded from social grants and from the unemployment insurance fund, they risk literally starving to death if the state does not implement a disaster relief package. An urgent measure is needed to avert a humanitarian crisis in Africa’s most industrialized country.