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South Africa recently emerged from a strict five-week blockade aimed at fighting the spread of the coronavirus.
The strict level 5 blocking regulations prohibited any movement of people except the essential requirements.
Most companies were required to close, the sale of alcohol and cigarettes was prohibited, and no outside exercise was allowed.
Before this strict blockade, the national disaster status regulations also imposed some restrictions on businesses and citizens.
Gatherings of more than 100 people were banned, international travel restricted, schools closed, and the sale of alcohol was prohibited after 18:00.
The effect of these restrictions is clearly visible on the number of new coronavirus cases in South Africa.
However, to accurately interpret the statistics for COVID-19 in South Africa, the nature of the disease must be taken into account.
Adjusted dates to assess the impact of regulations
The incubation period for COVID-19, which is the time between infection and symptoms, is 5 to 6 days on average. However, it can last up to 14 days.
This is in part what makes the virus so difficult to contain. An infected person can be contagious for a long time before they know they have the virus.
When the coronavirus pandemic hit South Africa, most of the COVID-19 tests were done reactively, based on people who had symptoms.
Professor Salim Abdool Karim, who chairs the COVID-19 advisory committee of the Minister of Health, said Understanding this long incubation period is crucial.
He said that to understand the numbers of coronavirus cases that people are seeing today, they must look back at what was happening in South Africa two weeks earlier.
This is because when someone tests positive for the coronavirus, it reflects an infection from two weeks ago.
Patients only begin to experience symptoms after the incubation period, at which time they see a doctor, clinic or hospital.
From there, the patient should receive a laboratory test, and only if the results are positive is it considered a case of active coronavirus.
MyBroadband used Karim’s suggested two-week shift to interpret the impact of current government interventions.
The table below provides an overview of the two-week date change for significant periods in the past two months.
| Two week date setting | ||
| Period to evaluate | Infection date | Date of results |
| Before the state of disaster | March 5 – March 14 | March 19 – March 28 |
| Disaster state | March 15 – March 26 | March 29 – April 9 |
| Emergency shutdown | March 27 – April 16 | April 10 – April 30 |
| Locking Extension | April 17 – April 30 | May 1 – May 14 |
The impact of interventions on coronavirus case numbers
A day after the national shutdown began, confirmed numbers of coronavirus cases in South Africa plummeted.
In the week before closing, there was an average of 111 new cases per day and this was increasing rapidly.
In the week after closing, the average number of daily cases decreased to 76.
Very few people expected this. Even health minister Zweli Mkhize said The low number of infections took them by surprise.
He said in early April that they expected the total number of confirmed cases to have reached between 4,000 and 5,000 around April 2. Instead, he was sitting under 1,500 cases.
Karim explained that minor than expected infections after the start of the blockade were the result of restrictions related to the state of the disaster two weeks earlier.
These interventions broke the trend of the previous week, during which the number of daily coronavirus cases increased from 38 cases on March 21 to 243 cases on March 27.
The blockade served to stop the spread of the virus. Although the number of new cases increased during the block, it was mainly due to further testing.
An interesting observation, illustrated in the table below, is how effective the status of disaster interventions was.
Using the infection date, rather than the report date, shows that there was an average of 135 new cases per day in the week prior to the disaster state.
During the disaster state, there was only an average of 62 cases per day. Thus, it effectively broke the rapid increase in infections.
It was highly effective in stopping the rapid increase in new cases of coronavirus in South Africa without significantly disrupting commercial activity.
The chart below shows the growth and slowdown in daily coronavirus cases based on government-implemented interventions.
The dates have been adjusted to show the date of infection, two weeks earlier, instead of the report date.
As the number of confirmed coronavirus cases is closely related to the number of tests performed, that table is also provided below.
The third table shows the number of deaths from COVID-19, which are also related to the number of coronavirus cases.
The dates in the last two boxes have also been adjusted to two weeks to show the date of infection.
Percentage of positive tests.
The number of coronavirus cases is closely related to the number of tests that are performed and with whom the test is performed.
Karim said that until April 6, all tests were carried out on people who showed symptoms and who visited the rooms of doctors or hospitals.
This changed when community health workers were sent to the field to find people to perform tests.
Through community testing, the number of daily tests has increased significantly, resulting in an equivalent increase in confirmed cases.
Between March 6 and April 6, an average of 1,800 COVID-19 tests were performed per day. This increased to 7,550 per day between April 7 and May 7.
This increase in daily testing means that the percentage of positive tests is a better measure of outbreak growth, rather than just looking at the daily tests.
“If we look at that rate, which is about 2.7% of the tests, we have seen little difference in the proportion of positive tests in the last five weeks.” Karim told News24.
“But now we will most likely begin to see a slow but steady increase in that rate due to the relaxation of the blocking regulations.”
The table below shows the percentage of positive tests based on adjusted dates to reflect the date of infection.
the worst is yet to come
President Cyril Ramaphosa recently warned South Africa must prepare for an increase in COVID-19 infections as restrictions are lifted.
He said the level 5 blockade had done a lot to stem the wave of infections that was to increase exponentially. However, this will now change.
Karim echoed Ramaphosa’s views, saying that we can expect to see a slow and steady increase in the number of COVID-19 cases in the next 8-10 weeks.
“The projections are that around July, there will be an inflection or a sharp increase in cases that are likely to peak in late August or early September,” Karim said.
He said this gives people two to three months to return to their lives and take the children to school.
“When the July inflection occurs, we could expect to see alert levels go up again and high blocking levels would be an option,” Karim said.
This, he explained, is because the government has a risk-adjusted approach to blocking levels.
“The state adjusts its approach based on the burden of the disease, how many cases we have and the threat of transmission presented by the cases, and the ability of our health services to deal with the cases.”
Now Read: What to Expect From Level 3 Blocking Rules
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