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South Africa is likely unable to prevent the exponential spread of Covid-19, with the full extent of the disease likely to hit the country later this year.
And while South Africa acted long before other nations in identifying the virus and implementing measures to stop its spread, it has only given the country time to prepare for what scientists call “almost inevitable”: a dramatic increase in infections.
This is according to Professor Salim Abdool Karim, chairman of Health Minister Zweli Mkhize’s Covid-19 advisory group, who addressed a press conference alongside other scientists on Monday night. It was the first briefing with the country’s top scientists since the coronavirus was first reported in South Africa on March 5.
Karim was joined by, among others, Professor Glenda Gray, the President of the Medical Research Council, Professor Koleka Mlisana, a microbiologist at the University of KwaZulu-Natal, and Professor Brian Williams, formerly an epidemiologist at the World Organization for the Health.
“What we have managed to do is delay an exponential curve,” Karim said. “It is a difficult truth, but can we avoid exponential spread? No … unless we have a mojo that other countries don’t have.”
He also explained:
- The blockade could not be ended abruptly, as we risk wasting the profits made in the past few weeks and returning to an exponential increase in cases.
- The decision on a new extension of the blockade would be based on the propagation rate observed in the new average daily cases between April 10 and 16, who were 95% sure that they would remain between 40 and 80 cases. More than 90 cases per day calculated over a week would result in a block extension.
- The cases reported as confirmed today were actually an infection that took place two weeks ago, and infected people are contagious days before they show symptoms.
- Plans were being developed for a systematic end to the blockade, which would focus on not putting high-risk people in close contact with low-risk people.
- The testing criteria, restricted only to people with certain symptoms, have been expanded in recent weeks to detect more cases, along with a significant increase in testing capacity.
- The main concern fell on Johannesburg, Cape Town and eThekwini (Durban), where a large outbreak was more likely to occur due to the large population.
News24 reported Sunday that government projections, presented to the parliamentary health portfolio committee, showed that this scenario of peak infection had been delayed until September.
“No one in the world has encountered this virus. We have no immunity, no vaccine, no treatment. We are all at risk.”
“As soon as the opportunity arises for this virus to spread, it will return to the exponential curve,” Karim said.
A slide from Professor Karim’s presentation on Monday night, showing the most likely future scenario of Covid-19 cases in South Africa.
Importantly, the blockade and other initial steps had bought valuable time to prepare and try to contain the critical points.
Karim, a world-renowned figure in the field of HIV research and epidemiology, is the chairman of a Ministerial Advisory Committee (MAC) comprised of more than 20 professors, doctors and scientists who advise Mkhize and the National Command Council chaired by President Cyril. Ramaphosa
Karim spoke at a press conference on Monday night, scheduled to shed light on the technicalities of the government’s response.
Experts from the MAC and Mkhize explained what they expected in the coming weeks and months, detailing the steps taken so far and what the decision-making had informed.
Karim and Mkhize stayed away from any projections about the number of people who expected to become infected at the peak of the virus, and how many people should need hospitalization or die from Covid-19.
Unique trajectory
Karim explained that while there was concern about whether the tests were adequate in the poorest communities and that many cases went undetected in those areas, early and decisive interventions were much more likely to have slowed the spread of Covid-19.
“We were expecting to see exponential growth in our epidemic. But this did not happen,” he said.
Test capacity had increased, and as such dispelled these concerns for the most part.
Professor Cheryl Cohen, co-director of the Center for Respiratory Diseases and Meningitis of the National Institute of Communicable Diseases (NICD), explained that the first cases in the country were largely imported.
Imported cases concern infected travelers abroad, who returned home and then transmitted the virus to those with whom they came into contact.
Karim explained that these two groups, the travelers on the one hand and the people they infected on the other hand, were expected to transmit the virus to their communities.
A slide from Karim’s presentation on Monday night showing how the virus was expected to spread, compared to how it has behaved.
“When [Covid-19] it enters a community, it spreads like a forest fire, “Karim said.
“For some reason, those two groups didn’t lead to this. We still have broadcasts from the community, but it’s at a low level.”
As the local epidemic curve flattened and stabilized in a lower average number of new daily cases, the testing capacity for the 80% of the population without medical assistance has increased.
He stressed that the test numbers were still too low.
Response stages
According to Karim, the government response was informed by eight key strategic responses planned and executed from the beginning.
The first four stages had been developed in the past few weeks, while the next four stages would be informed by the data over the next two weeks.
- Stage 5, identifying critical points to enable rapid intervention was key, and massive teams of health workers on the ground were essential to this.
- Stage 6 consisted of preparing the availability of medical care by the time the peak of infection arrived, which had started a few weeks ago. This included finding and building field hospitals where patients could be evaluated before flooding the hospitals. Karim said there was great concern about the availability and availability of the health care system to serve the number of patients who would need care.
- Stage 7, which Karim said he understood that people did not want to talk about, was to ensure that funeral capabilities could meet demand and prepare citizens for the psychological and social impact of large numbers of victims.
- Stage 8 involves constant vigilance and vigilance, including test campaigns in mines, schools and large companies to ensure that a second wave epidemic does not occur after containing the initial outbreak.
A slide from Karim’s presentation on Monday night shows how the infection curve, which closely followed that of the United Kingdom, has changed significantly in recent weeks.
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