Coronavirus in South Africa: The lull before the tsunami?

During the past fortnight South Africa has seen a dramatic, and unexpected slow-down in the daily rate of coronavirus infections.

Health experts are warning that it is far too early to see this as a significant development, and worry that it could even trigger a dangerous sense of complacency.

President Cyril Ramaphosa has now suggested that the two weeks of lockdown is responsible. He has extended the nationwide restrictiions, scheduled to end in one week’s time, to the end of the month.

But – as the country and the continent continue to brace for the potentially devastating impact of the pandemic – doctors are struggling to explain what’s going on.

Lockdown fears for Johannesburg residents

The beds are ready. Wards have been cleared. Non-emergency operations rescheduled. Ambulances kitted out. Medical teams have been rehearsing non-stop for weeks. Managers have spent long hours in online meetings drawing up, and tweaking their emergency plans.

But so far, and against most predictions, South Africa’s hospitals remain quiet, the anticipated “tsunami” of infections that many experts here have been waiting for has yet to materialise.

Street view in Cape Town
Businesses in Cape Town have been mostly adhering to the lockdown

“It’s a bit strange. Eerie. No-one is sure what to make of it,” said Dr Evan Shoul, an infectious disease specialist in the main city, Johannesburg.

“We’re a bit perplexed,” said Dr Tom Boyles, another infectious disease doctor at Johannesburg’s Helen Joseph Hospital, one of the biggest public hospitals in the city.

“We’ve been calling it the calm before the storm for about three weeks. We’re getting everything set up here. And it just hasn’t arrived. It’s weird.”

Aggressive tracing of contacts

It is nearly five weeks since the first confirmed Covid-19 case in South Africa, and until 28 March, the daily graph tracking the number of new infections followed a familiar, accelerating, upward curve.

But on that Saturday, the curve suddenly broke sharply – from 243 new cases in one day, to just 17. Since then, the daily average has settled at around 50 new cases.

On Thursday President Ramaphosa said it was “too early to make a definite analysis”, but he said that since the lockdown had been introduced the daily increase in infections had dropped from 42% to “around 4%”.

“I think the more people we test, the more we’ll reveal whether it’s an aberration, or it’s real. The numbers are not yet there,” cautioned Precious Matotso, a public health official who is monitoring South Africa’s pandemic on behalf of the World Health Organization (WHO).

Complacency fears

There is a general acknowledgement here, from the health minister to frontline hospital staff, that it is dangerously early to try to reach any firm conclusions about the spread of the virus.

“It’s difficult to predict which road we’re going to take – a high, middle or low [rate of infection]. We don’t have widespread testing.

“There might be early signs that are positive, but my fear is that people start becoming complacent, based on limited data,” said Stavros Nicolaou, a healthcare executive now coordinating elements of the private sector’s response.

Informal vendors gather in front of a municipal office building in Braamfontein, Johannesburg, on April 8, 2020, as they try to obtain a permit for working during the 21 days national lockdown that started on March 27, 2020, in an attempt to halt the spread of the COVID-19 coronavirus outbreak
Informal traders have protested that the lockdown has left them without an income

The sense of a vacuum caused by this extended lull – the potential “calm before a devastating storm,” as Health Minister Zweli Mkhize described it last week – is, inevitably, being filled by speculation.

The widespread assumption has been that the virus – introduced to South Africa, and many other African countries largely by wealthier travellers and foreign visitors – would inevitably move into poorer, crowded neighbourhoods and spread fast.

Nervous anticipation

According to experts, that remains the most likely next stage of the outbreak, and there have already been several confirmed infections in a number of townships.

But doctors here and in some neighbouring countries have noted that public hospitals have seen not yet any hint of an increase in admissions for respiratory infections – the most likely indication that, despite limited testing, the virus is spreading fast.

Source: https://www.bbc.com/

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