When the national lockdown in South Africa comes to an end, it will not be business-as-usual. That was the message from Salim Abdool Karim when presenting on the government’s response to the coronavirus pandemic.
Karim is chair of the COVID-19 advisory committee to Minister of Health Zweli Mkhize.
He explained that even if the lockdown is a success, it does not mean the end of the coronavirus in South Africa.
If the lockdown is ended abruptly, there is a risk that all of the positive results seen so far will be undone.
This is because it will create a situation where high-risk and low-risk people will interact, including traveling together on buses, taxis, and trains.
Therefore, there has to be a gradual relaxing of the lockdown.
“We have to think about and plan for a systematic easing of the lockdown, starting with transport hubs and then working our way down from the lowest risk to the highest risk,” Karim said.
Expect a coronavirus explosion
As South Africa relaxes its lockdown, it is unlikely that the coronavirus will simply fizzle out, he said.
The most likely scenario is that the lockdown has delayed the inevitable and there will be an exponential growth of coronavirus infections in South Africa.
Lockdown has bought South Africa some time, about 4-6 weeks, and will likely reduce the peak case load for hospitals and medical workers.
Karim said the delay in the spread of the virus in South Africa is important to avoid a situation like the one in New York, where the healthcare system is overloaded.
It has given South Africa time to flatten the curve, and time to prepare for the inevitable growth in cases.
To ensure that the inevitable spread of the coronavirus is not allowed to go unchecked, South Africa must consider keeping certain restrictions in place post-lockdown.
This includes limitations on international travellers, and the screening and self-isolation of those who are at risk of being infected.
Everyone must also continue to be conscious of hygiene, washing their hands regularly, maintaining physical distancing, and avoid touching their face.
As people return to work after the lockdown, the government also plans to expand its screening programme to detect potential infections early.
“We are not going to wait for patients to pitch up at hospitals to act,” Karim stated.
There are three components to this initiative:
- House-to-house screening and testing, especially in vulnerable communities. There are currently over 28,000 workers conducting screenings.
- One day per month, or more frequently, 5% of staff from emergency rooms, ICUs, and respiratory units will be part of a national surveillance programme.
- A regular national surveillance day for schools, mines, prisons, and big companies.
Constant coronavirus surveillance
The regular screenings of a sample of South Africa’s population will initially involve self-taken swabs, with the aim to later switch to finger pricks, Karim stated.
He said these measures ensure the small flames of a few coronavirus infections are put out quickly, and don’t turn into a raging fire.
South Africa is a country with many at-risk people, Karim added, including patients with tuberculosis and people who are HIV-positive and not on antiretrovirals.
“On top of everything else, we are going to have our COVID-19 epidemic at the same time as our annual flu epidemic,” said Karim.
South Africa will therefore have to deal with the situation where you don’t know whether someone has the flu, or if they have COVID-19.
South Africa’s elderly are also at risk.
“We need to think about whether it’s going to be possible to have some kind of partial lockdown,” he said.
This would be a voluntary partial lockdown for people over 60 or 70, along with those with comorbidities, to reduce their potential exposure to the coronavirus.
“What it means is that our children will go to school and they’ll play in school, but when they go home they can’t play with granny. They cannot play with grandpa,” said Karim.
“They [children] will pose a risk to transmit the virus to their grandparents. We are going to have to protect our elderly in this period.”
Karim stated the voluntary partial lockdown could be until the end of September, which is when they think the main wave of the epidemic will be over.
He emphasised that he doesn’t know definitely whether South Africa’s coronavirus epidemic will be over in September and he has only provided that as a target date for now.