On 18 April, Health Minister Zweli Mkhize revealed that South Africa had 3,034 confirmed coronavirus cases. This represented a daily increase of 251 cases.
This was the biggest daily increase since the virus hit local shores and followed an increase of 178 new cases on 17 April.
This rapid rise in recent days raised concerns of accelerated spread in community transmissions, which in turn could lead to a lockdown extension.
The lockdown extension concern is based on criteria shared by Professor Salim Abdool Karim, chairperson of the Health Minister’s COVID-19 advisory group.
Karim provided four scenarios for the average number of new daily cases between 10-16 April.
- Equal to or above 90 – continue lockdown.
- 45 to 89 and the positivity to screening ratio (CHW) is above 1 in 1,000 – continue lockdown.
- 45 to 89 and the positivity to screening ratio (CHW) is equal to or below 1 in 1,000 – ease lockdown.
- Below or equal to 44 – ease lockdown.
Karim explained this set of criteria gives South Africa clear guidance on how to deal with the lockdown.
Passive and active cases
If one looks at the coronavirus statistics reported by Mkhize, the average number of new daily cases is well above 90. However, the numbers reported only tell part of the story.
Karim explained the criteria he listed is for passive cases and should exclude cases identified through active screening.
Passive cases refer to people who have contracted the virus and went for testing after showing symptoms.
This is what happened for the first few weeks in the country, and to compare “apples with apples” only passive cases should be used to match Karim’s criteria.
Thousands of “active screening” tests have been conducted in South Africa recently, but the Department of Health does not provide case numbers based on active versus passive tests.
Karim said differentiating between “passive and active cases” is a key issue which the committee is currently grappling with.
If there is a significant number of active cases among the total new cases this week, this may reduce the average number of new daily cases to below the 90-case threshold.
Mkhize comments on lockdown extension
Speaking on Saturday, Mkhize said the rise in new COVID-19 cases does not mean the lockdown will be extended.
He said the average number of new daily cases, which was somewhere between 90 and 95, was still “within the broad range” of 45 and 89.
He reiterated that the 90-case threshold is only for people who presented themselves for testing.
He said taking active screening and testing into account, the COVID-19 advisory group felt there was not a “huge indication” of a big increase in new cases at this stage.
Mkhize further highlighted that Karim’s infection criteria is not the only consideration when deciding on extending the deadline.
He said they are also looking at the economic impact of the lockdown, people going hungry, and creating a sustainable environment to curb the spread of the virus.
“It’s a combination of factors we have to take into account. There isn’t one factor which is more important than the other,” he said.
He said the government wants to contain the spread of COVID-19 in a way which will also allow people to work, earn a salary, and have enough food to eat.
Lockdown extension possible, but no decision made
While a lockdown extension in South Africa remains a possibility, the government has not made a decision about this yet.
Minister of Cooperative Governance and Traditional Affairs Nkosazana Dlamini-Zuma said the government is currently uncertain as to what will happen at the end of the April – when the current lockdown is set to end.
“We don’t know for sure that the lockdown will end on 30 April. Even if it does, we can’t open the floodgates,” she said.
The current restrictions will be adapted on a weekly basis, and these changes include industry sectors being allowed to operate again as the restrictions are gradually eased.
Dlamini-Zuma added that certain restrictions are likely to remain in force “for a very long time”.
The number people are worried about
The chart below, which shows the average number of new daily cases starting on 10 April, is what people are concerned about.
Based on Karim’s criteria, the red line, at 90 cases, is when the lockdown should continue. The green line, at 44 cases, is when the lockdown should be eased.
For this comparison the total number of new daily cases was used – not only the passive cases, as directed by Karim.
As stated, however, the Department of Health does not release a breakdown of passive versus active tests.
The average number of new daily cases exceeding 90 has raised concern about a lockdown extension, but as Karin and Mkhize explained, this is not guaranteed.