While it is likely, it is difficult to quantify whether South Africa’s lockdown has lowered the rate of COVID-19 transmissions in the country.
This is because fewer people were tested each day in the first three weeks of the national lockdown compared to those who were tested before the lockdown.
This is according to Professor Shabir Madhi of Wits University, who is the head of President Cyril Ramaphosa’s public health subcommittee.
Madhi said it is of critical importance that the lockdown is used to ramp up testing, as this can help to reduce the rate of community transmission.
The poor testing rates throughout the first three weeks of the lockdown have hampered this, however.
“For the past 10 days, this has improved and we now testing approximately 6,000 per day – and as we have seen there have been approximately 150 new cases per day since having scaled up testing,” said Madhi.
While he has previously used the example of 600,000 people being tested in South Korea as a good target, and suggested that 15,000 to 20,000 tests should take place per day in South Africa, he said that testing numbers aren’t the only thing that is important.
Where we are in the epidemic is also a key consideration.
He explained that since the number of cases is still in the thousands, as opposed to being in the tens of thousands, the goal should be to identify these cases as quickly as possible so that infected people can be isolated – and target tracing of their contacts over the past 2-3 days can be conducted.
“To be able to achieve this, you need to test at quick rate – tests per day – of all symptomatic individuals, which will even then not identify all infected cases as 50%-80% of infected cases will be asymptomatic,” said Madhi.
“However, this sort of screening strategy, which is more pragmatic than testing everyone, allows you to identify at least a third of the infected cases and their contacts, who if put under isolation or in quarantine will assist in reducing the rate of community transmission.”
Madhi said that a degree of community transmission is inevitable in South Africa, and it is therefore not possible to prevent all infections – nor is it desirable.
Instead, the goal should be to control the rate of infection, which can be achieved with measures such as banning mass gatherings and enforcing physical distancing.
Lockdown losing support
Madhi added that it is impossible to sustain the national lockdown on multiple fronts, and that instead the lockdown needs to be phased out.
South Africans appear to agree with this, as research done by Victory Research for City Press and Rapport shows that while 87% of respondents supported the initial lockdown, only 42% support an extension past April.
A large reason for this is financial, as 18% claim they cannot afford to go another week in the current lockdown state, and over half of respondents are unable to afford basic groceries for longer than three weeks.
South Africa will be decreasing the level of lockdown to level 4 on 1 May 2020, which will allow more businesses to resume operations.
To learn more about the new business rules under level 4 lockdown, read our article here.