South Africa’s strange COVID-19 case numbers

The Department of Health revealed on 6 April that South Africa had 1,686 coronavirus cases – an increase of 31 cases over the past day.

This was the lowest daily increase since 1 April, and much lower than the peak daily increase of 243 on 27 March.

As at today, 7 April, the total number of confirmed COVID-19 cases was 1,749.

What stands out about the number of COVID-19 cases in South Africa is that it does not follow the same trend as in other countries.

In countries like the United States, Spain, and Italy, for example, there is a consistent increase in cases until they reach a plateau.

None of these countries showed a rapid increase in cases and then a sudden decline – as observed in South Africa.

This trend is so unexpected that even Health Minister Zweli Mkhize acknowledged the number of infections is not what they anticipated.

Mkhize said last week they expected between 4,000 and 5,000 cases by around 2 April. This makes sense if South Africa followed the same infection pattern as other countries.

He put the lower-than-expected infection rate down to closing South Africa’s borders quickly, quarantining of inbound travellers, enforcing a lockdown, and preventing mass gatherings.

The graphs below illustrate the differences in daily case increases in South Africa compared to other leading nations.


Daily New Cases in the United States


Daily New Cases in Spain


Daily New Cases in Italy


Daily New Cases in South Africa


Lower testing

While the measures which the government implemented to fight the virus outbreak are most likely effective, the minister said South Africa needs to remain alert to prevent a mass outbreak.

He explained that coronavirus testing in South Africa has to date been reactive and restrictive, which means we may not have the full picture of the problem.

He said internal COVID-19 transmissions have started, and this has the potential to spread silently among poor people who do not have the means to be tested.

The lower number of tests in South Africa may therefore contribute to our numbers not following international trends.

According to Worldometer’s COVID-19 data, the number of tests per 1 million people in South Africa is far lower than developed countries.

In the United States, Spain, and Italy, the number of tests per 1 million people is between 5,800 and 12,000.

In South Africa, fewer than 1,000 tests per 1 million people have been conducted.

This is likely to change, however, as the minister said they are now targeting specific communities where people are showing mild symptoms of the virus.

Mkhize added that South Africa needs to conduct hundreds of thousands of tests to really understand the number of infections and the spread of the virus.


Number of tests per million people per country


Number of tests versus number of confirmed cases

One of the factors often overlooked is that there is a close relationship between the number of tests conducted and the number of new coronavirus cases.

While countries like the UK has consistently ramped up the number of tests, South Africa has not seen the same increase.

Apart from one day – 27 March – the number of daily tests in South Africa has not increased significantly.

The graphs below show the relationship between the number of tests and the number of new cases.


New daily tests for coronavirus in the UK (source: BBC)


New daily cases of coronavirus in the UK (source: BBC)


New daily tests for coronavirus in South Africa


New daily cases of coronavirus in South Africa


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South Africa’s strange COVID-19 case numbers