PRETORIA - The rapid spread of Covid-19 in South Africa can only be combated if individuals assess their actions and the risk they pose for their communities.
With the easing of lockdown restrictions and more open economic activity, there has been a surge in Covid-19 infections with the Western Cape continuing to have the highest number of infections and deaths.
This week President Cyril Ramaphosa announced an easing on restrictions on personal care services, hotel accommodation, resorts and restaurants for ‘sit-down’ meals; limited opening of cinemas, theatres and casinos; and non-contact sport including tennis and golf added to running, hiking and cycling.
The “advanced level 3 lockdown” changes were gazetted last night meaning they can come into effect immediately.
Professor Salim Abdool Karim, the world-renowned HIV scientist and infectious diseases epidemiologist who chairs the Ministerial Advisory Committee on Covid-19, believes the next 100 days will be crucial in reducing the impact of the pandemic on the country.
“During the first 100 days of the pandemic we were able to avert a situation like we saw in the UK. We didn’t have a peak in March, as everyone else did who were at the same level as we were at. We flattened the curve and the flattening of the curve bore us time.”
Karim said there were however unintended consequences of having a severe lockdown.
“Among them was that enforcement turned out to be much more severe than we anticipated and I was personally quite taken aback at the impact it had and the loss of life was deeply regrettable.”
Karim said Covid-19 was still at a low level in much of the country, “but we have a rapidly growing epidemic with well-established community transmission in the Western Cape”.
“We have an early starting epidemic in the Eastern Cape, and we have the very early stages of transmission in Gauteng - which has recorded close to 15 000 cases - and to a lesser extent in KZN.”
Karim said that at the onset of the pandemic he had spoken of how “little flames become big fires”, and this was evident in the Eastern Cape where people had attended a funeral and 10 people became infected.
“One of those 10 was a prison warder from West Bank Prison, and that led to several people in the prison becoming infected. The other staff in the prison then took it to the community - and before you know it, it multiplies and has grown.
“These outbreaks and this kind of transmission was what I was most deeply concerned about... that we would miss the small flames and only pick them up when they are already big fires. That is what has been happening.”
“Now we’re seeing small flames everywhere and our efforts to dampen them have been somewhat limited because we learn about them too late.
“What’s likely to happen over the next 100 days is that we’ll continue to see the rapid spread of the disease in the Western Cape until it gets to a peak in July or August, and once it gets to its peak we can expect it to steadily decline.”
Karim said the fundamental issue in epidemics was that people changed their behaviour and began to take it more seriously when people they know who had the disease were hospitalised or died.
“It becomes more personal. You feel you have to act. Until then, it’s just something that affects others. As epidemics grow people change their behaviour and we will likely see that kind of scenario in South Africa, and when that happens the prevention that people take will have a huge benefit to slowing the epidemic down.”
June 12 marked 100 days since Health Minister Dr Zweli Mkhize announced the first confirmed case, that of a man who had returned from a holiday in Italy.
Karim said South Africans had to move from a state of anxiety, which was prevalent for the first 100 days, to a state of agency, where they would have to prevent themselves and others from being at risk.
“My colleagues in behavioural science call this moving from anxiety to agency. The anxiety was created when people were told this is a deadly virus to a small proportion of people and there was government action by telling people to stay at home. We banked on that to control the spread of this disease and people became anxious.
“Now we have to convert that anxiety and approach we took early on to say to people ‘your actions are important’.”
“Agency is about us taking back the power to influence our risk. Do you feel you have the ability to influence your destiny? We can’t expect to get all of these prevention measures implemented through enforcement, but it now depends on people understanding that their actions impact on their risk, their families’ risk and their communities’ risk. If they put themselves at risk, they put everybody at risk, and that realisation is going to be central to everybody changing their behaviour.”
Tough discipline is required to enforce hygiene protocols and manage risk especially as more sectors open up so that more people can get back to work.
The rules laid out for personal care services outline additional measures to protect staff and clients.
The changes now imply that we will not be moving to level 2 in July.