South Africa, which had one of the earliest and strictest bans in the world, marks a significant shift in the fight against the coronavirus, writes Andrew Harding, correspondent for BBC Africa.
It was hardly a “mission accomplished” moment.
South African President Cyril Ramaphosa looked appropriately grumpy and sounded appropriately cautious when he appeared on national television this week to warn of the dangers of a second wave of infections and to urge the public not to loosen their guard over the virus.
Yet the President’s key message was a simple, optimistic, and formidable truth.
“We managed to get through the worst of this epidemic,” he said.
As the infection rate drops below an important threshold of one new case per day and 100,000 people, South Africa is entering a new phase – with relief and with some pride.
What the President and his scientific advisors call the “new normal”.
With almost all economic activity resuming, the nation’s borders slowly opening and one of the earliest and strictest lockdowns in the world ending, this seems like a significant moment – an opportunity to take stock, even celebrate, and the ever-sensitive subject To explore from Who or what should share the most Covid-19 borrowing credits?
“I had visions of Italy … that we are not ready, that we will be overwhelmed,” recalled Professor Salim Abdool Karim, chairman of the government’s Covid-19 advisory body and public face of the scientific community, and thought back to March and What he and the government publicly warned of was an oncoming viral “storm”.
Instead, very few hospitals have been overwhelmed, and the official death toll of around 15,000 is significantly lower than even the most optimistic models predicted.
Prof Karim speaks over an internet connection from his Durban office and does not hide the relief he is feeling.
But like many scientists, his tendency is not to sit back and enjoy the good news, but rather to continue to hypothesize and test to better understand both Covid-19 and South Africa’s response to it.
There is now a lot of data to wade through.
Much of it is contradicting itself. Or rather, much of it has yet to be put in the right context.
Take South Africa’s long fight against HIV and tuberculosis.
New evidence suggests that TB patients are particularly susceptible to Covid-19.
On the other hand, the systems for coping with the two pre-existing diseases “helped us and prepared us better for coping with Covid,” said Prof. Karim.
Even if South Africa has good reasons to celebrate its successes, there is also a lot to criticize.
“We had a pretty bad epidemic,” said Prof. Karim.
“At one point we were the fifth worst in the world. I wouldn’t call that something to be proud of.
“I would have been really proud if we could mitigate the effects to a much greater extent.”
You may also be interested in:
“My son died in a freezing cold South African hospital tent.”
- In South Africa’s “hospitals of horror”
- Decide who lives and dies in a Cape Town community
- South Africa’s toxic relationship with alcohol
As we have reported here for the past few months, there have been cases of appalling mismanagement, alarming allegations of corruption and some serious errors in the handling of the outbreak.
I’ll leave the economic ramifications of the lockdown – and the retrospectively enriched legitimate debate about whether the government struck the right balance – to another day.
But what is the reason for South Africa’s relative success in fighting the virus?
Prof. Karim has compiled a list of nine factors or hypotheses that he applies not only to South Africa, but also to other countries – not least on this continent – which seem to have been spared the worst.
- Its first point is underreporting – a particular problem in less developed countries
- Its second test will not be tested due to limited capacity and resources
- The third – at the top of many experts’ lists – is the demographics and younger population of many African countries
- Next comes the question of how the virus got to South Africa – via travelers who did not mingle with the general population and allowed authorities to eradicate the first wave of infections relatively effectively
- Fifth, there is the early lockdown in South Africa and many other parts of the continent
- The sixth point – one that I addressed in a recent article – is the hypothesis of pre-existing immunity due to previous exposure to the four common circulating coronaviruses
- Seventh is the potential impact of warmer temperatures
- Eighth is the possible role of altitude on the virus
- And the ninth includes the word “stochastic” – an indication of the unpredictable way this virus appears to spread and the difficulty of predicting when individual spikes are likely to occur.
Nine theories. But of course Prof. Karim is not completely convinced of any of them, at least not without further evidence.
“I doubt any of these makes any significant contribution that explains all of the difference [of why some countries have done better than others],” he said.
“Even in combination, these wouldn’t explain most of the difference we’re seeing. It remains fascinating to me.”