Is South Africa heading back into lockdown - and what can the UK learn?

As coronavirus cases surge and deaths begin to mount, South Africa’s government has left the country’s population guessing about whether a lockdown will be reimposed.

Health Minister Dr Zweli Mkhize said on Monday that a new hard lockdown “cannot be ruled out”, but denied that a decision was imminent.

His intervention followed several days of mixed messages about whether South Africa would reverse the easing of what have been some of the strictest social distancing restrictions in the world.

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Cognitive dissonance

South Africa marked a “sombre Covid-19 milestone on Monday night, as cases passed the 200,000 mark,” the SowetanLive news site reports. “Only 14 other countries have now recorded more cases of the respiratory illness.”

Although low by the standards of Western Europe, the death toll in South Africa is also rising quickly and now stands at 3,310, according to latest figures. The country had not recorded more than 100 daily deaths before 23 June, but has exceeded that figure four times in the past week.

The recent spike in infection rates has fuelled fears that Covid-related fatalities will begin to rise even more quickly. On Saturday alone, more than 10,000 new cases were reported.

Yet despite the alarming statistics, “South Africa is in the process of easing its restrictions in phases, with the latest being the reopening of schools for more students this week”, the BBC reports.

Preparing for the peak

“Experts fear that a combination of poor planning on the government’s part and public distrust of authority will see a huge rise in the number of coronavirus cases in the coming weeks, particularly in Johannesburg,” says The Telegraph.

The South African Centre for Epidemiological Modelling and Analysis has forecast that between 35,000 and 50,000 South Africans could die from Covid-19. However, predicting the course of coronavirus outbreaks has proved challenging.

Professor Lee Wallis, head of emergency medicine for the Western Cape Government, told CNN that while the peak in Cape Town was not as high as had been expected, “he believes that the surge could last longer than predicted by their earlier models - even for many months - a situation that will strain both the health system and a population desperate to get back to some kind of normal”.

On-off lockdown

Ministers appears to be in two minds about how to tackle the surge in cases.

At the weekend, the South African Sunday Times reported that Gauteng, the small but densely populated province which includes Johannesburg and Pretoria, was seeking “to reintroduce hard lockdown regulations in an attempt to curb soaring Covid-19 numbers”.

Bandile Masuku, the province’s health minister, told the newspaper that he wanted a two-week lockdown in which “nobody goes to work and no one moves... so at least there is predictability and you can control infections in that way”.

But President Cyril Ramaphosa swiftly “dismissed the call for an intensified national lockdown - citing serious financial concerns and a general degeneration of the country’s socioeconomic fabric”, The South African reports. Instead, he urged “greater adherence to hygiene measures and social distancing directives”, says the news site.

Yesterday, however, both the national and provincial governments revised their positions.

In Gauteng, Masuku “said a hard lockdown would have a devastating impact on the economy of the province” and was not his preferred option, Independent Online reports.

Health Minister Mkhize subsequently said that such measures may not be necessary after all. “At the moment, we have not taken a decision for a hard lockdown but it cannot be ruled out as a future instrument that can be used,” he said. “If there’s a need and it looks like it’s the only way out, we might have to institute that."

An impossible decision

Ministers face an unenviable choice in a country without the resources to support people forced out of work.

The “sudden and sweeping lockdown” imposed in March brought life to “an almost complete standstill”, says The Telegraph. “South Africans were only allowed to go out to buy food or visit the doctors, while the sale of alcohol and cigarettes was banned entirely.”

Ramaphosa was praised for his decisiveness, but it came at a price. More than 40% of South Africans live below the poverty line, many of them “employed by factories and production lines shut down due to the coronavirus outbreak”, according to Deutsche Welle. “Without sufficient state assistance, those people have also been at risk of hunger.”

Announcing the lifting of some of the measures last month, Ramaphosa said: “We have to think about these people who are employed in these industries and those who depend upon them for their livelihoods. Through the easing of the lockdown we are continuing to balance our overriding objective of saving lives and protecting livelihoods.”

The decision angered people “who are terrified about the spiking numbers” - and are now “shouting at government to reintroduce lockdown”, says News24’s Mandy Wiener. However, others are “vociferously against the lockdown”, even in its less stringent form.

Salim Abdool Karim, an epidemiologist and member of the country’s Covid-19 advisory team, defended the government’s balancing act.

“It’s no longer sustainable for us to continue along this path,” he told Deutsche Welle last month. “We’re having to make the very difficult decision of easing the restrictions, so that people can start accessing healthcare, accessing food and so on.”

Lessons for the UK?

Gauteng’s health minister has promised that any new lockdown will be based on “a better understanding of what they are and how they work, given the experience we have had over the past few months”.

Parties, church services, funerals and protests had all led to problems, said Masuku, and not only because of infections but also because they threatened to overwhelm the contact-tracing system.

“Restricting numbers assists us in curbing infection, because you would rather deal with 20 people that you must do tracing for,” he continued. By contrast, a gathering of “50 people means you already have a minimum of 150 people for tracing and the possibility of infections spreading”.

The other lesson to be learned may be that people can be vigilant for only so long. “There’s a sense of fatigue ahead of the peak,” one South African told Eyewitness News. “People need to be extra careful [but] they’ve kind of given up.”