With South Africa’s Covid-19 lockdown now stretching past the 100-day mark, the government’s handling of the crisis has received a mixed report card.

“Some things we have done exceptionally well – we have been world leaders in certain respects,” Maverick Citizen editor Mark Heywood told a Daily Maverick webinar on Sunday evening.

“Some things we have done terribly badly.”

Heywood said one aspect on which the government could not be faulted was “political commitment” and speed in handling the crisis – something he said that South African Aids activists had fought for in vain for years by comparison.

But the areas in which problems have become evident range from medical resources to economic support measures.

South Africa’s coronavirus testing capacity and rate is a major concern.

“I think we are underestimating the testing backlog,” Medical Research Council president Professor Glenda Gray told the webinar.

With the turnaround for testing performed in the public sector now stretching to as much as nine days, Gray pointed out that the problems this poses for contact tracing are significant – given the number of people with whom an individual who tests positive could have interacted within that time.  

Gray said that as a result of the strain on the laboratory system, testing within communities would have to be put on the “backbench” in favour of prioritising healthcare workers and people admitted to hospital.

The root causes of the testing problems are twofold, Heywood suggested: “systems failure and poor planning” – the latter on the part of the National Health Laboratory Service. The “systems failure” is most pronounced in the public health sphere, with the private sector managing to turn tests around on average within two days.

At the time when Heywood was talking, the daily figures for Sunday 14 June had not yet been released, but some hours later they would show that in the 24 hours beforehand South Africa’s reported case figures rose by almost 4,500.

But both Heywood and Gray pointed out that testing challenges are not exclusive to South Africa. Within “lower-middle-income economies” globally, said Gray, “we are all under-testing”.

And with a shortage of testing kits and testing reagents a global reality, Heywood suggested that it is imperative that South Africa focuses on trying to develop the tests and their constituent elements locally.

Because of the acknowledged insufficiency of South African testing at the moment, the true extent of the pandemic here is very difficult to estimate. Heywood said some health experts believe the true number of Covid-19 cases to be up to 10 times larger than currently reported: 70,038 cases as of 14 June.

For a lot of time there was talk of Africa as a continent being “behind the curve,” Heywood said.

“It appears to be taking off in parts of Africa now, and things are going to change tragically.”

He pointed out that South Africa now has the eighth fastest-growing epidemic in the world in terms of reported daily case increases.

At the time when Heywood was talking, the daily figures for Sunday 14 June had not yet been released, but some hours later they would show that in the 24 hours beforehand South Africa’s reported case figures rose by almost 4,500.

Gray’s assessment is that South Africa does not seem to be following the developed world pattern of the disease thus far, but that one thing is clear: “We have not yet peaked.”

There is no clear sense of when that peak will come.

“We can say we are in the surge,” Gray said. The Western Cape is predicted to peak first, followed by Eastern Cape and Gauteng, but “we don’t know how long those peaks are going to last”.

A question which appeared to be on the minds of many webinar viewers was how effective the 100-day lockdown has been in terms of preparing South Africa’s health system for the surge: ostensibly one of the key reasons for the hard lockdown.

Gray acknowledged that it was a major concern that more than three months of lockdown have not yet produced clear plans on how the public and private health spheres will coordinate to manage the medical onslaught.

“Perhaps one of the shortcomings of the first 100 days of the lockdown has been the lack of concrete public-private partnership,” Gray said.

“It’s late in the day to not have got this completely nailed down.”

Gray and Heywood agreed that the idea of returning to a hard lockdown to attempt to curb the spread of coronavirus once again is now impossible, given the catastrophic economic fallout already.

She said that Western Cape had made good progress in reaching the necessary agreements, but that uncertainty over sharing resources, including ICU beds, in the other provinces remained a worry. And it’s not just ICU beds that are in short supply.

“Do we have enough oxygen? Do we have enough C-Paps [machines]? Do we have enough ventilators?” asked Grey.

Ventilators either have to be manufactured in South Africa at speed or imported – and Gray said initial indications were that importing the machines would take around 120 days.

Yet, Covid-19 itself is just one element of South Africa’s current crisis, which is much wider in its social and economic impact. Heywood suggested that it is in dealing with the socio-economic fallout of the health emergency that the government is failing most severely.

He pointed out that although the Solidarity Fund distributed 280,000 food parcels in May, that has now ended. What replaces it is a voucher system which is taking some time to roll out.

“It’s likely there will be more acute hunger in these winter months of June, July and August,” Heywood said.

Gray and Heywood agreed that the idea of returning to a hard lockdown to attempt to curb the spread of coronavirus once again is now impossible, given the catastrophic economic fallout already.

Webinar moderator Ferial Haffajee cited new research by UCT academic Professor Jeremy Seekings showing that the government’s attempted financial relief measures have emphatically failed to meet the mark, with fewer than 150,000 people having received the promised Covid-19 hardship grant.

Observed Haffajee: “We are one of the most over-policed lockdowns, and yet with such tremendous ineffectiveness at the social relief end, it does tell you about where money is spent – or where power is held perhaps in the governing council.”

In the view of both Gray and Heywood, it is incumbent on ordinary citizens as well as government to step up and do their bit to address the escalating crisis of hunger and poverty.

“There are a lot of people who are just standing by and letting this unfold as if it is someone else’s problem,” said Heywood.

But he urged South Africans to offer assistance to those in need in whatever way possible: to volunteer at an NGO, to buy and distribute extra food, and to offer support to measures aimed at holding the government to account – such as the forthcoming court action launched by Equal Education to force the reimplementation of the school feeding programme nationally.

“The next 100 days are going to be very sobering,” she said, warning of bereavement, trauma, increasing hunger and violence.

What is needed, he said, is to cultivate a sense of social solidarity.

“If we don’t have that, this country will fall apart under the strains that are coming in the months ahead,” said Heywood.

Gray delivered a similar concluding message.

“The next 100 days are going to be very sobering,” she said, warning of bereavement, trauma, increasing hunger and violence.

“We have to be prepared for a different kind of South Africa.”

But Gray also stressed that she had faith in the innate resilience of South Africans to overcome these challenges.

“We need to dig deep into the character of our citizens and find the humanity that will help us get through.” DM