Lockdown: the what, why, when and where to from here
Zweli Mkhize explains the move from one-size-fits-all to district-based approach, which bodes ill for the Cape
South Africans have borne the brunt of a nationwide lockdown for seven weeks, with the diligence and perseverance of citizens proving effective in curbing the spread of Covid-19 in the country. President Cyril Ramaphosa on Wednesday announced that the government is now preparing for a further easing of the lockdown and a gradual opening of the economy.
Alert levels 3 to 1 will allow a progressively greater relaxation of restrictions.
The president said some areas of the country may be designated at a particular alert level, while others may be designated at other levels. The move comes after careful negotiation between the associated risks of continuing restrictions on economic activity and the likelihood of an upsurge in positive Covid-19 cases should the lockdown be ended abruptly.
What the government has achieved in this time to combat the virus is immeasurable. Close to 10 million people have been screened for Covid-19 and testing in the public and private sector has been ramped up exponentially, with 270,000 more tests being conducted in this period than initially planned for.
The government has also worked fervently to increase the number of beds in hospitals across the country in preparation for an influx of patients with Covid-19.
The two phases of lockdown experienced thus far, levels 4 and 5, have been implemented successfully, assisting in flattening the curve of the Covid-19 spread and buying the government time to strengthen the health-care system. But the collective response to the virus has not come without challenges.
Community organisations, specifically local government, civil society, religious organisations and community policing forums, will be empowered to monitor compliance and enforce regulations.Health minister Dr Zweli Mkhize
In some instances, data emerging on case numbers in some provinces has been misaligned and sometimes inaccurate. Covid-19 hotspots have emerged in the Eastern Cape and Western Cape, with more than half the country’s cases emanating from the two provinces.
Cluster outbreaks concentrated in and around Cape Town are driving the pandemic in these regions and require targeted efforts to track and trace contacts in the Western Cape and Eastern Cape.
The time has now come to look forward and take bold steps to beat the virus. The government has thus prepared a district-based approach to its Covid-19 response, moving away from a one-size-fits-all method.
The World Health Organisation (WHO) has provided sound guidelines for countries contemplating the easing of lockdown. These include:
- Evidence showing that the Covid-19 transmission is controlled and the public-health capacity in that area can easily identify, isolate, test, treat and quarantine every case, and trace every contact.
- Outbreak risks needing to be minimal and preventive measures in workplaces and schools needing to be put in place.
- The risk of importation being managed and communities empowered to adjust to new norms under different levels of lockdown.
Districts have therefore been differentiated in accordance with the average active cases experienced in one week. Depending on the average active cases per 100,000 people, districts will be individually assigned levels of lockdown.
The case numbers will be monitored and the National Coronavirus Command Council (NCCC) will review the level of lockdown per district every two weeks. Inter-sectoral and interdepartmental oversight structures will be put in place with the guidance of national government and corresponding regulations pertaining to each level of lockdown will be integrated into each district.
Community organisations, specifically local government, civil society, religious organisations and community policing forums, will be empowered to monitor compliance and enforce regulations. This should bring communities together, rather than create hostility against members of the police and the army.
While these measures are put in place, more needs to be done to bolster our health-care system. Professional medical teams need to be reinforced with medical experts, psychologists and social scientists. Each district should have a dedicated rapid-response team to intervene should there be cluster outbreaks while screening, testing and case management are conducted.
According to current estimates, without the implementation of the lockdown and other measures, at least 80,000 South Africans could have been infected with Covid-19 by now and our death toll could have been eight times higher. The lockdown was, therefore, necessary.
While South Africans move to different levels of lockdown, the fundamentals of Covid-19 prevention should not be forgotten. Social distancing, wearing cloth masks in public, and regular hand hygiene should persist.
• Dr Mkhize is SA’s health minister.