South Africa has the world’s fifth highest COVID-19 cases

South Africa has recorded over 434,200 cases of the coronavirus, making it the fifth highest country in the world, with only slightly fewer cases than Russia, and placing it above the UK, Iran and Italy.

The number of cases is rising rapidly. According to the Financial Times , “It took three months for South Africa to record its first 100,000 cases on June 22. It then hit 200,000 on July 6. The rate at which detected cases are doubling in the country, about every two weeks, implies that confirmed infections will be one million early August. The country’s peak may be that month or September, according to modelling carried out for the South African government.”

While the country of 58 million people has officially recorded more than 6,655 deaths due to the disease, the South African Medical Research Council (SAMRC) has calculated that the number of excess deaths over the comparable figure in previous years suggests a death toll of more than 17,000.

These figures included deaths from conditions such as HIV and tuberculosis that might normally have been diagnosed and treated but for the redirection of health resources to the pandemic, as well as those caused directly by COVID-19. Some people are thought to be avoiding seeking treatment as fears of the virus spread and public hospitals are overwhelmed.

The real number of deaths due to the pandemic is considerably higher than the officially reported numbers, thanks to the woeful state of the country’s health care system. A BBC investigation in Eastern Cape found that hospitals and clinics were filthy and dilapidated, with medical staff having to do cleaning and laundry. Its health care systems, underfunded and starved of resources for decades, were in complete collapse, amid disturbing reports of unborn babies and mothers dying in overcrowded and understaffed wards. Nurses and doctors reported a lack of personal protective equipment (PPE), no ambulances and a complete lack of ventilation, with patients sleeping on the floor “under newspapers” and others fighting over oxygen because of severe shortages.

Dr Michael Ryan, director of the World Health Organization’s (WHO) Health Emergencies Programme, said, “I am very concerned right now that we are beginning to see an acceleration of disease in Africa.” He added, “While South Africa is experiencing a very, very severe event, I think it is really a marker of what the continent could face if urgent action is not taken to provide further support. South Africa may, unfortunately, be a precursor, it may be a warning for what will happen in the rest of Africa.”

Of the more than 812,000 cases and 17,000 deaths recorded in Africa, home to 1.3 billion people, more than half have been in just five countries—South Africa, Egypt, Algeria, Nigeria and Ghana—in part due to their higher testing capacity. But according to the WHO, the pandemic is spreading rapidly, with cases more than doubling in the last month in 22 African countries, with particularly sharp spikes in Ethiopia, Kenya, Cameroon, and Djibouti, mostly from community transmission.

According to the Surgo Foundation, even its lowest estimates of Africa’s fatalities—based on age and gender distribution and adjusted for poor quality of health services and co-morbidities, such as HIV/Aids—implies that if 60 percent of Africans eventually become infected, more than 4 million will die.

Africa Centres for Disease Control and Prevention (Africa CDC) chief John Nkengasong said, “Our hospitals will be overwhelmed,” and urged governments to carry out more testing, tracing and isolation.

Gauteng province, which includes Johannesburg and Pretoria, is the epicentre of the coronavirus in South Africa, recording 144,334 cases or 36 percent of confirmed infections. But Health Minister Zweli Mkhize has warned that KwaZulu-Natal, South Africa’s coastal province centred around Durban, could “take over” as the next epicentre.

Dr Bandile Masuku, a Gauteng official, shocked the country recently when he said that the province was preparing 1.5 million graves. Asked about the preparations, Africa CDC chief John Nkengasong said, “There’s absolutely no harm to think ahead” and that it was best to plan for the “worst-case scenario.”

In a bid to contain the virus, the African National Congress (ANC) government of President Cyril Ramaphosa announced the reintroduction of some lockdown measures, including a night time curfew, a ban on gatherings and social visits, and the closure of all schools for four weeks from July 28.

In Gauteng, thousands of teachers have chosen not to go back to the classroom for fear of catching the virus, including teachers over the age of 60 with comorbidities. Parents have chosen not to send their children back to school, with attendance ranging from 25 to 58 percent. At least 154 schools have been forced to close after reporting cases of COVID-19. Gauteng’s member of the Executive Council (MEC) for Education Panyaza Lesufi said, “The majority of learners preferred to learn at home.”

Mine workers have been particularly hard hit by the pandemic, with the platinum sector the most affected. Of the 6,623 miners who tested positive, 3,485 were from the platinum mines and 1,620 from the gold mines. At least 52 mineworkers have died of the coronavirus. Buffalo Coal was forced to cease operations after a miner tested positive. The disease is likely to spread even deeper as tens of thousands of miners begin to return into South Africa. At least 45,000 migrant mineworkers from Mozambique are returning to the country as lockdown restrictions are eased.

S&P Global Ratings predicts the South African economy, which before the pandemic was in its second recession in two years, will contract by 6.9 percent due to the pandemic, while the South African central bank predicts a 7.3 percent contraction. The treasury has revised its forecast for the 2020-21 budget deficit from 6.8 percent of GDP to 15.7 percent, with more than 20 percent of the budget going on debt servicing.

Some three million people lost their jobs over the lockdown period, and an already high unemployment rate of 30 percent is set to rise further, with the South African Chamber of Commerce and Industry fearing it could reach 50 percent. Without work and income, between five and six million workers (15 percent of adults) moved back to their villages.

The government’s pledge to provide income support failed to materialise for more than a tiny fraction of the 15 million it was supposed to help. Most of the people contacted in a research report cited in the Economist reported they had run out of money for food in May, while nearly half reported they could not afford enough food in April.

Eskom, the main government-owned power utility company, has seen its debt rise from $27 billion to $29 billion, even as the country is subject to frequent power outages. As a result of neglect, sabotage and flooding that has gone unremedied for years, the corporation has cut power generation on a regular basis. It was forced to shut its Camden plant that generated 1,600 megawatts amid fears that “the dam where it stores ash from burning coal was at risk of bursting.”

The power outages have battered the economy and created widespread suffering and discontent. Workers and their families living in the townships in poorly ventilated and poorly insulated shacks have been left to battle the elements as the winter digs in. At least six provinces will receive “disruptive” snowfall, “very cold conditions” and blizzards in the coming weeks.

The police have responded with force to protests and strikes. To cite two recent examples, community care workers demanding permanent employment in Eastern Cape province were met with stun grenades and rubber bullets after refusing to leave provincial health department’s offices, while 40 workers demanding unpaid wages were arrested and imprisoned in Stellenbosch.