The Coronavirus Response in South Africa

Countries should not face penalties for effective reporting on coronavirus variants; doing so incentivizes staying silent on dangerous new cases. [Photo: Getty Images]

Note: A podcast episode by WZB’s Soziologische Perspektiven auf die Corona-Krise with Joseph Harris on the same topic can be found here. 

South Africa was hit hard during the country’s first coronavirus wave that began in March 2020. While an aggressive lockdown was initially praised for stopping spread and saving as many as 20,000 lives, the lockdown had important consequences of its own. And as pressure to reopen grew, by July 2020, the country stood mired in the largest coronavirus outbreak on the continent and one of the largest in the world. What factors left South Africa so vulnerable to the coronavirus? What policies and programs comprised the governmental response? How has the country navigated COVID-19 since that time, and what support can Germany and other industrialized nations offer the country today? Based on a chapter Harris wrote on the politics of South Africa’s coronavirus response in an edited volume that can be accessed for free here, his present article explores these questions.

South Africa had been decimated by a plague once before in the past 40 years. An HIV/AIDS pandemic made funerals a hallmark of daily life in the country in the 1990s and has left more than 7.5 million South Africans live with HIV, or nearly a fifth of the adult population. The country also has one of the largest TB burdens in the world, with tuberculosis being the leading cause of death in the country.

The precarity of immunocompromised life in South Africa is compounded by economic precarity. More than half of South Africans live in poverty, with official unemployment numbers that hover around 25%, and some unofficial estimates roughly double that. A legacy of apartheid, staggering inequality allows the top ten percent of the population to hold 86% of the country’s wealth. While a system of social grants offer a modicum of financial assistance to citizens, a private health system serving 15% of the population (and holding 70% of the nation’s ICU beds) receives the same amount of financial resources as the public system that serves 85% of the population.

South Africa’s pandemic policies

Cyril Ramaphosa’s election as president in 2019 offered promise of a brighter future and a break from the corruption that marked immediate past president Jacob Zuma’s tenure and the infamous AIDS denialism of President Thabo Mbeki before him, whose policy decisions ultimately cost the country more than 330,000 lives. A businessman, former union leader, and prominent member of the African National Congress, Ramaphosa spoke to a broad cross-section of the populace. However, a coronavirus outbreak that would prey on the country’s socioeconomic fragility was not on Ramaphosa’s agenda.

When the first cases of coronavirus surfaced in early March 2020, Ramaphosa sought to distinguish himself from his predecessor by ensuring that science and scientists guided his response to the coronavirus pandemic, in sharp contrast to Mbeki. Epidemiological modelling suggested a need for speed in instituting a lockdown in order to avoid the most catastrophic mortality projections. And indeed the lockdown – instituted on March 27, the day of South Africa’s first COVID-19 death – had immediate effect, leading case numbers to decline and beating epidemiological projections.

However, the lockdown – the strictest on the continent – had a profound social cost. Some 230,000 people were arrested, and twelve people were actually killed during enforcement actions. Already high unemployment soared to never seen before levels. And hunger – a problem for 14 million people before the pandemic – became an acute crisis. Social programs that were instituted to respond to these problems rolled out slowly and unevenly, with urgently needed food programs actually distributing less food during the pandemic than before it, leading civil society groups to launch lawsuits against the government. Reports of corruption surfaced – engulfing even the president’s own spokesperson – as funds intended to address the crisis began to flow.

Amid this backdrop, pressure to reopen began to grow, and as it did, frictions between the Ramaphosa administration and scientists and the medical community – once in lock-step – began to grow as well. Facing acute shortages of PPE (and later in 2021, of vaccines) as industrialized nations bought up all supply, deaths surged through the summer, and health systems became overwhelmed. And by mid-September 2020, official deaths from COVID reported by the government totaled just below 16,000, while the number of excess deaths – the number over and above what is usual – numbered almost 45,000, suggesting COVID’s true toll was much higher. More worrying, both for its potential impact on immunocompromised patients and also for its potential impact on drug resistance, the pandemic led to disruptions in access to HIV/AIDS medication.

Since I published that chapter on South Africa’s initial coronavirus response, there have been two waves in South Africa since that initial wave that killed so many, a larger Beta variant-driven wave that peaked in January 2021 (just under 20,000 cases a day) and an even larger Delta wave that eclipsed that one in July 2021. To date, official deaths from COVID number around 90,000, while the number of excess deaths from May 3, 2020 to November 20, 2021 – tracking the majority of the coronavirus waves – stands at nearly 273,000. Currently, the Omicron variant is raising alarms around the world due to mutations that could lead it to escape vaccine protections and its growing dominance as a new strain driving the current wave that is building in South Africa. South Africa is in the news again.

Germany and other industrialized countries need to support South Africa

How can Germany and the world support South Africa right now? Praising the country’s scientific community for the fantastic job they did identifying the new variant and making it known to the world would be a good start. Ensuring that South Africans don’t face discrimination with travel bans is an important second step. Despite the fact that we know Omicron is already here, EU member states have instituted travel bans. Rather than outright travel bans from affected places, important research has suggested that quarantines of about 14 days are among the most effective tools in stopping spread of the virus. In line with these findings, Germany’s RKI Institute lists South Africa as an area of variant of concern and requires travelers from South Africa to quarantine upon arrival for 14 days with no exceptions. However, the travel ban remains. Countries should not face penalties for effective reporting; doing so incentivizes countries to sit on dangerous new cases and stay silent. A third important step would be to help support pandemic relief programs, particularly food support programs, in South Africa and the region. Hunger has been a major issue during the pandemic in South Africa. A temporary social relief of distress grant ended in May 2021, renewing calls by activists for an enduring basic income grant before being reinstated in August 2021. More than 10 million people have already applied. Finally, ensuring that the South Africa’s scientists have the reagents they need to continue the important sequencing work they are doing, identifying new variants, amid travel bans will be critical for South Africa, Germany, and the world.

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