The lockdown restrictions that do and don’t work in South Africa: expert

South Africans planning to travel domestically over the December holiday period should continue going ahead as planned, says professor Shabir Madhi, professor of vaccinology at the University of the Witwatersrand.

Speaking in an interview with Health360 this week, Madhi said he does not believe that the government will introduce the same level of restrictions as in December 2020, where the country faced a second wave of Covid-19 infections.

He added that the decision to close beaches over this period last year did not achieve anything and that South Africa should remain ‘open for business’ domestically.

“The most important thing is that we avoid congregating indoors, where we don’t know the vaccination status of others. This is especially important where people are not wearing face masks and are in poorly vaccinated areas.

“Those sort of activities lend themselves to the rapid spread of the virus which can then lend itself to overwhelming healthcare services, which we are looking to avoid.”

Madhi encouraged people to do activities outdoors, get vaccinated and get a booster dose if eligible.

“If you haven’t been vaccinated now is a good time to forget your ego and the misinformation, and simply do the right thing.”

The restrictions that do and don’t work 

South Africa’s experience over the last 18 months of the Covid-19 pandemic shows that the various government lockdowns were not effective in reducing infections, said Madhi.

While the restrictions might have bought some time during the initial Covid-19 wave to prepare healthcare facilities, this is about the total gain.

Beyond this, the lockdowns have been largely superfluous except where the country’s healthcare facilities are coming under threat, he said.

Madhi said that the quickest way to address this threat is to try and reduce the number of trauma cases at hospitals, such as through curbs on alcohol abuse.

However, he said that this should be done at a regional level where specific healthcare facilities are under threat and not at a national level. He said this extends to other lockdown restrictions such as closing pubs and clubs.

Mahdi said that he does not expect these restrictions will be needed for the country’s fourth wave driven by the Omicron variant; while transmissibility is high, the number of hospitalisations are still relatively low.

Hospitalisations important factor 

Health experts have raised concerns around the rapid increase in Covid-19 infections in South Africa. However, authorities are still tracking the rate of hospitalisations, deaths and severity of the Omicron variant before deciding on new lockdown restrictions.

Professor Koleka Mlisana, co-chairperson of the government’s Ministerial Advisory Committee, told eNCA that there was still not enough data to analyse how severe South Africa’s new Omicron cases are.

She cited anecdotal reporting from hospitals that show that younger age groups are currently the most affected by the variant but that the length of hospitalisations is shorter compared to previous Covid-19 cases. This means the country is probably looking at a milder form of the disease – but she reiterated that it was still too early to tell based on the information available.

South Africa has introduced several lockdown restrictions since the start of the Covid-19 pandemic in March 2020, with the majority of these measures aimed at easing the strain on the country’s hospital and healthcare sector.

While a milder virus could mean less strain on hospitals, and less stringent restrictions, Mlisana said there is still cause concern as the rapidly increasing Omicron Covid-19 cases risk overburdening the health system.

In a national address on Sunday evening (28 November), president Cyril Ramaphosa says that South Africa will keep its lockdown restrictions unchanged at level 1 but will review lockdown measures over the coming week.

“In taking the decision not to impose further restrictions at this stage, we considered the fact that when we encountered previous waves of infection, vaccines were not widely available and far fewer people were vaccinated.”

The president has also established a task team to look at the introduction of mandatory vaccinations for certain activities.

“Government has set up a task team that will undertake broad consultations on making vaccination mandatory for specific activities and locations,” he said.

“The task team will report to the Inter-Ministerial Committee on Vaccination chaired by the deputy president, which will make recommendations to Cabinet on a fair and sustainable approach to vaccine mandates.”

Ramaphosa said that the introduction of such measures is a complex and challenging issue but is necessary to combat the spread of the virus. “If we do not address this seriously and as a matter of urgency, we will continue to be vulnerable to new variants and will continue to suffer new waves of infection.”

South Africa’s daily number of confirmed Covid-19 cases almost doubled from Tuesday as the omicron variant takes hold. According to the National Institute for Communicable Diseases, the country recorded 8,561 infections in the last 24 hours and a positivity rate of 16.5% on tests.

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