Flawed testing strategy made extended lockdown crucial, say experts

09 April 2020 - 21:20 By Tanya Farber
President Cyril Ramaphosa arriving at the Department of Health's Covid-19 Information Centre on April 9 2020, hours before addressing the nation
President Cyril Ramaphosa arriving at the Department of Health's Covid-19 Information Centre on April 9 2020, hours before addressing the nation
Image: GCIS

The extended lockdown announced by President Cyril Ramaphosa on Thursday will give SA vital data about the spread of Covid-19 which it missed out on earlier in the pandemic.

This is according to epidemiology and infectious disease experts who said the criteria for testing before April 3 were too stringent.

South African president Cyril Ramaphosa announced an extension to the nationwide lockdown on April 9 2020. Speaking in Pretoria, the president said that while there is evidence that the lockdown has helped in the fight against Covid-19, an additional two weeks is needed to continue efforts to reduce new infections.

Prof Jabulani Ncayiya, an epidemiologist from the University of Cape Town, said extending the lockdown until the end of April had “bought us time to put more measures in place to control the spread”.

He said SA had “lagged behind in testing” but  increased cases “can help us see how and where it is spreading, and whether other measures we put in place are working”.

Ncayiya said an extended lockdown would not have been decided “just for the sake of it” and that “intensifying measures” would result from the new data.

He said the decision by Ramaphosa and the national coronavirus command council was a “balancing act” between public health concerns and the “socio-economic impact of lockdown”.

The right decisions had been taken, but “ramping up testing could have been done earlier because that data is so vitally important. If you don’t have information, you don’t have the data to respond appropriately.”

Prof Shabir Madhi, a Wits University expert on infectious diseases, told TimesLIVE on Thursday it was “very likely that we didn’t maximise the opportunity” because we didn’t scale up testing quickly enough.

He added: “Testing should have been done at scale to test anyone who was symptomatic. As soon as we established local transmission [cases not brought in from overseas], at that point we should have relaxed the criteria for testing.”

Instead, only those who had symptoms and had been overseas or had been in contact with another positive person were allowed to be tested.

On April 3 the criteria were relaxed, but Madhi said “what is being implemented now should have been implemented right from the start”.

He feared that the lockdown, if it had not been extended, would “not have achieved much”.

Dr Kerrin Begg, a global health expert at Stellenbosch University said: “There is always a balancing of benefits and harms we need to take into account when making policy decisions, and there are also uncertainties and unknowns.”

While physical distancing was a key strategy, one also had to consider “the economic aspects of livelihood, because it’s no good if people can’t afford to eat”.

Until a week ago, said Begg, cases were being brought in from outside the country. “Now our biggest worry is community transmission, especially for those in informal settlements and other densely populated areas.”