Western Cape's Covid-19 toll a taste of things to come for all SA, says Abdool Karim

All eyes are on the Western Cape as the epicentre of Covid-19, with the province accounting for 211 of SA's 312 fatalities.

But Prof Salim Abdool Karim said on Wednesday it was probably just a matter of time before the rest of the country saw the same pattern. He said the Western Cape was providing an “early indication” of how the pandemic played out, and this included “a much higher number of cases in the hospitals”.

“When we look at the way an epidemic occurs, we have an eight-stage strategy. We have finished the first four - preparation; prevention; lockdown; and active case-finding with field workers looking for patients.

“We are now in stage five of going to hotspots, but that started in the Western Cape two weeks ago,” Karim, chair of the health ministry's advisory committee on Covid-19, told a webinar organised by the South African Clinical Trial Research Association.

In Cape Town, Khayelitsha Spar, Goal Supermarket in Delft and the GlaxoSmithKline factory in Epping seeded hotspots in which 552 tests produced 223 positive results.

That is a positivity rate of 40%, compared to a national average below 2%.

Karim said: “Everyone is asking, if we don’t have a problem, why are we sitting at home? But the fact is, we don't have a problem because we were sitting at home.”

He said it wasn’t a case of “trying to end the pandemic” or getting to a point where it was “out of control”.

The goal, simply, was to flatten the curve so that “the capacity exists to care for patients” when the clinical burden becomes heavy.

What SA must avoid is a situation similar to those in New York and Italy, in which “the virus is left unchecked and spreads so rapidly that it begins to overwhelm the health-care system”.

SA was on its 52nd day since confirmation of the 100th Covid-19 case, Karim said, adding that data before the 100th case was too limited to be significant. 

“Our entire population is at risk - rich, poor, men, women ... and one in five of those who have symptoms may need hospital care,” he said.

Before lockdown, the number of active cases was doubling every two days. After lockdown, it was doubling every 15 days. 

“It was slowing down, and since the easing of the lockdown, we have maintained a pretty reasonable rate of around 12 days for active cases to double.”