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Expect COVID-19 outbreaks after the end of lockdown

It’s a new normal, warn South Africa’s leading coronavirus scientists. And schools and workplaces won’t be exempt from seeing sporadic outbreaks of the new coronavirus, they say.

South Africa will see outbreaks of the new coronavirus after a national lockdown eases on 1 May, warn leading epidemiologists Quarraisha Abdool Karim and her husband, Salim.

“It’s going to happen whether we like it or not,” chairperson of the ministerial advisory committee on COVID-19 Salim Abdool Karim explained. “It is just how this virus continues to spread.”

Salim Abdool Karim is also the director of the Centre for the Aids Programme of Research in South Africa (Caprisa). He was speaking Thursday as part of a webinar organised by the Bhekisisa Centre for Health Journalism. He was joined by fellow committee member Quarraisha Abdool Karim, who is also an associate scientific director at Caprisa. The pair have been helping to lead South Africa’s response to the new coronavirus, known as virus SARS-Cov-2.

“The key thing is not to get worked up about it,” Salim Abdool Karim cautioned. “You know what to expect, you know it’s coming, and when you see it, we’ll put in place [ways to mitigate it].”

South Africa embarked on a national lockdown to stem a rising tide of SARS-CoV-2 infections on March 27. Data developed in part by the Abdool Karims shows that the lockdown helped to slow down the rate of infections, which in late March were doubling almost every two days.

Today, cases of the new virus are doubling roughly every two weeks, Salim Abdool Karim revealed.

Levels of transmission of the virus within communities remain low, he said, citing data from South Africa’s community screening and testing programme that shows about 3% of those referred for testing are diagnosed with the virus. 

[WATCH] Expect outbreaks in schools and workplaces

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Starting 1 May, lockdown restrictions will ease slightly — allowing more workers to return to their jobs and Grade 7 and Grade 12 pupils are expected to be back in class in June, the department of basic education announced yesterday. 

But workplaces and classrooms will not be immune to what the duo of scientists expect to be small local outbreaks across the country. 

“We cannot stop this virus from spreading. We have to find a way of living with it,” they said.  

Various mathematical modelling exists locally and internationally to try to predict the course of South Africa’s COVID-19 epidemic — the disease caused by the new virus. Salim Abdool Karim says most projections agree that a significant increase in cases is expected sometime between July and September. When this happens, the government may re-institute a level 5 national lockdown, much like the one the country just concluded on 30 April.

“We have the next two to three months to get back into our lives…and we can then expect when the transmission starts occurring rapidly that alert levels will go back up rapidly,” Salim Abdool Karim explained.

South Africa’s coronavirus alert level system explained

Another level 5 lockdown is possible

President Cyril Ramaphosa recently announced that the country had developed five different COVID-19 risk alert levels and that — using hyper-local data on the epidemic — these varying risk levels could be applied nationally, provincially and even at a district level. These risk levels are determined mainly by how many COVID-19 cases are being reported in an area and the strain on healthcare services.

But periodic outbreaks are likely to be part of what Quarraisha Abdool Karim called a “new era” until an effective vaccine against SARS-CoV-2 can be found. 

“The absolute reality is that the virus is here and we’re going to have to live with it,” she said. “We could cocoon ourselves for 18 months until we get a vaccine or we can slowly start doing things.”

She continued: “But I wouldn’t call it going back to normal.”

The duo says South Africans will need to remain vigilant despite the easing of lockdown restrictions, practising social distancing and continuing to don cloth masks and wash hands frequently.

We are testing enough people for the new coronavirus

By the end of Thursday, South Africa had conducted 207 530 new coronavirus tests. Still, there has been widespread concern that the country does not have the capacity to test enough people to know for sure the size of its outbreak. 

To increase testing, the government has roped in academic and research laboratories to perform the complicated test required to diagnose COVID-19 alongside private and public laboratories. But so far, the country has not been able to process more than about 11 600 tests in a single day — far fewer than the 30 000 to 35 000 the National Health Laboratory Services said it had the capacity to do by the end of April. 

But Salim Abdool Karim says that based on the rate of people testing positive for the new virus, current testing levels are adequate.

“We could do 30 000 tests per day but doing that many tests per day may not be the wisest use of our resources at this stage,” he said. “Our target [number for] testing is much lower than 30 000 tests a day — we should be doing about 8 to 10 000 tests a day instead.” 

He concluded: “But our priority is to make COVID-19 testing available to everyone who is sick.”

Laura Lopez Gonzalez is a freelance health journalist and editor. She was Bhekisisa's news editor then deputy editor between 2016 and 2020.