The catastrophic Covid-19 situation in Gauteng, which has resulted in a shortage of hospital beds, oxygen and ventilators, is on track to reach the worst-case scenario, creating a dilemma for a provincial government that wants to avoid closing down the economy.
A worst-case scenario, according to Wits University physics professor Bruce Mellado, is when a resurgence will infect everyone who has not already been infected.
“The first and second waves did not follow the worst-case scenario and the numbers went down long before herd immunity was reached. The third wave in Gauteng is following the worst-case scenario.
“The additional problem is that we have had a spike within the wave and perhaps we are seeing a second one. That is very serious,” he said.
Mellado, the head of the Gauteng government’s Covid-19 medical advisory committee, was speaking during a media conference on Thursday. What would be critical, Mellado said, was if the spike in cases experienced by Gauteng on Wednesday continued in the next two days and was worse than that day’s figure — a record at more than 10,000 — which might indicate that tighter and harsher measures were needed.
SA’s economic powerhouse was among the hardest hit by the severe lockdowns of 2020, which wiped out a decade of growth and accounted for most of the more than 1-million jobs lost in the country.
Gauteng premier David Makhura, whose administration has come under severe criticism for a failure to prepare for the third wave, including delays in getting Charlotte Maxeke hospital working again after a fire in April, castigated residents for their lack of compliance with health protocols, such as the wearing of masks and maintaining social distancing.
He said “law enforcement would increase quite dramatically over the next few days” including roadblocks.
On Wednesday, Gauteng recorded 10,806 cases, or 62% of all those nationwide, exceeding the peaks of the first and second waves. This has resulted in reports of patients queuing outside hospitals, and ambulances standing in line to drop them off.
Mary Kawonga, head of Makhura’s Covid-19 advisory team, said the number of cases in Gauteng on June 21 was about 45 per 100,000 of the population compared with 34 in the second wave.
Makhura said hospitalisations in public and private hospitals on Thursday totalled 5,842, up from about 3,800 five days earlier. Hospitalisations lag infections so there are likely to be more admissions following the recent surge in cases.
The seven-day rolling average for the test positivity rate for Gauteng on Wednesday was 34% and the daily test positivity rate was an extremely high 37%, which indicated a very high level of community transmission, Kawonga said.
According to the World Health Organization, the positivity rate must be below 5% for the pandemic to be under control. Nationally, the positivity rate on Wednesday was 24.9%, according to the National Institute of Communicable Diseases.
According to the SA Medical Research Council, in the week June 13-19 there were 3,124 excess deaths — the number of deaths above what would normally be expected — and there have been 173,000 since May 3 2020, indicating fatalities from Covid-19 have been much higher than the official number of around 60,000.
While there has been speculation of tighter lockdown restrictions, Makhura said a shutdown of the economy as happened under level 5 in 2020 was unsustainable for Gauteng.
“We cannot afford to shut down the economy,” Makhura said, adding that he would not ask this of the national coronavirus command council. He was not in favour of different levels of restriction for different regions.
Kawonga said the province proposed that hybrid measures be adopted combining some level 4 and level 3 restrictions and questioned whether the existing alcohol restrictions were sufficient.
Regarding bed availability, the premier said beds at hospitals were being repurposed for Covid-19 cases and some elective surgeries were being postponed. Blocks one and two of Charlotte Maxeke hospital, which were unaffected by the fire that ravaged the facility and took about 1,000 beds out of circulation, had been cleared for use by structural engineers. The oncology unit was also ready.
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