S' Africa: Infectious Diseases expert reflects on two years of pandemic disruption

It has been a turbulent two years for the country with well in excess of three and a half million cases of the virus and more than 97-thousand deaths. 

According to the latest (16 February) government figures in South Africa less than half of the population, 47 percent, is vaccinated against COVID-19. The first patient was a 38-year-old man who had returned from a visit to Italy with his family on March 1. He'd gone to see a doctor two days later after developing symptoms.

South Africa became the first country in southern Africa and the third in sub-Saharan Africa to register a case of the new coronavirus.

The lockdown in South Africa started on the 27 March 2020 - it has been described as one of the toughest in the world.  There was a night-time curfew and a ban on the sale of alcohol and tobacco products as the country sought to curb people's social contacts.

By April the country had begun PCR testing for the virus.

Residents in townships in Johannesburg were urged to make the most of free COVID-19 testing in mobile tents provided by the local municipal governments.  Officials also handed out pamphlets to raise awareness of the disease.

Dr Jeremy Nel an Infectious Diseases Specialist at the University of the Witwatersrand says the country tried to do everything by a rulebook most countries were following.  These included isolating cases, lockdowns, social distancing and compulsory mask wearing.

He says: "I think in the beginning South Africa did really well a lot of things, but then unfortunately, as it turned out, it was just bad luck that the things that did well, it didn't really help a huge amount."

----  Lockdowns and Testing ---- 

The lockdowns imposed tremendous hardship on the population.  In the South African township of Olievenhoutbos, five weeks after lockdown began, thousands of people queued for food handouts.

COVID-19 restrictions put more people out of work in a country that already had a high unemployment rate and millions of people living in poverty.

Frontline health workers and care staff were also concerned about their risk of infection.

At the time even the scientists knew little about the coronavirus which had brought the world to a standstill.

Nel remembers: "There was a lot of staff anxiety in the beginning because of the fear of catching COVID. The fear of getting ill in the line of duty, so to speak and again, not made better by the unknown. And many people wondering how they can protect themselves and who's going to get sick and et cetera."

As the world scrambled for PPE, South African doctors found their staff had received a poor deal.

Nel says it was due to the fact that South Africa, like many other countries on the continent, was reliant on imports for supplies.

He says: "We used to get most of our PPE from Europe and Europe had just been hit with COVID just before us. So all the PPE was in Europe and they were using it themselves and we struggled to get (it) and that added to the anxiety because we were very much touch and go as to where they would have to say enough masks for healthcare workers. And it's difficult because I think you have every expectation to say that if we give appropriate PPE to health care workers, they must work and they must do the job because that's what we all signed up for. It's different, though, if you don't have PPE, that's asking a lot of people to walk into a room where they can easily, easily get infected. "

As the Christmas holidays approached, South Africans found themselves in a second lockdown.

----- Vaccination drive --- 

There has been a great deal of debate about the equitable sharing of COVID-19 vaccines.

According to the journal Nature, countries on the African continent import 99 percent of vaccines, and most do not produce the ingredients.

The country's second COVID-19 surge saw a return to alcohol bans and stricter night-time curfews.

The discovery of the Delta variant of COVID 19 caused the greatest concern, it led to more severe symptoms.

On the 24 June 2020 South Africa started a vaccine trial, the first to take place in Africa.

The trial of the vaccine developed at the University of Oxford in Britain would also be conducted in Britain and Brazil, but Nel says access to the vaccine has been disappointing for South Africans.

"Had we had more people vaccinated by the third wave, for example, we would have saved a lot of lives. So many people, you know it's a very tragic thing to be staring at someone who's struggling for breath on a ventilator when knowing that the vaccine actually was available to them. And for whatever reason, you know, they didn't get it and it may not be their fault. Maybe there just wasn't, the access wasn't good enough. Or maybe, you know, maybe they had doubts, they were delayed or whatever, for whatever reason, but they could have had it. In theory, it's available in the country. And you know, we were seeing people coming in and dying who didn't need to die, " recalls Nel.

Like most of the world, South Africa has had to struggle with yet another variant, this time omicron.

Nel says the picture in his country now is the same everywhere.

"We see omicron now spreading throughout the world, every country now gets the same picture of the waves (of infection), you really just can't slow it down and that's because it's so much more infectious than the beginning waves, the previous virus."