🔒 How world sees SA: Cape Town super-spreaders on global Covid-19 hotspot map

The world is watching Covid-19 developments in Cape Town, which stands out as having a much higher rate of transmission than anywhere else in Africa. The Washington Post has produced an in-depth feature, telling its readers that South Africa’s strict lockdown has had the opposite of its intended effect in the Mother City, driving individuals to contaminated supermarkets after local shops were ordered to close. President Cyril Ramaphosa announced last week that by the end of May the government will transition its lockdown to a tiered approach, in which areas with hot spots will have more restrictions than those without. Schools reopen from June. But the forecast is for a spike in cases as the country heads into winter. – Jackie Cameron

By Thulasizwe Sithole

Cape Town is best-known internationally as a tourism hotspot – but now it has earned a reputation as being Africa’s Covid-19 hotspot. That’s the message in the Washington Post, which notes that the city accounts for 60% of cases in South Africa, 15% in sub-Saharan Africa and 10% of Africa’s as a whole.

“South African epidemiologists are looking to the city — with more than 9,300 cases as of Tuesday — to provide insight into how the virus is spreading on a continent that has largely escaped the waves of death seen in Western Europe and the United States,” say WP reporters.

The early answer, officials and experts say, is two-pronged. First, the city welcomed more tourists from hard-hit regions of the world than did other places in Africa, meaning the coronavirus was widely seeded here early. Second, major hotspots emerged in two supermarkets and a pharmaceutical factory that supercharged the virus’s spread.

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“This is really about a small number of so-called super-spreader events,” Salim Abdool Karim, an infectious-disease expert and chair of the government’s coronavirus task force, is quoted as saying. 

“Too many people were going to the supermarkets, and they didn’t have the right procedures early enough. It just takes one person, and everything in there is contaminated — the baskets, the metal surfaces — just by breathing,” he says.

Cape Town is likely to provide an indication of what’s likely to happen in the rest of the country in the next weeks as lockdown restrictions are relaxed, says Karim.

“South Africa began targeted testing in Cape Town on April 7, and since then, the number of positives as a proportion of tests has only gone up. While the rest of the country, which is under strict lockdown, is seeing positive rates hover around 2 percent, Cape Town’s rate is regularly above 10 percent and spikes above 15 some days,” point out the reporters.

The WP says South Africa has more than 16,000 confirmed cases. “At first, they seemed to be clustered in Johannesburg and Durban, South Africa’s first- and third-largest ­cities. At that point, cases were growing exponentially, but after a lockdown went into effect on March 27, growth slowed in those cities. Less than a month later, Cape Town had eclipsed them, and it has accounted for most of this month’s positives.”

The hardest-hit areas in Cape Town are “the working-class areas of Tygerberg, which is mostly mixed-race”, and Khayelitsha, “which has an almost entirely black population”, The Washington Post tells its readers.

“Some experts cautioned against jumping to conclusions based on that geography, given that testing is most aggressive in known hot spots, and say there may be areas where cases have been largely asymptomatic. The testing centres are very much linked to where the hot spots are,” it reports.

A significant factor in the higher rate of Covid-19 infections appears to be linked to government’s early approach, which allowed tourists from hard-hit countries to enter the city until late March. Testing at the airport was largely limited to temperature checks, which don’t catch asymptomatic travellers.

Alan Winde, the leader of Western Cape, is in self-imposed quarantine after coming into contact with a TV cameraman who died last week of Covid-19, the disease caused by the coronavirus. He is quoted as saying: “I get asked every single day, why is this the epicentre?”

Winde warns that current projections show as many as 80,000 symptomatic infections in Western Cape by late July. He also outlines a new concern: logjams in testing in both government and private laboratories.

“We have a backlog of about 11,000 and Johannesburg has about 15,000 because all of a sudden our national health laboratories and the private sector are running at maximum,” he said. “If we’re not testing sufficiently and not getting our answers back quickly enough — it’s taking anywhere between six and 10 days to get a result — then that is really useless.”

For Karim, the lockdown, while credited with slowing the spread of the virus in the rest of the country, may have had the unintended effect of quickening it in Cape Town. The hotspots in Tygerberg and Khayelitsha were probably driven by the lockdown’s closure of spaza shops, akin to corner stores, that in turn drove many people to crowded supermarkets.

“That’s how this virus spreads, through hotspots. It’s not like HIV, which goes slowly from person to person. A contaminated environment leads to an outbreak, plain and simple,” Karim tells the WP. “It’s a matter of identifying them as rapidly as possible. Sometimes it’s too late — you only see the flames when it’s a full fire.”