South Africa is living a virtually indispensable containment containment of COVID-19, after in just three weeks it has gone from a confirmed case to around a thousand, one of the fastest spreads in the world.

Just last Thursday the 5th the country reported its first confirmed person with the new coronavirus strain. A week later there were already 17 in five of its nine provinces and two weeks later the cases totaled 928. President Cyril Ramaphosa took advantage of his participation in the virtual conference of the Group of 20 (G20) to make the announcement of the number of infected, but with the caveat that there is fear that the number may be higher.

Health authorities estimate that 60 percent of its population, some 34 million of its nearly 57 million inhabitants, could acquire the infection, which would be the most important challenge for the health system.

In the country at the southern tip of Africa, healthcare is constitutionally guaranteed, and is provided in both public and private institutions.

Public institutions bear the greatest burden of care, serving 84 percent of the population, while 16 percent attend private doctors, hospitals, and clinics.

The situation has a first complication when it is considered that 64.7 percent of South Africans live in rural areas.

Going more in detail, each year, about 1,300 doctors graduate from South African medical schools, which for the World Health Organization (WHO) is insufficient for the size of the population.

In fact, a report from the specialized site Bloomberg indicates that there are 0.9 doctors for every thousand patients, a lower rate than that registered by Brazil, Russia, China and Mexico, coincidentally all partners in the Group of 20.

However, another study by the University of Cape Town’s Graduate School of Business places that rate even lower, at 0.77 doctors per thousand patients.

The third complication that is faced is the migration of health professionals, which is the same between the nurses and doctors sector, although the WHO warns that studies are needed to specify this migration.

However, the organization itself warns that this migration is a fact, since South African doctors have a good theoretical and clinical preparation.

That, not counting the migration that occurs from the public to the private sector, where working conditions are better as are wages.

With this structure, South Africa began to face the pandemic, which has left a greater number of cases than in any other country on the continent.

Perhaps this is why it is understood that people on the streets say that they are afraid and in preparation for the curfew that began on Friday the 27th, they have gone to the worship centers to pray and ask that COVID-19 leave.

The classic transmission route that begins with infections from abroad and then occurs locally, in South Africa seems to have accelerated to the maximum.

We have to alert all South Africans that the risk of internal transmission has been established. Once the infection begins to spread in taxis and buses, a new dynamic is created, Health Minister Zwei Mkhize warned.

The classic alert where the population over 60 years of age is the most at risk, in South Africa is low, since only nine percent of its inhabitants are in that range.

But in contrast, other health conditions stand as much higher risk, specifically because of the high prevalence of human immunodeficiency virus (HIV) and tuberculosis, which means that all age ranges are at risk.

HIV-positive South Africans reach 7 million, and 2 million do not receive any treatment, said Susan Goldstein, deputy director of the Wits Center for Health Economics and Science Decision. It is a very worrying situation, he told the Aljazeera chain.

The public health expert points out that it is not known how the pandemic could develop in the poorest areas where quarantine sites are non-existent, but expresses confidence that private sector clinics and hospitals can open their doors.

Only then would we have enough beds, and that is precisely what national health insurance is trying to achieve, he adds.

South Africa, to date in the presidency of the African Union (AU), called for unity at this time and specified that the contagion figures in the other countries of the continent are not compared.

Prior to the start of the stoppage of activities, South Africans had a national day of prayer seeking to allay their worst fears.



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