COVID-19 pandemic in South Africa
|COVID-19 pandemic in South Africa|
|First outbreak||Wuhan, Hubei, China|
|Index case||Hilton, KwaZulu-Natal|
|Arrival date||5 March 2020|
(1 year, 4 months, 3 weeks and 2 days ago)
|Confirmed cases||2,383,490 +5,683 as of 26 July 2021[update]|
|Active cases||144,020 as of 26 July 2021[update]|
|Recovered||2,169,452 as of 26 July 2021[update]|
|70,018 +243 as of 26 July 2021[update]|
|Test positivity rate||24.3% as of 26 July 2021[update]|
(2,437,167 complete) as of 26 July 2021[update]
The COVID-19 pandemic in South Africa is part of the ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 5 March 2020, Minister of Health Zweli Mkhize confirmed the spread of the virus to South Africa, with the first known patient being a male citizen who tested positive upon his return from Italy. The first death to have occurred from the disease was reported on 27 March 2020.
On 15 March 2020, the President of South Africa, Cyril Ramaphosa, declared a national state of disaster, and announced measures such as immediate travel restrictions and the closure of schools from 18 March. On 17 March, the National Coronavirus Command Council was established, "to lead the nation's plan to contain the spread and mitigate the negative impact of the coronavirus". On 23 March, a national lockdown was announced, starting on 27 March 2020. On 21 April, a 500 billion rand stimulus was announced in response to the pandemic. Ramaphosa announced that from 1 May 2020, a gradual and phased easing of the lockdown restrictions would begin, lowering the national alert level to 4. From 1 June, the national restrictions were lowered to level 3. The restrictions were lowered to alert level 2 on 17 August 2020. From 21 September 2020, restrictions were lowered to alert level 1.
In December 2020, the country experienced a second wave of COVID-19 infections. The lockdown was tightened from an adjusted level 1 to an adjusted level 3 starting on 29 December 2020. The lockdown was lowered from an adjusted level 3 to an adjusted level 1 starting on 1 March 2021. On 17 February 2021, the national COVID-19 vaccination program was officially rolled out.
On 8 May 2021, local cases of variants of concern Delta (first detected in India, which has a higher transmissibility and reduced neutralisation than South Africa's dominant variant, Beta) and Alpha (first detected in the UK, which has a higher transmissibility and is more lethal than South Africa's dominant variant, Beta) were reported. On 31 May 2021 the country was moved from adjusted level 1 to an adjusted alert level 2, due to a third wave of infections. On 15 June 2021 the country was moved to alert level 3. On 28 June 2021, the country was moved to adjusted level 4, with the Delta variant fast becoming the dominant strain in the country. On 9 July 2021, sixteen months into the pandemic, doctors in Johannesburg described the system there as beyond its breaking point, with insufficient beds and barely enough oxygen. On 25 July the country was moved to adjusted level 3.
As of 17 July 2021[update] there have been 203446 excess deaths of persons older than 1 years from natural causes since 3 May 2020, with 85-95% of these excess deaths attributable to COVID-19, and the remaining 5-15% probably mainly due to overwhelming of the health services.
First wave: March 2020 – November 2020
On 1 March 2020, the first patient later confirmed with COVID-19 in South Africa, returned with his wife and 8 others from the Metropolitan City of Milan in Italy, travelling via Dubai, O. R. Tambo International Airport in Kempton Park, Gauteng and King Shaka International Airport in Durban to Hilton. On 3 March, the patient reported with symptoms to a private general practitioner and isolated himself; the doctor isolated herself as well. On 5 March the Minister of Health, Zweli Mkhize, announced the first confirmed case, epidemiologists and clinicians from the National Institute for Communicable Diseases (NICD) were deployed to KwaZulu-Natal in response and the patient went to Grey's Hospital in Pietermaritzburg.
On 7 March, it was announced that a woman from the same travel group from Italy, returning to Gauteng, also tested positive.
On 11 March 6 new cases were reported, with 1 case from the same travel group from Italy, while the other 5 cases appear unrelated having travel histories to other European countries. The first case was confirmed in the Western Cape province. 3 new cases were announced on 12 March, including the first case in Mpumalanga province. The first local transmission and first case in the Free State province was also announced, but withdrawn later in the day by the NICD who confirmed that the case's test result was in fact negative. This brought the total cases to 16.
On 15 March, the first local transmissions, not yet confirmed by government labs, were announced by President Cyril Ramaphosa. and the following day, the first confirmed case from Limpopo province was announced. The day thereafter, on 17 March, the first confirmed cases of local transmission were announced by government labs, 4 in Gauteng, 3 in KwaZulu-Natal, and 1 in the Western Cape. On the next day, 18 March, the first confirmed case of local transmission in Mpumalanga was announced by government labs.
On 20 March, the Free State province recorded seven cases, becoming the sixth of South Africa's nine provinces to be infected. Of the seven cases, five were from abroad (Israel, France and Texas) who had congregated in Bloemfontein for a prayer breakfast attended by 859 people. The Eastern Cape reported its first case one day later.
On 23 March, a national 21-day lockdown was announced by President Ramaphosa to begin on 27 March to 16 April. By 24 March all nine provinces had confirmed cases, with the first cases in the Northern Cape and North West announced. The country's first death was announced on 27 March.
There were 1,353 confirmed cases in March. Five patients died and 31 recovered, while 1,317 remained active cases at the end of the month.
On 1 April, researchers from the NICD and South African National Bioinformatics Institute at the University of Western Cape released the genetic sequence of the SARS-CoV-2 from a South African COVID-19 patient. Pick-up trucks dispensed free hand sanitizer in Alexandra in early April.
On 9 April, it was announced that South Africa's cabinet members, which include the President, Deputy President, Ministers and Deputy Ministers would donate one-third of their salaries for three months to a solidarity fund.
On 9 April, the St Augustine's Hospital in Durban was shut down following a localised outbreak of over 60 confirmed cases and four COVID-19 related deaths; by then 1,845 had tested positive for the virus nationally with total 18 deaths.
On 13 April, chair of the Ministerial Advisory Committee on COVID-19 Salim Abdool Karim indicated that the lockdown had been effective in delaying transmissions. He also described the country's 8-stage plan to combat the coronavirus. This included criteria for extending or easing the lockdown.
By 23 April, when President Ramaphosa again addressed the nation the total number of cases had increased to 3953. Detailed figures released by the NICD showed that in April that the number of cases had taken distinct trajectories in different provinces. In the two weeks from 9 to 23 April, the cases in the coastal provinces had a very high increase – Eastern Cape cases rose 583% from a low base, KwaZulu-Natal rose 108% and Western Cape 148%. North West (67%) and Gauteng (57%) had high increases, while the other provinces had much lower increases from 6% in the Northern Cape to 23% in Limpopo (all with low absolute numbers – 106 in the Free State and under 30 in each of the other provinces).
On 30 April 2020, Ramaphosa received a consignment of personal protective equipment (PPE) donated by global internet group Naspers on 30 April. There were 4,294 new cases in April, raising the total number of confirmed cases to 5,647. The death toll rose to 103. The number of recovered patients increased to 2,073, leaving 3,471 active cases at the end of the month.
On 19 May 2020, scientists advising the government estimated 475 confirmed COVID-19 deaths by the end of that month, and more than forty-thousand deaths by November. They also estimated that there could be insufficient ICU beds by June or July. The scientists stated that these estimates were subject to deviations and were based on simple and pessimistic assumptions. By the end of the month, there had been 683 deaths, with 27,036 new cases and 16,809 recoveries.
In June, there were 118,526 new cases, raising the total number of confirmed cases to 151,209. The death toll rose to 2,657. The number of recovered patients increased by 56,734 to 73,543. At the end of the month there were 75,009 active cases.
As of 3 July 2020, the median age of those who had died was 61 years and males had a 1.5 times greater death rate compared to females.
On 12 July, in an address to the nation, President Ramaphosa announced that the anticipated surge in COVID-19 cases had arrived. The state of disaster was extended until 15 August 2020 and the alcohol ban was reintroduced along with a new curfew from 21:00 until 4:00. Resumption of alcohol sale and distribution had led to increased pressure on hospitals from road traffic accidents, trauma and violence which happened mostly at night.
On 22 July, the South African Medical Research Council (SAMRC) and the University of Cape Town's Centre for Actuarial Research estimated that 17,090 excess natural deaths had taken place between 6 May and 14 July 2020 in South Africa. These represented, by the second week of July, a 59% increase in natural deaths compared to the same time period in previous years 11,175 (65%) of these excess estimated natural deaths were in those above age 60 years. Excess natural deaths were COVID-19 related either directly or indirectly through delayed diagnosis and treatment of other conditions. Unnatural deaths, from car accidents and murders, were 20% lower than expected.
In July, there were 341,974 new cases, raising the total number of confirmed cases to 493,183. The death toll tripled to 8,005. The number of recovered patients increased by 252,628 to 326,171. At the end of the month, there were 159,007 active cases.
On 15 August, President Ramaphosa addressed the nation announcing the passing of the COVID-19 peak, the lowering of restrictions to level 2 and the extension of the national state of disaster by another month.
There were 285,067 new cases in August, raising the total number of confirmed cases to 627,041. The death toll increased to 14,149. At the end of the month there were 71,969 active cases.
On 16 September, the President made a national address where he announced the further lowering of restrictions to level 1, beginning from 21 September 2020. The national state of disaster was extended by one more month.
There were 45,531 new cases in September, bringing the total number of confirmed cases to 672,572. The death toll rose to 16,667. The number of recovered patients increased to 606,520, leaving 49,655 active cases at the end of the month.
On 18 October, Minister of Health Zweli Mkhize announced that he had tested positive for the COVID-19.
The national state of disaster was extended by another month.
For two consecutive weeks, excess natural deaths were above the normal expected rate. These excess deaths were far below the July excess death peak.
There were 52,880 new cases in October, raising the total number of confirmed cases to 725,452. The death toll rose to 19,276. The number of recovered patients increased to 654,182, leaving 51,994 active cases at the end of the month.
On 11 November, President Ramaphosa addressed the nation where he announced extension of the state of disaster by another month until 15 December 2020. Relaxation of international travel, shop trading hours restrictions along with continued COVID unemployment support were announced. There were 64,552 new cases in November, raising the total number of confirmed cases to 790,004. The death toll rose to 21,535. The number of recovered patients increased to 731,242, leaving 37,227 active cases at the end of the month.
Second wave: December 2020 – April 2021
On 3 December, the President addressed the nation. He noted a resurgence of COVID-19 in some districts of the Eastern and Western Cape provinces. Nelson Mandela Bay Metropolitan Municipality was identified as a coronavirus hotspot; restrictions were tightened for this area. The national state of disaster was extended until 15 January 2021.
On 7 December, the government said that end-of-school parties known as "rage parties" are super spreader events.
On 9 December, the Minister of Health announced that the country had entered the second wave of infections. The country was now recording over 6000 cases per day from fewer than 1000 cases per day at the end of September. The average proportion of positive COVID-19 tests had risen from 10% to 18%.
On 14 December, the President announced in an address to the nation, the closure of some beaches, lowering of the number of people that can attend gatherings and the tightening of other measures to curb the second wave.
On 27 December, the number of confirmed cases reached 1 million.
On 28 December 2020, President Cyril Ramaphosa addressed the nation again and announced that the country would go back into a partial lockdown level 3 for 14 days to reduce the speed of the second wave during the festive season. This introduced a curfew from 9 pm to 6 am, the ban on sale and transport of alcohol, closure of public amenities like beaches, lakes and dams and the compulsory wearing of masks in public.
There were 267,157 new cases in December, raising the total number of confirmed cases to 1,057,161. The death toll rose to 28,469. The number of recovered patients increased to 879,671, leaving 149,021 active cases at the end of the month.
A vaccine rollout strategy was announced on 3 January 2021, with doses for 10% of the population already secured and more on the way. During the first phase, frontline healthcare workers would be vaccinated.
On 11 January, President Ramaphosa addressed the nation. He announced the continuation of current pandemic alleviation measures, vaccine rollout developments and the extension of the state of disaster
On 13 January the government said it had arrested 7,000 people since the end of December for not wearing face masks.
In the week ending 17 January 130,000 new cases and 4,000 deaths cause public and private hospitals to be overrun. The 501.V2 variant has been found in all nine provinces as well as in foreign countries, but experts are unsure if the rise in cases is related to the new variant or to a lack of compliance with health guidelines during the holiday period. Several countries have banned flights from South Africa, and all 20 of the country's land entry points have been closed until February. South Africa lost 2.2 million jobs in the second quarter of 2020, and GDP is expected to show a 6.1% decrease for the year. In total, South Africa has registered more than 1.3 million coronavirus confirmed infections and at least 36,851 related deaths.
On 27 January the Department of Health announced the emergency use approval of the AstraZeneca Vaccine and that the transportation of one million doses would be delivered from India on 1 February with a further half a million doses in late February. They also announced a full vaccination plan as well as a platform to manage the mass vaccination of the country.
There were 396,600 new cases in January, raising the total number of confirmed cases to 1,453,761. The death toll rose to 44,164. The number of recovered patients increased to 1,299,620, leaving 109,977 active cases at the end of the month.
On 1 February, President Ramaphosa announced the arrival at O. R. Tambo International Airport of the first batch of COVID-19 vaccines produced by the Serum Institute of India. Although South Africa would remain at alert level 3, easing of restrictions effective the next day was announced because the peak of the second wave had passed. In his address to the nation, Ramaphosa also mentioned that the South African Cabinet had approved the proposal to nominate the Cuban Medical Brigade for the 2021 Nobel Peace Prize for its role in sending over 3 700 members around the world to help fight COVID-19.
On 7 February, it was announced that the Oxford–AstraZeneca COVID-19 vaccine did not work well in protecting clinical trial participants from mild or moderate illness caused by the 501.V2 variant severe acute respiratory syndrome coronavirus 2, also known as B.1.351 lineage. The vaccination programme was announced to be put on hold.
On 17 February, the national COVID vaccination program was officially rolled out, beginning at Khayelitsha District Hospital in the Western Cape Province where healthcare workers, the President and Minister of Health were given shots of the Janssen vaccine.
On 28 February, The President addressed the nation, announcing relaxation of restrictions with a move from adjusted alert level 3 to adjusted alert level 1.
There were 59,632 new cases in February, taking the total number of confirmed cases to 1,513,393. The death toll rose to 49,993. The number of recovered patients increased to 1,430,259, leaving 33,141 active cases at the end of the month.
On 5 March 2021, the number of people fully vaccinated against COVID-19 surpassed 100,000 in the country.
The South African Medical Research Council estimated more than 150 000 excess deaths during the pandemic by 20 March 2021, with 85-95% of these excess natural deaths attributable to COVID-19, and the remaining 5-15% probably mainly due to overwhelming of the health services.
On 30 March 2021, President Ramaphosa, addressed the nation ahead of the Easter Holiday. He gave information on COVID-19 vaccination progress, announced temporary restrictions on offsite holiday alcohol sales and the easing of measures around religious gatherings.
There were 34,764 new cases in March, taking the total number of confirmed cases to 1,548,157. The death toll rose to 52,846. The number of recovered patients increased to 1,474,319, leaving 20,992 active cases at the end of the month.
On 13 April 2021, Minister of Health Zweli Mkhize announced the suspension of Janssen COVID-19 vaccine (Johnson & Johnson) use following health concerns raised by the Food and Drug Administration (FDA).
There were 33,053 new cases in April, taking the total number of confirmed cases to 1,581,210. The death toll rose to 54,350. The number of recovered patients increased to 1,505,620, leaving 21,240 active cases at the end of the month.
Third wave: May 2021 – present
By 1 May there were 157542 excess deaths of persons older than 1 years from natural causes since the start of the pandemic, with 85-95% of these excess deaths attributable to COVID-19, and the remaining 5-15% probably mainly due to overwhelming of the health services.
On 8 May, The National Institute for Communicable Diseases confirmed that they had sequenced COVID-19 specimens from individuals who had recently travelled to India. This resulted in that four of the specimens tested positive for B.1.617.2 (two cases from Gauteng and two from KwaZulu-Natal). Eleven cases were also detected of the B.1.1.7 variant of concern, which has a higher transmissibility and is more lethal than South Africa's dominant B.1.351.
On 30 May, President Ramaphosa, due to a surge in COVID-19 infections, addressed the nation announcing the tightening of restrictions from adjusted level lockdown 1 to 2, beginning on 31 May 2021. The third COVID-19 wave had taken hold.
On 15 June 2021 President Cyril Ramaphosa announced that the country was moved to alert level 3 due to the third wave.
On 27 June 2021, in a national address, the President announced the tightening of restrictions with a move to adjusted level 4 beginning on 28 June 2021.
On the 25th the president announced moving the country to adjusted level 3 restrictions.
Preparations and response
On 30 March 2020, the government announced its intentions of initiating an enhanced screening and testing programme. On 3 April 2020, the NICD made alterations to its testing guidelines to further allow for anyone who presented with relevant COVID-19 symptoms to be tested (previously there were additional requirements such as history of foreign travel or recent contact with a confirmed case). By the start of April, 67 mobile testing units had been established and 47000 people had been tested, some in drive-through facilities.
Many private clinical pathology laboratories were also conducting tests. The CEO of the NHLS, Dr Kamy Chetty, said that by 9 April 2020 the majority of tests had been done in the private sector as the initial cases had been linked to international travellers who were likely to be on private medical aids.
By 9 April 2020, South Africa had conducted 68874 tests at 1.2 tests per thousand, considerably lower than for example Turkey (3.3), the United Kingdom (3.6), and South Korea (9.7). However, the ratio of positive tests to total tests conducted was significantly lower than most countries. By 10 April, the number of tests had increased to 73028, making the average number of tests per day in the first 10 days of April roughly 3300. The chair of the board of the NHLS, Eric Buch, stated that it had a capacity of 15000 tests per day and would welcome doing more tests.
On 14 April, Stavros Nicolaou, head of Business for South Africa's healthcare working group and Aspen Pharmacare executive, said that South Africa had the capacity and kits to do 25000 tests a day.
By 23 April the total number of tests was 143570. The number of daily tests increased: for the first 14 days of April the daily average number of tests was 3394; for the next 9 days the daily average was 6283. The rate of positive tests versus total tests remained less than 3%. The Minister of Health released figures that showed that of all the tests done up to 23 April 62% had been done in the private sector and 38% in the public sector. However, that ratio was changing as the public sector increased capacity. The public sector performed 63% of the new tests reported on 23 April 2020.
By 27 April, 185497 tests had been performed on South African residents, with the public sector doing the majority of the tests. Provincial test coverage varied by over a factor of 8. The number of tests per 100000 residents (based on 2019 population estimates) was Northwest 66, Limpopo 69, Mpumalanga 101, Northern Cape 111, Eastern Cape 247, KwaZulu-Natal 270, Free State 284, Gauteng 439, and Western Cape 541 (national average 317). A surveillance programme was started to monitor community transmission (as opposed to tests done on people who displayed symptoms or who had been in contact with COVID-19 patients). In the three arms of the programme 812 tests had been done and two positive cases had been detected.
By 28 June, the total number of tests was 1567084. The private sector had now overtaken the public sector, in terms of tests completed. The private sector had done 804248 test with the public sector only doing 762836.
By 11 July, 2108570 had been done with the private sector still doing the most tests.
Clinical trials, vaccines and treatment
On 17 March 2020, the South African Health Products Regulatory Authority announced that it would expedite review of treatments, vaccines and clinical trials.
A team from 8 universities and 14 hospitals led by Helen Rees and Jeremy Nel from the University of the Witwatersrand participated in the World Health Organization Solidarity Clinical Trials that investigated medications.
State of disaster
On 17 March, Ramaphosa, supported by Deputy President David Mabuza, convened the inaugural meeting of the National Command Council on COVID-19, or as it was subsequently called, the National Coronavirus Command Council, "to lead the nation’s plan to contain the spread and mitigate the negative impact of the coronavirus".
On 18 March, Minister of Cooperative Governance and Traditional Affairs Nkosazana Dlamini-Zuma signed a government gazette limiting the number of patrons at pubs, clubs, and restaurants to 50.
Parliament suspended all activities as of 18 March. and the African National Congress (ANC) and Democratic Alliance (DA) postponed their elective conferences. The Commission for Conciliation Mediation and Arbitration (CCMA) cancelled all scheduled cases from 18 March 2020 and prohibited walk-in referrals of new cases – in lieu of electronic referrals.
Schools were closed on 18 March 2020, resuming in early June. Most universities suspended classes around this time as well. University of Pretoria, University of Cape Town, Stellenbosch University, Rhodes University, University of KwaZulu-Natal and Durban University of Technology graduation ceremonies were cancelled or postponed until further notice.
After panic buying, some retailers put limitations on the number of certain items customers could buy. On 19 March, Minister of Trade and Industry Ebrahim Patel signed a government gazette that enforces price controls on essential items and that could see price gougers punished with measures including a R10 million fine, a fine equivalent to 10% of a firm's turnover, or 12 months in prison.
On 3 June, Minister Dlamini-Zuma extended the state of disaster, which was to lapse on 15 June, three months after its announcement, to 4 July citing "the need to continue augmenting the existing mitigation measures undertaken by organs of state to address the impact of the disaster."
Tobacco and alcohol
During the announcement on the lifting of level 5 lockdown measures on 23 April, Cyril Ramaphosa announced that the sale of tobacco would be permitted again, this statement was contradicted on 29 April by Minister Dlamini-Zuma. The resulting uncertainty over tobacco sales during level 4 lockdown caused British American Tobacco to file an urgent court appeal which was dropped on 6 May and reopened by 29 May. The ban raised concerns by the Human Sciences Research Council and South African Revenue Service that it would encourage the growth of illicit tobacco sales thereby growing the power and influence of organised crime. The ANC Women's League defended Dlamini-Zuma's statement amid accusations that she was receiving financial support from illicit tobacco traders. By 4 May, Ramaphosa confirmed the continuation of the ban during level 4. The Democratic Alliance accused Dlamini-Zuma of lying to the public over the strength of support for the tobacco ban and called for her removal from office. On 11 December The Western Cape High Court ruled that the tobacco sales ban was unconstitutional.
During the level 5 lockdown period, the sale of alcohol was banned; so as to reduce pressure from alcohol-related incidents putting additional pressure on hospitals. The ban was controversially reimposed on 12 July amid concerns that the ban was leading to the growth of illicit alcohol sales.
The uncertainties around the length of the lockdown, its intensity, and concerns over the erosion of civil liberties has drawn criticism from a number of notable individuals and political parties in South Africa. Former finance minister and senior ANC member Trevor Manuel questioned the rationality of the way in which government implemented the lockdown whilst expressing concern that the lockdown endangered the South African Constitution. The DA challenged the use of the military to enforce night curfews, criticised the ban on e-commerce and restrictions on exercise hours, and filed a court challenge over the constitutionality of the lack of parliamentary oversight in the National Disaster Management Act. The Freedom Front Plus filed an application to the Gauteng High Court challenging the constitutional validity of the National Disaster Management Act. The Economic Freedom Fighters criticised the relaxation of some of the May 2020 lockdown regulations as an example of giving into industry pressure by allowing them to reopen.
The number of passengers ferried per trip in minibus taxis was criticised during the lockdown restrictions, in July 2020. The Colleges of Medicine of South Africa stated that allowing minibus taxis to operate at 100 percent occupancy, for short journeys, was a possible danger to public health and contradicted some lockdown restrictions. Initially in the first stage of the lockdown period minibus taxis were required to operate at 70 percent occupancy, provided passengers wore masks and windows were opened. This 70% occupancy requirement was noted as being flouted by taxi operators.
Medical screening was performed prior to departure, four South Africans who were showing signs of coronavirus were left behind to mitigate risk. Only South Africans who tested negative were repatriated.
Test results cleared all the South Africans, including the flight crew, pilots, hotel staff, police and soldiers involved in the humanitarian mission who, as a precautionary measure, all remained under observation and in quarantine for a 14-day period at The Ranch Resort.
On 27 April 217 Cuban medical health specialists (mostly doctors) arrived in South Africa to assist with the pandemic response at the invitation of the South African government and were deployed across the country.
Their arrival and the reported R429 million cost paid to the Cuban government was controversial. The South African Medical Association stated that their deployment was premature as many South African doctors and nurses had not yet been deployed as part of the pandemic response. The South African Internationally Trained Health Professionals Association criticised the government for not instead using unemployed South African medical graduates. The Democratic Alliance stated that government should first prioritise using local healthcare professionals. The Daily Maverick questioned the high cost paid for the doctors. The United States government criticised their deployment and payments made for their services as a form of human trafficking whilst the Cuban embassy rejected allegations of profiting from the deployment of its doctors and stated that criticism was part of a "smear campaign".
On 5 August 2020, the World Health Organization (WHO) deployed a "surge team" made up of 43 experts including David Heymann, who headed the international response to the 2003 SARS epidemic, to help the national and provincial responses to minimize the spread and impact of COVID-19.
On 8 August 2020, the department of health released a COVID-19 contact tracing app. The app aims to reduce infections in the second and third waves of Covid. the app is available on Google Play, the App Store and The Huawei App Galley.
At the beginning of the national shutdown on 27 March South African economists predicted that the pandemic could cause a 2.5% to 10% contraction of South Africa's total GDP in 2020. The national lockdown and resulting economic slowdown reduced demand for electricity by more than 7500 MW thereby temporarily reducing the impact of the long running South African energy crisis. It is estimated that the government would experience a revenue shortfall for 2020 of between R70 and 100 billion. This resulted in the South African government announcing a R500 billion stimulus package thereby accelerating deficit spending from 6.8% to over 10% of GDP for the 2020 financial year. In late July it was announced that South Africa would be taking out a R70 billion IMF loan increasing the country's total debt to GDP ratio to 83%. Trade unions and the EFF were critical of using the IMF to take out the loan whilst the DA and other opposition political parties voiced concern over corruption when using the borrowed funds.
The Johannesburg Stock Exchange lost 15% of its value in the week ending 13 March 2020, its worst week in 21 years. On 19 March, the South African Reserve Bank governor, Lesetja Kganyago announced a reduction of the country's repo rate by 100 basis points or 1 percentage point to 5.25%. On 14 April, a further reduction to 4.25% per year was made. On 22 March, Standard Bank announced a 90-day payment holiday for small and medium-sized business and students to try and shield them from the economic impact of the outbreak, starting from 1 April. In May it was estimated that the state will lose R285-billion in tax revenue for the financial year 2020/21 due to the pandemic and resulting lockdown.
Within the first month of the lockdown three million South Africans had lost their jobs contributing to an increase in food insecurity and poverty. By mid-July wide spread food shortages were reported across the country and in rural Eastern Cape in particular. In December 2020 it was reported by Finfind and the Department of Small Business Development that 42.7% of small businesses in South Africa had closed due to the economic impact of the lockdown.
Corruption and profit gouging
Corruption has had a significant negative impact on efforts to fight the pandemic by inflating the costs of government procurement whilst eroding public confidence in government institutions. Years of corruption prior to the pandemic has reduced the capacity of the country's health service. Incidents of police corruption also increased during the lockdown period as security officials used their expanded positions of power to extort bribes from members of the public. Concerns were raised that funds from a COVID-19-related R70 billion IMF loan to South Africa would be lost through corruption. On 7 August President Ramaphosa announced that ministerial committee would be set up to investigate COVID-19 corruption in state tenders.
Sicuro Safety and Hennox Supplies were fined after admitting to inflating its prices of face masks by 900%. A company supplying the Gauteng government was found to be charging double the price for sanitiser and four times the normal price of surgical face masks. Officials in the Kwazulu-Natal government were suspended for making "massively overpriced" purchases of PPE and blankets. In late July President Ramaphosa announced that measures would be implemented to combat corruption in the delivery of food parcels and the procurement of exorbitantly priced goods. The Special Investigation Unit (SIU) stated that it was investigating a number of suspicious transactions and alleged acts of corruption from the R500 billion COVID-19 Relief Fund. A number of government officials implicated in allegations of COVID-19-related corruption include Ace Magashule, the wife of Bandile Masuku, and the husband of presidential spokesperson Khusela Diko. Magashule, Diko and Masuku have denied any involvement in COVID-19 related procurement corruption allegations.
Events cancelled or postponed
Major sporting codes suspended their activities, including Super Rugby, 2019-20 Pro14 season, Varsity Rugby, Craven Week, Premier Soccer League, Athletics South Africa, Sunshine Tour golf, Wimpy Lifesaving South Africa national championships and Parkrun. The Cape Epic cycle tour, the 2020 Two Oceans Marathon and the 2020 Comrades Marathon were cancelled. The 2020 Cape Town Rugby Sevens, 4–6 December 2020, were cancelled.
Live events cancelled or postponed included the Mangaung African Cultural Festival (MACUFE), Bloem Show, AfrikaBurn, Cape Town International Jazz Festival, Klein Karoo Nasionale Kunstefees, Splashy Fen Festival, Rand Show, National Arts Festival (changing to virtual), SciFest Africa (postponed to 9–15 September), WWE Live South Africa (postponed until September), Comic Con Cape Town, and Matric Rage festivals in Johannesburg, Jeffreys Bay and Plettenberg Bay. South African tours were postponed by the Lighthouse Family, Boyz II Men and BeBe Winans.
Trade and agricultural shows postponed or cancelled included HuntEx, DecorEx Cape Town & Durban, Tyrexpo (postponed to 4–6 August 2020), Power & Electricity World expo (postponed until 20–21 August), the Pietermaritzburg Royal Show, SA Cheese Festival, Qualité Awards Dinner, and Agri-Expo Western Cape Youth Show.
The Zion Christian Church cancelled its annual Easter pilgrimage. The Muslim Judicial Council (MJC) suspended Friday prayers, then closed mosques altogether on Sunday 22 March, but the call to prayer will still be given. Chief Rabbi Warren Goldstein suspended Synagogues. Traditional circumcision schools in the Eastern Cape were suspended.
The City of Johannesburg closed all public facilities indefinitely including public swimming pools, recreational and civic centres, stadiums, libraries, sporting facilities, and the Johannesburg Zoo. The Ethekhwini Metropolitan Municipality closed all of Durban's public facilities including swimming pools, beaches, libraries, community halls, and museums while restrictions have been put in place for the Durban Art Gallery and cemeteries to only allow 50 people at a time. The City of Cape Town closed all public facilities indefinitely including public swimming pools, recreational and civic centres, stadiums, sporting facilities, and the nature reserves.
On 5 August, members of the entertainment, restaurant, fitness, and events industries staged a socially distanced national protest by lighting buildings red. The #LightSAred campaign was staged so as to highlight the negative economic impact of the COVID-19 lockdown measures on these industries.
In April 2020, a number of liquor stores and food stores were targeted by looters in the Cape Town suburbs of Elsies River, Delft South, Samora Machel, Manenberg, Sherwood Park, Nyanga Junction, and Gatesville. On 21 July 2020, a truck carrying COVID-19 specimens was hijacked at a clinic in Motherwell, Eastern Cape and found abandoned 500 metres away.
The arrival of the COVID-19 virus in South Africa saw an increase in the dissemination of misinformation about the virus on social media and other platforms. These range from messages minimising the virus's harm in the country to the propagation of conspiracy theories about government actions to control the virus.
One individual was arrested for posting a video showing himself drinking in public with friends following the national lock-down whilst stating that there was "nothing called corona here". In another incident a man claimed that 10000 government officials would be going door-to-door using contaminated test kits to test people for the virus. A conspiracy theory that Bill Gates wished to test a COVID-19 "vaccine" in Africa or South Africa first caused significant controversy on social media following the publication of a now retracted story in News24.
On 23 March 2020, President Cyril Ramaphosa addressed the nation and announced a 21-day national lockdown effective from midnight 26 March through to 16 April, with the deployment of the South African National Defence Force (SANDF) to support the government. On 9 April the President announced a two-week lockdown extension, until the end of April. Exempt from the lockdown are people deemed necessary to the effective response to the pandemic such as:
- health workers, pharmacy and laboratory personnel, emergency personnel;
- security services (police officers, military personnel, and private security);
- people regarded as necessary to the basic functioning of the economy (supermarkets, transportation and logistical services, petrol stations, banks, essential financial and payment services); and
- those working in industries that can not be economically shut down (such as mines and steel mills).
During the lockdown, all gatherings except for funerals were prohibited. Restaurants, taverns, bottle stores and all other stores not selling essential goods were to close during the lockdown period. Schools, already closed a week before the lockdown period, will not reopen until after the lockdown. Non-exempt people are only allowed to leave their homes during this period to access health services, collect social grants, attend small funerals (no more than 50 people) and shop for essential goods. See the South African Government Gazette 25 March 2020 for a complete list of exemptions and non-exemptions during the lockdown period. South Africans were ordered not to take their dogs for a walk during the lockdown, though they may walk them around their house or apartment building.
People may not be evicted from their place of residence during the lockdown.
Movement between provinces, and between metropolitan and district areas are prohibited except for
- essential workers, to and from work;
- transportation of sanitised and disinfected cargo from ports of entry;
- the transportation of mortal remains; and
- the attendance of funerals (restricted).
All borders of the country are closed during the lockdown, except for designated ports of entry for the transportation of fuel, cargo, and goods.
International and domestic passenger flights are prohibited, except for flights authorised by the Ministry of Transport, for the evacuation of South African nationals in foreign countries, and for certain repatriations.
The lockdown resulted in fewer deaths from road accidents and homicides. During Easter, from 9 April 2020 to 13 April, there were 28 fatalities from road accidents during the lockdown, compared to 162 in 2019. During the lockdown, 432 murder cases were reported, compared to 1542 during the same period the previous year: 29 March 2019 to 22 April 2019. Overall deaths for the year up to 21 April 2020 were "generally within the bounds of expectation" according to the Medical Research Council. Nonetheless for the 5 weeks before 21 April 2020, non-natural deaths including those from homicide and road traffic accidents were lower for both females and males.
Minister of Police Bheki Cele announced, on 5 April, a reduction in cash-in-transit thefts thanks to increased road blocks and more visible policing. He also announced a reduced murder rate. Trauma related hospital admission decreased by two-thirds. By the end of the first seven days of the lockdown a total of 2,289 people had been arrested for violating lockdown orders. Minister Cele announced, on 13 November, that from July to September, compared to 2019, many different crimes ranging from contact and property crimes to sexual offences all declined because of national lock-down.
Minister of Communications and Digital Technologies Stella Ndabeni-Abrahams, on 8 April, was put on special leave for two months, one without pay, for violating lockdown regulations. A picture of her appeared on social media while having lunch at ANC NEC member Mduduzi Manana's home.
Enforcement was done across the country with varying degrees of success. In the Eastern Cape it was reported in early April that little to no enforcement of the lockdown was implemented in at least some of the province's rural areas.
The use of force by police and SANDF personnel was controversial with multiple reports of excessive force in enforcing the lockdown. This included incidents of beatings and preventing people from filming police abuses leading the public advocacy group Right2Know to release a statement that the police had no right to prevent the public "from exercising their constitutional right to film and record incidents".
By 3 April, the eighth day of the lockdown, the Independent Police Investigative Directorate (IPID) reported that they were investigating eight deaths involving the police since the start of the lockdown. At the time, this exceeded the number of deaths in the country due to the pandemic. This was in-spite of President Ramaphosa's public call for police restraint. By 12 April a total of nine people had died due to police and army action following the beating to death of a man in Alexandra by the army.
The South African National Editors' Forum issued a statement expressing concern over police action denying the media access to sites when covering COVID-19 related stories. On 27 April the Office of the United Nations High Commissioner for Human Rights expressed concerns about the heavy handed and highly militarised enforcement of COVID-19 related lockdown measures in a number of countries including South Africa. By 30 April the government confirmed that a total of five people were alleged to have been killed by police within the first three weeks of the lock down along with 152 incidents of assault by police.
The Pretoria High Court ordered the South African government to take steps to prevent police abuse during the lockdown, following the death of Collins Khosa, who died of injuries after being beaten by the police.
Confirmed new cases per day
Confirmed deaths per day
Model-based simulations indicate that the 95% confidence interval for the time-varying reproduction number R t was higher than 1.0 until mid-July, exceeding 1.0 again from late October to December 2020.
The first vaccinations in the Western Cape took place on 17 February.
On 17 February 2021, South Africa started its national vaccination program against Covid-19. The program will go through in phases, prioritizing healthcare and frontline workers and then those over the age of 60. According to health officials, South Africa has administered 5,831,389 vaccine doses across the country as of 21 July 2021. South Africa has accepted delivery of 3 different vaccines, Johnson and Johnson, Pfizer-BioNTech and Oxford-AstraZeneca, administering both Janssen (Johnson & Johnson) and Pfizer-BioNTech, with the Oxford-AstraZeneca vaccine suspended, due to its ineffectiveness against the Beta variant (501.V2).
Vaccines on order
|Vaccine name||Approval progress||Quantity||Doses arrived||Accepted delivery||Section 21 (EUA)||Began administering||Full Approval|
|Oxford–AstraZeneca||EUA Suspended||1.5 Million||1,000,000||1 February 2021||Suspended||Suspended||N/A|
|Janssen vaccine||EUA Approved||30 Million||1,700,000||16 February 2021||1 April 2021 (full authorization)||18 Feb 2021 (Phase III)||Pending|
|Pfizer vaccine||EUA Approved||40 Million||4,483,440||3 May 2021||16 March 2021||17 May 2021||Pending|
|CoronaVac Vaccine||EUA Approved||5 Million||0||Not yet||3 July 2021||Not yet||N/A|
|Pfizer vaccine||EUA Approved||1.4 Million||1,400,000||27 June 2021||16 March 2021||17 May 2021||Pending|
|Other (TBA)||EUA pending||7.6 Million||0||Not yet||Not yet||Not yet||N/A|
|Janssen vaccine||EUA Approved||220 Million||0||16 February 2021||1 April 2021 (full authorization)||18 Feb 2021 (Phase III)||Pending|
Cumulative vaccinations in South Africa
Graph of cumulative doses administered across the country
Fully vaccinated (All doses) Partially vaccinated (1st dose only)
|Phase||Priority group||Start date||People eligible
|1a||Front-line and health care workers (Sisonke Protocol)||17 Feb 2021||500000||Complete|
|1b||Remaining health care workers||17 May 2021||700000||In progress|
|2a||People over 60||17 May 2021||5000000||In progress|
|2b||Teachers and support staff||23 June 2021||582000||Complete|
|2c||Police Force & SANDF||5 July 2021||800000||In progress|
|2d||People over 50||5 July 2021||4800000||In progress|
|2e||People over 35||1 Aug 2021||11000000||Not started|
|3||Anyone over the age of 18||1 Sep 2021||17900000||Not started|
On 7 February 2021, it was announced that the Oxford–AstraZeneca COVID-19 vaccine did not work well in protecting clinical trial participants from mild or moderate illness caused by the 501.V2 variant. The vaccination program was announced to be put on a hold.
On 17 February 2021, the national COVID vaccination program was officially rolled out, beginning at Khayelitsha District Hospital in the Western Cape Province where healthcare workers, the President Cyril Ramaphosa and Minister of Health Zweli Mkhize were given shots of the Janssen vaccine.
On 5 March 2021, the number of doses administered surpassed 100,000.
On 21 March 2021, South Africa sold and began transporting its 1 million doses of Oxford-AstraZeneca vaccine to other African Union Members. Concerns over the rollout of the vaccine in African countries have been raised, as the 501Y.V2 variant spreads in African countries.
On 17 April 2021, The government announced that the first batch of 325,260 Doses of Pfizer vaccines would arrive on 3 May 2021. From there the same amount of doses are expected to arrive weekly, until 31 May 2021, where the number of daily doses delivered will increase to 636,480 weekly.
On 2 May 2021, the government announced that the first 1.1 million doses of the Janssen vaccine would receive an extended safety assessment, in line with international regulators, and stock would be released in mid May.
On 3 May 2021, the first batch of 325,260 Doses of the Pfizer vaccine arrived at O.R Tambo International Airport via Lufthansa and Astral Aviation. The vaccines were then sent to the National Control Laboratory for quality assurance. The Pfizer-BioNTech vaccine is set to be rolled out to South Africans from 17 May 2021.
On 10 May 2021, the last week of the Sisonke Protocol (Phase 3b) began. The trial was expanded to non patient facing health care workers, including administrative and supportive staff due to sufficient capacity and doses.
On 15 May 2021, the Sisonke Protocol ended with a total of 478 733 doses given to health care workers. The remaining doses were allocated to the Medical research Council to conduct further studies of the Johnson & Johnson vaccine on certain population groups.
On 17 May 2021, Phase 2 of the vaccination program began and started with vaccinating old age homes with the 2-dose Pfizer vaccine. Phase 2 ran alongside phase 1B to vaccinate the remaining 500 000 health care workers.
On 24 May 2021, the fourth and final batch of 325,260 Doses of the Pfizer vaccine arrived at O.R Tambo International Airport via Lufthansa and Astral Aviation. Following this, next week doses delivered will increase to 636,480 Doses weekly.
On 31 May 2021, the first batch of 636,480 Doses of the Pfizer vaccine arrived at O.R Tambo International Airport via Lufthansa and Astral Aviation. This delivery is the first batch of consignment 2 with an incremental increase of 311,220 Doses Weekly.
On 31 May 2021, The total number of vaccine doses administered surpassed 1 million.
On 11 June 2021, The Department of Health and Food and Drug Administration (FDA) released a statement on the Janssen vaccine, produced at the Emergent BioSolutions Plant in Baltimore, USA. This resulted in the vaccines also produced at the Gqebherha plant need further assessment by SAHPRA and the FDA. To get the South African program back on the roll, 300 000 doses are cleared to be shipped to South Africa as a matter of extreme urgency.
On June 18, 2021, 300,000 doses of the Janssen vaccine arrived at O.R Tambo International Airport. This is the first batch of the Emergency consignment due to contamination of locally manufactured doses. These doses are expected to be used mainly by teachers and the SANDF and SAPS.
On 18 June 2021, The total number of vaccine doses administered surpassed 2 million.
On 3 July 2021, SAHPRA approved China's Sinovac CoronaVac Vaccine for local use via emergency use authorisation on the condition that Sinovac provides further information on risk and efficacy.
On 5 July 2021, The Department of Health announced that the government would now reimburse private sites for the vaccinations of all uninsured people. Allowing any person qualified for a vaccine to be allocated to the most appropriate site, regardless if it is private or public. 
During the 2021 South African unrest, the vaccine rollout encountered a slowdown as businesses and vaccine sites were shutdown due to protests and looting in Gauteng and Kwazulu-Natal."South Africa says vaccine rollout, essential healthcare disrupted by unrest". Reuters. 13 July 2021. Retrieved 15 July 2021.</ref>Writer, Staff. "Here's what happens if you miss your Covid-19 vaccine due to looting in South Africa". Retrieved 15 July 2021.</ref>
On 14 July 2021, the rollout for educators officially ended with more than 500 000 people being vaccinated. However, any educators who could not make it to a vaccination site during the official program still qualify to be vaccinated.
On the 25th, the president announced that anyone over the age of 18 could be vaccinated from 1 September 2021, and that within 3 months 31 million additional doses from Pfizer and Johnson & Johnson were scheduled for delivery.
- COVID-19 pandemic in Africa
- COVID-19 vaccination in South Africa
- COVID-19 pandemic by country and territory
- List of deaths due to COVID-19
- 2020 in South Africa
- 2021 in South Africa
- Free State case found to be not positive after confirmation test.
- 61 cases announced by president Ramaphosa later in the evening.
- Originally 46 new cases were reported.
- 123008 total tests, including repeat tests on the same person
- 2020-04-27 23:59
- 2020-04-27 23:59
- 2020-04-27 23:59, median age 38 years (IQR 29-51 years), those aged <10 years accounted for 3% (156/4996)
- 2830 active cases
- The median age of patients who died was 64.
- 40 ventilated
- 2020-05-09 23:59, median age 37 years (IQR 28-49 years), with the highest risk amongst those aged 40-44.
- 376 quarantine sites with 30823 quarantine beds
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