Introduction
South Africa is in the midst of the third wave of the COVID-19 epidemic. It peaked on 5 July 2021, when the seven day moving average of reported daily new infections reached 19 970. On 13 July 2021, there was a total of 12 537 new cases being reported over a 24 hour period with the daily death rate reaching 633.[i] The third wave has been driven by the delta variant which is known to be ‘97% more transmissible than the original lineage’[ii] and 60% more contagious than other variants according to the World Health Organization.[iii]
The peak of the second wave which hit South Africa in January reached 19 042 daily cases.[iv] In comparison, the third wave was marginally more severe. Between 1 July and 21 July Gauteng accounted for 50% of new cases. The ratio of new infections in July to those in June was higher in six other provinces than in Gauteng. The situation led to the imposition of a level 4 lockdown, with restrictions being imposed on social, religious and political gatherings, school closures, and a ban on alcohol in order to ease the pressure on public and private hospitals due to alcohol related admissions. The economy was further affected with the restaurant industry being forced to operate at 50% capacity without the sale of alcohol. The situation in South Africa is already dire with many individuals losing income and having to take salary cuts. For this reason, the events of the past fortnight raised fears for the economy which is already holding on by a thread.
Riots and looting
In the past week South African news has been overtaken by reports of violent riots and looting which started in protest to the incarceration of former president Jacob Zuma. The riots have mostly taken place in the provinces of Kwa-Zulu Natal and Gauteng. Gauteng is the epicentre of the resurgence of COVID-19 with the dominant delta variant. These riots may increase the rate of transmission in Gauteng, prolonging the third wave.[v]
The effect of the looting is evident on small and big businesses as well as the economy, increasing unemployment and making it difficult for businesses to recover from their losses. However, there are ripple effects which are not as clear. These include those on the health sector, and by extension the vaccine roll out.
The health care system
Violent protests and riots are increasing the workload of the health sector, which is already under great pressure from the pandemic.
Along with the vaccine roll out which has been affected, the unrest has also had an impact on access to other types of chronic and lifesaving medication for TB, HIV and diabetes. Although these medications are necessary for many of these individuals, the risk posed by riots and looting to staff members and patients is too great to continue their provision in the current climate. These groups of people are at a heightened risk of suffering severe effects and symptoms from the COVID-19 virus and should not be placed in an even more vulnerable position during the third wave.
Lifesaving medical care was further compromised due to the torching of ambulances needed to transport patients to medical facilities and the prevention of the much needed delivery of medical supplies such as oxygen for patients in a critical condition. Looters not only targeted big retailers and malls but also looted medical centres, pharmacies and, horrifically the South African National Blood Service (SANBS).
The Independent Community Pharmacy Association of South Africa (ICPA) has issued a statement in which it has expressed the seriousness of the situation in regards to the looting of independent pharmacies which had acted as sites for vaccinations prior to the riots. It stated that:
‘The violent protests are having a direct negative effect on the fight against COVID-19 and these frenzied gatherings also constitute COVID-19 super spreader events. In addition, many vulnerable citizens will not be able to access their chronic medicines or obtain urgent acute medication from their pharmacies which have either been destroyed or are closed due to the unrest.’[vi]
Public transport has also been brought to its knees. Taxi drivers fear losing their vehicles to violence and destruction. Thousands of health care workers rely on taxis industry to get to work. Staffing levels have been reduced because of an inability to get to work, magnified by worker fears of being caught in the cross fire in the current faceoff between the police and protesters.
The vaccine roll out
The Department of Health issued a media statement in which it confirmed that
‘The national vaccination programme is continuing across most provinces, with vaccines being safely distributed to operational sites. However, the recent violent protests have impacted the vaccination rollout … in some districts and areas in both KwaZulu-Natal and Gauteng’.[vii]
The private sector has likewise closed many of its vaccinations sites. Dis-Chem and Clicks closed sites across KZN and Gauteng as precautionary measures. Clicks has had to ‘close 106 vaccination sites and 279 pharmacy and health stores’.[viii] Discovery closed all its vaccination sites except for one in Cape Town on Tuesday 13 July.[ix] All these companies are concerned for the safety of both their staff and those to be vaccinated and have decided to halt operations for the time being.
According to ICPA, some 50 pharmacies were looted with around 2 000 vaccine doses being stolen.[x] Although this may seem to be a small number compared to the roll out targets, each vaccine, at a time when the death toll of the third wave continues to rise, is potentially lifesaving.
South Africa’s vaccination efforts have long been the target of much criticism, with setbacks being suffered on a frequent basis. President Ramaphosa had hoped to increase the number of daily vaccinations to 300 000 within the next few weeks, before violence started to become widespread. The vaccine roll out has slowed down by about 50 000 fewer vaccinations taking place per day than before the riots. In KZN, where the riots have disrupted most of the vaccine roll out, fewer than 2 000 people were vaccinated last week.
The interruption to the vaccine roll out will not only disrupt the momentum that it had begun to gain, but will also delay the economic recovery of the country with South Africa being forced initially to continue with the intense level 4 restrictions, and the new restrictions under level 3.
Sophie Smit
Legal Researcher
sophie@hsf.org.za
[i] Covid-19 resource page and online portal. Available here.
[ii] National institute for communicable diseases ‘covid-19 update: delta variant in South Africa’ (29 june 2021), available here.
[iii] Laura Lopez Gonzalez News24 ‘Covid-19: Eight common questions answered about the Delta variant’, available here.
[iv] Laura Grant, Alastair Otter and Mia Malan ‘How do we know if South Africa is in a third wave — and could there be a fourth?’ (9 June 2021), available, here.
[v] National institute for communicable diseases ‘covid-19 update: delta variant in South Africa’ (29 june 2021), available here.
[vi][vi] Mercedes Besent SABC News ‘Unrest in KZN and Gauteng to further delay SA’s vaccine rollout programme’ (12 July 2021), available here.
[vii] Department of Health Media statement on the impact of violent protests on health services. Available here.
[ix] Antony Sguazzin Bloomberg ‘rioting halts vaccinations in key south African provinces’ (13 july 2021), available here.