Covid fatigue, super-spreader events and a virulent local variant of the virus put economy and healthcare in crisis.

Families wait outside a hall for food.

Families wait outside a hall for food. 
Photograph: Kim Ludbrook/EPA/Jason Burke

South Africa is struggling to contain a second wave of Covid-19 infections, fuelled by a virulent new local variant of the virus, “Covid fatigue” and a series of “super-spreader” events.

On Friday health officials announced 844 deaths and 21,832 new cases in a 24-hour period, the worst toll yet. Experts believe the second wave has yet to reach its peak in the country of 60 million, and fear healthcare services in the country’s main economic and cultural hub may struggle to cope with the influx of patients.

Unlike wealthier countries, South Africa cannot afford to repeat the hard lockdown imposed last year, which caused massive economic and social damage. Some predict a third wave when winter comes in the southern hemisphere in May and June and there are fears that current vaccines may be less effective against the new variant.

“We are going to get a third wave, even a fourth. This pandemic has only just started,” said Tivani Mashamba, professor of diagnostic research at the University of Pretoria.

Funeral workers wearing PPE at the burial of a coronavirus victim
Funeral workers wearing PPE at the burial of a coronavirus victim, south-west of Johannesburg. 
Photograph: Siphiwe Sibeko/Reuters

There is also growing criticism of authorities’ apparent failure to secure adequate supplies of vaccines. Last week health officials announced that around 1.5m doses of the AstraZeneca vaccine would be available for health workers by the end of next month.

It is unclear how promises to roll out jabs to two-thirds of the population through the year can be kept, though South Africa will get enough shots for 10% of its 60 million citizens through the global Covax initiative, designed to ensure equitable supply of cheap vaccines to poorer countries.

The official Covid-19 death toll in South Africa now stands at 31,368, but reliable excess mortality figures suggest over 71,000 have died since May. The country is the worst hit in Africa.

On a 4,000km journey from the badly hit province of KwaZulu-Natal through to the western city of Cape Town, now the centre of the second wave, the signs of the pandemic were clear. Shops and restaurants were shuttered on every high street in every town, with infrastructure suffering from an acute lack of repair and maintenance. Unemployment has soared as key industries such as mining and hospitality have suffered.

Paramedics from a community-run ambulance service based in Lenasia
Paramedics from a community-run ambulance service based in Lenasia, a township south of Johannesburg. 
Photograph: Michele Spatari/AFP/Getty Images

“We had almost nothing. Now we have nothing at all,” said Nicolas Mvoko, a former vineyard worker who recently lost his job in the Hex Valley, in the Western Cape. Wine and beer manufacturers have suffered from repeated bans aimed at preventing gatherings at which social distancing has been ignored and relieving pressure on the health system.

The poor and rural province of Limpopo appeared to have escaped the worst of the first wave, but has been hit badly by the second.

“It’s actually really bad here. Everyone knows someone who’s passed away. The health system is very weak,” said Mashamba. “Covid fatigue was a big factor. You can’t believe how many weddings were going on. I was invited to baby showers. I thought: this is horrendous, you’re exposing pregnant women.”

Efforts to control the flow of people across borders are also undermined by corruption and inefficiency. Huge crowds gathered at the crossing point with Zimbabwe last week as migrant workers rushed to return to jobs in South Africa after Christmas. Though all were meant to have had negative official Covid tests, a reported bribe of 2,500 rand to frontier guards secured passage with no questions asked.

Alex van den Heever, professor of social security systems administration at Wits University, Johannesburg, said South African policymakers, led by president Cyril Ramaphosa, had limited options.

“The problem in South Africa is a [hard lockdown] has massive social and economic impact. South Africa isn’t in a position to support those who lose their earnings and parts of the country are effectively unlockdownable because of the social context,” he said. “The government is constrained in what it can do… We have to ride the wave, target what we can.”

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By masking up, we show our commitment to saving lives and livelihoods, in this wave and the next. By adhering to the advice of scientists and healthcare workers, we can employ risk mitigation to use prevention as our cure. By disrupting social norms to practice distancing, safe sharing of food, and opening windows on public transport, we can put enough barriers between ourselves and this virus that our economy can survive.

Be a hero.
Wear a mask.