Cape Town, South Africa – From his 10-bed private clinic in western Johannesburg, Bayanda Gumende is more used to treating renal diseases than COVID-19. But with the city’s hospitals full, patients lingering in casualty wards for days and ambulances stuck waiting in car parks, that is beginning to change.
The 27-year-old chief nephrology technologist says he has been swamped with calls from patients desperate for oxygen and who cannot find it elsewhere. But with supply being limited, he is forced to prioritise.
“It has taken a toll on me. It is very emotional to watch people taking their last breath. Some people are gasping for air. There is literally nothing you can do about it. You cannot save everybody,” he says.
Gauteng is experiencing a crisis. We are under pressure. Patients calling for help, they can’t breathe. No hospitals available in Gauteng both Public and Private. Protect the elderly and those with pre existing conditions.
#level5#Covid19SA #COVID19 #COVIDVaccination pic.twitter.com/H0qap6SDQl
— Bayanda Gumede💊💉 (@BayandaGumede) June 21, 2021
South Africa accounts for close to 40 percent of all COVID-19 deaths on the continent, with 60,038 officially recorded fatalities so far. It is currently in the midst of a third wave, driven by the rapid spread of the Delta variant, first detected in India, which is fast becoming the dominant strain.
Professor Salim Abdool Karim, a world-leading epidemiologist and former co-chair of South Africa’s Ministerial Advisory Committee on COVID-19, believes that a mutation related to furin – an enzyme that “cleaves” the spike protein – makes this variant particularly dangerous.
“That cutting process is critical. It enables the virus to enter cells more easily, and therefore spread faster,” he says. “This variant is about twice as transmissible as the other variants of concern.”
Science has translated into policy. In a televised address on Sunday, President Cyril Ramaphosa announced a raft of new restrictions, including the banning of all alcohol sales and gatherings, as well as an expansion of curfew hours from 9pm to 4am.
For Gumende, it need not have got to this point. “Waiting until the virus has spread uncontrollably has forced us to move into a far harsher lockdown than was necessary,” he says. “They knew that the Delta variant was spreading across India. They should have banned flights from India to South Africa.”
For now, Gauteng province – home of the country’s financial hub, Johannesburg, and its administrative capital, Pretoria – has been the epicentre of this third wave, accounting for more than 60 percent of new cases. As of Monday, the province had 81,399 active cases.
During a press briefing last week, provincial Premier David Makhura said, “We are struggling. We are under extreme pressure. The pandemic is everywhere.”
The situation in Johannesburg in particular has been aggravated after the 1,000-bed Charlotte Maxeke Johannesburg Academic Hospital was forced to close following a fire in April. But many believe the authorities are not entirely blameless.
“Where is the preparedness of the existing system regarding ICU, oxygen, diagnostics and treatment?” tweeted Tlaleng Mofokeng, the United Nations special rapporteur on the right to health.
The truth is everyone predicted the third wave, where is the nasrec hospital? Where is the preparedness of the existing system regarding ICU, oxygen, diagnostics and treatment. It’s more than a year later. They had time, behaviour alone isn’t enough. Iyo hai shem basifuna sifile. https://t.co/HA0XsB3APl
— Dr Tlaleng Mofokeng (@drtlaleng) June 24, 2021
Some large health facilities in Johannesburg, such as the Nasrec field hospital and the AngloGold Ashanti Hospital, sit empty. “There are a lot of unemployed doctors and nurses,” says Gumende. “It just seems ridiculous to me that the government has not prepared at all.”
If there is still some debate as to how South Africa became the worst-hit country on the continent, the way out of this crisis is clear, according to Karim.
“The reality is that vaccination is a critically important part of trying to control the virus. We have to combine vaccination with some of our public health prevention measures.”
While Ramapahosa has been among the leading global voices calling for vaccine equity and a waiver of production patents, his government’s vaccination campaign has been slow. South Africa has administered just 2.9 million doses so far, despite receiving a total of 7.4 million vaccines. Less than 5 percent of the population have received a single dose.
Government critics, including opposition parties, say the rollout has been slow because of poor planning. But in his address on Sunday, Ramaphosa alluded to vaccine hesitancy.
“There is still a lot of misinformation being circulated about the COVID-19 vaccine. False stories are being spread on WhatsApp groups, on social media, and by word of mouth about the COVID-19 vaccine, claiming that the vaccine is not safe, that it can make you sick, or that it doesn’t work,” the president said.
“I have said it before, and I wish to say it again: Please think long and hard before you press share or send,” he told South Africans. “You are spreading panic, fear and confusion at a time when we can ill-afford it.”
Still, the slow rollout has left many frustrated.
Celeste Bortz is a 59-year-old teacher from Johannesburg. Her husband has been in hospital, on oxygen, for the past six weeks.
“My husband is 61 and missed the beginning of the vaccination programme by one week. If the government had been more on top of its game, things could have been so much better,” she said.
“In general, I like Ramaphosa. Last year he took the reins and locked down quickly. But I think the government could have handled this third wave better.”
A series of corruption scandals related to COVID-19 spending have also shaken public confidence in the government’s response to the pandemic.
In September 2020, a report (PDF) from the auditor general found “serious shortcomings” in the financial management of the government’s COVID-19 initiatives – from procurement of personal protective equipment, to hospital beds, to social relief grants.
Earlier this month, Health Minister Zweli Mkhize was placed on fully-paid “special leave” after awarding contracts to Digital Vibes, a communications company staffed by his former associates. An investigation is ongoing.
If, according to the presidency, this third wave could be the longest yet, Karim says it will certainly not be the last.
“We’re going to see more effective variants of the Delta and then we’re going to move on to the next one. It’s basically humans versus the virus and its variants. Right now, the virus is gaining the upper hand. It is able to keep one step ahead of us.”