South Africa: Inequality hides true picture of COVID-19 crisis

The funeral of a COVID-19 victim at the Olifantsfontein Cemetery in Gauteng during level three of the government’s lockdown. Photo: Oupa Nkosi / New Frame

Even as South Africa witnesses a sharp spike in its COVID-19 cases, the process of easing the lockdown is being continued by the government. This is despite warnings by numerous unions in different sectors regarding the lack of adequate safety preparations necessary to resume economic activity.

According to the latest data released by the country’s health department on June 30, the total number of confirmed cases in South Africa has risen to 151,209. More than 6945 of these were new cases. It is estimated that South Africa has more than 37% of the 405,870 COVID-19 cases recorded on the African continent as at July 1.

73,543 infected patients have recovered, which amounts to a recovery rate of 48.6%. The death toll stands at 2657 or 1.8% of all infected patients.

An overwhelming 41.3% of all confirmed cases in the country are concentrated in Western Cape Province, which had 62,481 cases as at June 30. However, the emerging hotspot with a high infection rate is Gauteng, which recorded 42,881 cases or 28.4% of all cases in South Africa. Eastern Cape Province is the next highest, with 27,686 or 18.3% of cases.

These three provinces account for the bulk of cases in the country, followed by KwaZulu-Natal, where 9041 people have tested positive.

Health minister Zweli Mkhize acknowledged on June 28 that “while every province will unfortunately witness an increase in their numbers, areas where there is high economic activity will experience an exponential rise – beginning with Gauteng (Johannesburg and Pretoria) and Western Cape, followed by Eastern Cape and KwaZulu-Natal Provinces.”

Nevertheless, South Africa is continuing to ease restrictions on economic activity. On the evening these figures were released, the government permitted restaurants, fast food outlets, hotels, conference centres and even casinos to resume activity, on condition that certain measures were followed.

Mining and manufacturing industries have been allowed to operate at full capacity since June 1. Schools were also reopened, but are to fully resume functioning in a phased manner.

Indicating that the government expects a rise in infections, Mkhize added, “As we had expected, we are approaching a surge during the latter winter months of July and August.”

Many have questioned whether the official figures are providing an accurate picture of the real extent of spread in communities that are unable to afford private healthcare and rely on public hospitals.

Only 35% of the 1.6 million tests conducted in the country up until June 30 were carried out in public hospitals. The remaining have been conducted by private hospitals at the cost of R1,200 (A$104) per patient, in addition to a few hundred rand for a doctor’s consultation, which is required to get tested.

The majority of South Africans cannot afford to pay this amount, which exceeds the per capita monthly income of more than 50% of the population. In September 2019, even before the economic shock of COVID-19, 56% of South Africans lived on less than $105 a month.

The upper-bound poverty line for the year 2019 was drawn at $105.40 per person per month, and $48 per person per month was the minimum required to afford an adequate daily energy intake.

In September, about 25% of the population was earning less than $48.20 per capita per month, according to the Household Affordability Index compiled by the Pietermaritzburg Economic Justice and Dignity Group (PMBEJD).

With the economy deteriorating further throughout the last quarter of 2019 as well as the first quarter of this year, the unemployment rate in South Africa soared to a 17-year record high of 30.1% by the end of March, when the lockdown began.

Since then, retrenchment notices referred to the Commission for Conciliation, Mediation and Arbitration (CCMA) between April 1 and June 25 are estimated to impact as many as 100,000 workers, the Mail & Guardian reported.

Last financial year, about 60% of retrenchment notices brought before the CCMA resulted in job-losses. The percentage is likely to be much higher this year, resulting in consequential downward pressure on the wages of those who retain employment.

In the meantime, the cost of the basic food basket rose by 13.7% over the past year. This has thrown a large number of people into debt as they can no longer afford the basic costs of food and other essentials for survival.

Under such circumstances, spending $104, along with the doctor’s fee, to get tested for COVID-19 at a private hospital is far beyond the reach of a large majority of South Africans, without incurring further debt.

It is also the same majority which is most vulnerable to the disease. Many in this category lack adequate sanitation facilities and are incapable of maintaining appropriate physical distance, especially in the overcrowded urban slums.

And yet, 65% of all the tests conducted have been in private hospitals. This raises the question: are the most vulnerable sections of the population, which includes the majority of South Africans, being sufficiently tested for COVID-19?

Could the real extent of COVID-19 spread in South Africa be far grimmer than the picture presented by the health department’s official figures?

[Abridged from People’s Dispatch.]

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