How SA's COVID-19 lockdown could get extended again

South Africa has already implemented the first four-stages of our response to the virus, namely; Preparation, Primary Prevention, Lockdown and Surveillance Active case-findings. 

-So, what's next? -

Though South Africa has reported 27 deaths and 2 415 cases, Karim – a renowned epidemiologist and infectious diseases specialist - says the country still has time to flatten the curve. 

"We are unlikely to get a treatment or a vaccine within the next few months. Those things take years. In our case, we hope that maybe we can get it in a year - maybe 18 months. Our epidemic should be over by then."

Speaking in Durban, on Monday, Karim, government's advisor to the COVID-19 pandemic response, presented a report on plans government has to deal with the crisis. 

-“What do we do this week?”  -  

"This week we need to ensure that all of us follow the lockdown rules, and then we monitor community transmission. The way we are going to go that is to monitor the average daily number of cases that are occurring through the passive normal testing, and we are going to monitor our active case finding in our communities by looking at positivity among those who are screened."

Karim says since the lockdown was activated, there's been a decrease to the number of average cases reported daily, last week South Africa reported 67 cases per day on average. 

READ: COVID-19 is 10 times more deadly than swine flu: WHO

Karim says this week will be critical for government because "we need to know what the number of average cases would be, why? Because we want to know what the community transmission levels are. Because we want to use that to guide us on what next steps we should follow and how we should manage the lockdown." 

"By 18 April we will know if community transmission and whether our interpretation of the community transmission is being kept low. If you look at the 67 cases per day on average, the 95 percent confidence interval is 45 to 89, in other words, the true number of cases is between 45 and 89."

"If the average number of daily cases, excluding active screening, between 10 and 16 April and if we see 90 or more cases on average then we need to continue the lockdown, the reason put very simply is because the average number of cases per day is going up."

"If the absolute number of cases is 44 or lower, we can ease the lockdown ."

"If we end the lockdown abruptly, we run the risk of undoing all the effort and benefit we have achieved. 

The next four stages to government's response are; Hotspots, Medical Care, Bereavement and the Aftermath, and Ongoing Vigilance. 

-Stage 5-

With regards to stage five, Karim says government will "need to find out where the clusters of cases are occurring, we need to go in there, and we need to slow it down."

"Stage six is about medical care. We are now in about week four or five of our planning. Its when we need to be ready for when those patients come. We need to ensure we have the capacity, that we have the field hospitals, where they will then make a decision if you need to go to the hospital."

Karim says stage seven will deal with expanding burial capacity, and the psychological and social impact the pandemic will. While stage eight is for maintaining ongoing vigilance and stage ahead of the virus.