Effective Implementation of Public Health and Social Measures in South Africa: Situational Analysis

Public health and social measures should respond to data about the growth of the epidemic and be implemented in a way that engages communities. Communities should be involved in helping to determine strategies for adapting measures to the local context, protecting livelihoods, and introducing appropriate relief measures to counteract the economic impact of these measures. The government should counter misinformation with appropriate risk communication and engage with communities to ensure voluntary adherence to COVID response measures.

• South Africa has the highest number of confirmed COVID-19 cases on the continent, and daily reported cases have been increasing since early April.
• The country has been in lockdown since March 27, but has announced plans for a gradual reopening. The government has defined five “levels” of lockdown restrictions and plans to adjust based on new infections. On May 1, the restrictions will be lowered from level five (the highest) to level four, meaning that strategic industries will reopen while maintaining precautions. In future, different provinces may be subject to different lockdown levels depending on trends in new cases. The level four restrictions remain onerous and there is significant concern about the feasibility of maintaining these restrictions.
• It will be important to watch the evolution of new cases as businesses begin to reopen. South Africa has one of the highest testing capacities in the region, which will support close monitoring of transmission.
• Population mobility in South Africa decreased dramatically at the end of March, in line with the national lockdown. • According to survey results, the vast majority of urban residents are aware of COVID-19. However, there is significant misinformation, some of which may provide a misplaced sense of protection or contribute to stigma which could lead to violence or prevent people from accessing needed care.
• Most people think that COVID-19 will be a problem for the country; however, far fewer believe that they are personally at high risk of infection.
• The majority support the government response and trust government information about COVID-19. There are also high levels of support for PHSMs, although there is greater opposition to measures that restrict economic activity. The government has enacted a number of social assistance measures.
• There has been significant unrest around the implementation of PHSMs, particularly among health workers and disadvantaged communities (migrants, low-income people, etc.), an indicator of the burden that these measures are placing on South Africans. In some cases, demonstrations have been met with violence from the police.