Coronavirus Hotspots Could Stay on Level 4 or Go Back to Level 5

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On Sunday, President Cyril Ramaphosa announced that South Africa will be moving to level 3 as of 1 June, but certain hotspot areas could remain on level 4 or move back to level 5.

“Even as we move to alert level 3 it is important that we should be aware that there are a few parts of the country where the disease is concentrated and where infections continue to rise,” Ramaphosa said.

“We will have a differentiated approach to deal with those areas that have far higher levels of infection and transmission. These areas will be declared coronavirus hotspots.”

Health Minister, Dr Zweli Mkhize, explained in detail how the government will determine the country’s hotspot areas as part of the new district-based lockdown.

Presenting to the National Council of Provinces (NCOP) on Tuesday, Mkhize said that high-risk areas will be classified as hotspots and that these districts will remain at level 4 with the intensive implementation of screening, testing and restrictions.

He added that the country’s districts will effectively be designated in one of three ways:

• Areas of ‘vigilance’ (less than 5 cases per 100,000 people);
• Emerging hotspots (less than 5 cases per 100,000 people, but rapid rise);
• Hotspots (more than 5 cases per 100,000 people).

“To determine the levels per district, the prevalence and incidence rates of each area should be calculated. However. this is currently not possible because of low testing rates and a lack of serological tests,” he said.

“To determine an ‘area of vigilance’ (less than 5 cases per 100,000) and ‘hotspots’ (more than 5 cases per 100,000), the average active case data per 100,000 population was used for the period 16 May to 22 May.”

To determine ’emerging hotspots’, Mkhize said that government will look at whether a district, which currently has fewer than 5 cases per 100,000 population, has seen a notable increase in cases over the 14 day period.

Districts 

Mkhize proceeded to provide a list of districts across the country which have currently been defined as needing ‘vigilance’, as an ’emerging hotspot’ or are currently defined as a ‘hotspot’.

The latest data analysis shows that 14 of South Africa’s 52 districts are considered hotspots, while nine have been identified as emerging hotspots.

Mkhize said that this is based on the number of active case per 100,000 between 16 May and 22 May.

Interventions

While the whole country moves to lockdown level 3, hotspot areas are subject to further restrictions based on specific interventions, according to Mkhize.

In vigilance and emerging hotspot areas, government will look to prevent new infections and keep numbers low by establishing multisectoral, multi-department and community response teams to encourage various protocols.

This includes:

• Social distancing;
• Frequent environmental cleaning;
• Hand hygiene practices, cloth masks and cough etiquette;
• Symptom screening;
• Community and contact tracing;
• Testing, isolation, quarantine and hospitalisation.

In hotspot areas, the districts will be sub-divided into ward clusters so that government can have a more targetted and rapid response.

This will include:

• Deploying teams of health experts to analyse and support districts;
• The same measures mentioned above;
• Extreme social distancing measures (including working from home);
• Strict health protocols;
• Return to work phased in;
• Hard lockdown only to be considered if all other measures fail to contain the spread.