[imagesource: SeongJoon Cho/Bloomberg]

Come May 1, Gauteng and other parts of the country look set to drop to alert level 3.

Brace yourselves for a sharp rise in social media posts about buying booze and cigarettes, and general flouting of the rules.

As for Cape Town, and the Western Cape at large, there appears to a good chance that we may remain on alert level 4.

The latest COVID-19 stats for the country show the Western Cape accounted for 11 262 of the country’s total 18 003 cases, which is more than 60%.

When looking at the death toll, there is a similar story. The Western Cape accounts for 211 of the 339 deaths, which is also more than 60%.

The Washington Post weighed in recently with a closer look at the numbers, which we covered yesterday, saying it was related to two issues:

First, the city welcomed more tourists from hard-hit regions of the world than did other places in Africa, meaning the coronavirus was widely seeded here early. Second, major hot spots emerged in two supermarkets and a pharmaceutical factory that supercharged the virus’s spread.

Prof Salim Abdool Karim, an infectious disease expert and chair of the ministerial advisory committee, also pointed out those “super spreader events”, adding that we should expect more of those across the country as lockdown restrictions are eased.

You can read more on the Washington Post article here.

Closer to home, the Daily Maverick’s Rebecca Davis took a really deep dive into “Unravelling the riddle of the Western Cape’s high COVID-19 numbers”.

Capetonians have been widely criticised for flouting physical distancing protocol by flocking to certain areas during the allotted exercise hours, and in response, many have pointed to the Western Cape’s numbers being high as a result of efficient and extensive testing.

The numbers do bear that out:

…the Western Cape government has repeatedly pointed out that the province has been undertaking strategic testing at a scale that no other province has come close to matching…

Between 20 April and 10 May, for instance, the testing report compiled by the National Institute for Communicable Diseases (NICD) shows that the Western Cape accounted for almost a quarter of all lab tests conducted nationally: 51,248 tests out of a total 222,209.

It is not just the volume of testing the province is undertaking that is significant, but also the kind of testing…the province is proactively testing people in areas which have already been identified as likely coronavirus hotspots, so the tests are likely to come back positive.

This too is reflected in the NICD data. Between 4 and 10 May, for instance, 1% of tests in Gauteng came back positive, whereas 12.1% of tests in the Western Cape came back positive.

The conclusion that is easy to draw from that is the Western Cape has more cases because we’re better at finding, and testing, those who have the coronavirus.

As with everything related to this virus, though, it’s not so cut and dry, and our provincial death toll remains an outlier.

Yes, there are delays in conducting autopsies and issuing death certificates, but experts remain puzzled. To quote Professor Tom Moultrie, the director of the centre for actuarial research at UCT, “the deaths are a mystery”.

Davis puts forwards three explanations for the Western Cape’s riddle, which we’ll outline briefly below:

Option 1: There is no difference between the picture of the pandemic in the Western Cape and the other eight South African provinces, except when it comes to testing. In this scenario, if the other provinces were to immediately adopt the Western Cape’s testing approach, their case numbers would immediately sky-rocket…

Option 2: Even though people are going undiagnosed in other provinces, they are also not dying at a commensurate rate. This would suggest that there is something about either the demographic features of the Western Cape population that make residents more vulnerable to a severe disease course, or that there are social determinants at play – such as the conditions in which they live, or their failure to adhere to lockdown…

Option 3: It is true that the Western Cape is doing more targeted testing, but it is also likely, assuming the accuracy of death records in other provinces, that the Western Cape also simply has more cases at the moment. Whether or not the other provinces “catch up” remains to be seen.

It is the third option that seems to be the position of local authorities, yet Premier Alan Winde remains steadfast in his belief that the Western Cape should drop to alert level 3 as soon as possible.

You can read the Daily Maverick’s deep dive into the numbers in full here.

At this stage, despite all of the ‘experts’ on social media will tell you, there are still so many variables and unknowns in play.

One thing we do know – if the Western Cape, or at least parts of it, remains on alert level 4 when other areas drop to alert level 3, expect some form of hell to break loose.

[source:dailymaverick]