Direct and Indirect Health Effects of Lockdown in South Africa

This paper investigates both the potential impact of national lockdown measures on COVID-19 transmission, and other health and non-health indicators in South Africa, based on available data. We present findings relating to both “costs” and “benefits” in health terms of the national lockdown side by side. Cumulative and new daily cases were plotted against changes in regulations. Disease transmission during each lockdown level was estimated using effective reproduction rate as a proxy, calculated using the EpiEstim method. The reproduction number was calculated at national and provincial level. To compare township and suburb living environments, the Cape Town township of Khayelitsha was compared with the southern suburbs of the same city. Indirect health effects were assessed by official reports and releases from government departments and institutes. Crime statistics were retrieved from the South African Police Service and StatsSA. We find that for large parts of the country and parts of the population, stringent lockdown was little or no better than measures already in place for controlling transmission of COVID-19. The net health effect of COVID-19 lockdowns in South Africa cannot yet be assessed because causes of death data have not been made available. Substantial excess deaths relative to previous years were observed, and the majority of these are not accounted for. There is reason to anticipate significant future health consequences of lockdown.