Covid-19 in SA: One virus, two countries

Mainstream media compared South Africa’s pandemic response to European and North American countries, claiming we had done well, but African countries in fact did much better than us.

This is a lightly edited excerpt from One Virus, Two Countries: What Covid-19 Tells Us About South Africa (2021, Wits University Press) by Steven Friedman. 

South Africa is in Africa but, if its response to Covid-19 is a guide, not of it. 

Strangely, for a country whose public debate is usually loud and polarised, there was little discussion in 2020 of how well the country fared in combating the virus. In the mainstream, it was simply assumed that it did well, despite over three-quarters of a million cases and over 20 000 deaths by late November. This was followed by a more severe “second wave” which proved at least twice as deadly as the first. None of this caused alarm in the public debate. It was, throughout the year, common to encounter people who insisted that South Africa was “doing well” in limiting Covid-19’s effect. 

But on what was this claim based? We were never told. Since South Africa’s case numbers were at one stage the fifth highest in the world and, by the end of November, still in the top 15 although it is only the planet’s 25th biggest country, the self-congratulation seems unjustified. It certainly did not “do well” compared to the countries of East Asia, most of whose case and death figures were a fraction of this country’s (or New Zealand, which appears to have largely defeated Covid-19). It did not “do well” compared to the rest of the African continent. For a long while, it experienced as many cases and deaths as the rest of the continent combined. While its share of both dropped towards the end of the year, it was still, by a large distance, the African country with the most cases and loss of life. But this made no impact on the South African debate. The virus’ impact on Africa was rarely reported on by the media and the comparison between South Africa’s experience and that of the rest of the continent was ignored by the debate. 

The rest of Africa would seem to be the most obvious area to which South Africa should be compared. Covid-19 cases and deaths may not simply be a consequence of how well governments have done in combating the virus. Climate might matter since the virus is airborne and spreads more rapidly indoors (and so also in countries where climate forces people inside). Age profile might also affect figures because young people were, during 2020, less likely to suffer severe illness or to die of the virus. So might the living conditions of most people. It could be argued that the states of East Asia (and Australasia) are very different to South Africa and that its experience cannot be compared to theirs. But it is hard to make this argument about the rest of Africa, the part of the world to which South Africa’s climate, age profile and living conditions (for the majority) are closest. It has no in-built disadvantages compared to the rest of the continent and should therefore experience case numbers and fatality rates similar to those of the rest of Africa (or better, given its more sophisticated healthcare facilities). The fact that it was far more affected than any other African country must mean that it did not do well at all. 

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The only reason for not measuring South Africa against the rest of the continent is a deep-rooted bias. The debate disregards how Africa has dealt with Covid-19 because it ignores it on all other issues too. About the only time the rest of the continent features in South Africa’s debates is when it is dragged in to settle arguments which are about something else. On one side of the fence, the continent may be cited as a cautionary tale (“if we carry on like this we will be as bad as the rest of Africa”). On the other, people and institutions which are insensitive to the concerns of Black South Africans will be accused of contempt for Africa. In both cases, Africa is an idea, not a place, still less one peopled with complicated human beings. For the rest, the continent is largely ignored. News from the rest of Africa rarely makes headlines and some international news outlets give more prominence than South Africa’s media to African developments. Nor is there evidence that the media’s indifference to Africa deprives South Africans of news and insights they want. The rest of the continent evokes little interest in citizens who engage on digital media (more commonly called “social” media despite the fact that they are owned by large profit-making corporations) or as consumers of traditional news. The media reflect the lack of interest; they do not create it. 

Despite the vagueness of the claim, it is not difficult to work out in comparison to whom South Africa is assumed to have done well. Brazil has done poorly, but the South African debate does not think or talk about Brazil. During 2021, India, after initially containing the virus, experienced a horrifying “second wave” (if cases and deaths are calculated as a percentage of population, its figures were not much different from South Africa’s but years of underfunding ensured that its health facilities could not cope). But the debate does not think or talk of India – its ordeal was noticed only because it was covered in detail by Western media. When South Africa’s government ministers and scientists talk of “the world”, they mean Western Europe and North America (the United States and Canada). Sometimes this is explicit – it was common for South Africa’s scientists to compare its experience directly to that of Western Europe or the USA. But it is also implied. Not long after Covid-19 arrived in South Africa, Salim Abdool Karim who is chair of the Ministerial Advisory Committee (MAC) on Covid-19 was, in effect, the government’s chief scientific advisor, declared that a severe epidemic was inevitable because no country had avoided one. Since at the time (April 2020) many countries, including the entire African continent, had done precisely that, his remark made no sense unless what he really meant to say is that no country of interest to the South African elite had avoided one, which meant no major Western European or North American country. 

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The assumption that “the world” is, in reality, the countries of the “West” is deeply ingrained in South Africa, despite frequent ritual salutes to “Africa” or the countries of the BRICS alliance, Brazil, Russia, India and China. It shapes not only the debate, but thinking on public policy. It is a consequence of both of the country’s history, particularly its specific form of minority rule, and of its current reality, marked by the existence of two very different worlds in one country. Inevitably, this reality framed its official response to Covid-19, ensuring that the country with the most sophisticated health facilities on the continent was, by a considerable margin, more severely affected than anywhere else in Africa. 

It is, of course, necessary to justify this core assumption that South Africa did not “do well” by comparing its experience in greater detail with that of the rest of Africa. An obvious danger of writing about Covid-19 while the pandemic is still in progress is that events move very quickly. At the time this book was being written, South Africa had passed through a “second wave” of increased infections which the rest of the continent was also experiencing. While this book discusses the “second wave” when this is necessary to help understand the issues it explores, its chief focus is on developments until the end of November 2020. This is necessary because the virus has not disappeared and the details of case and fatality numbers change every day. 

The discovery of vaccines has added a new dynamic and it is too early for a full assessment. A line must be drawn somewhere and the obvious place to draw it is at the end of the first phase of the virus, which is over and so more easily analysed. More important, the “second wave” – if that is indeed what it is, for there is good reason to challenge the claim that what happened in December 2020, as case numbers grew sharply in several provinces, was very different from what had come before – has not altered the arguments made in this book; on the contrary, it has confirmed them. The pattern created in much of 2020 has persisted into 2021 and, although the rest of Africa experienced higher case and death numbers, by the end of February 2021, South Africa’s epidemic was still substantially more severe as a proportion of population than that of any other country on the continent. Events in late 2020 and early 2021 add nuance to the analysis offered here but do not challenge it.

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