Open accessJournal Article

# COVID-19 in South Africa: outbreak despite interventions.

02 Mar 2021-Scientific Reports (Nature Publishing Group)-Vol. 11, Iss: 1, pp 4956-4956
Abstract: The future dynamics of the Corona Virus Disease 2019 (COVID-19) outbreak in African countries is largely unclear. Simultaneously, required strengths of intervention measures are strongly debated because containing COVID-19 in favor of the weak health care system largely conflicts with socio-economic hardships. Here we analyze the impact of interventions on outbreak dynamics for South Africa, exhibiting the largest case numbers across sub-saharan Africa, before and after their national lockdown. Past data indicate strongly reduced but still supracritical growth after lockdown. Moreover, large-scale agent-based simulations given different future scenarios for the Nelson Mandela Bay Municipality with 1.14 million inhabitants, based on detailed activity and mobility survey data of about 10% of the population, similarly suggest that current containment may be insufficient to not overload local intensive care capacity. Yet, enduring, slightly stronger or more specific interventions, combined with sufficient compliance, may constitute a viable option for interventions for South Africa.

Topics: Intensive care (55%), Population (52%)
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Open accessJournal Article
01 Jan 2021-
Abstract: South Africa has received international recognition for taking an active role in addressing extreme poverty by establishing a national social grant program. Lauded as one example to alleviate poverty, the operating assumption is that these strategies provide alternatives to mainstream development assistance. Notwithstanding their potential effects, the pathways generating livelihood change and their long-term implications for processes of citizenship formation and state society relations remain unclear. Drawing from an interdisciplinary study of social and economic change in Mpumalanga Province, South Africa, we analyze household surveys and qualitative interviews to examine how individuals manage their limited income through a balance of social grants, economic remittances, labor migration and strategic task-shifting. Though more than half of the households receive some form of pension support from the national government, many continue depending on remittances from household members living elsewhere. Social grants additionally interrelate with health maintenance in complicated ways, evidenced by high HIV rates within the study region. We argue that while the distribution of grants helps alleviate financial stress, the structure of assistance programs is more symbolically than materially significant for many families. Despite government assistance, families require social network mobilization and resources to access and secure healthcare and other basic needs.

Topics: Basic needs (56%), Social network (56%), Extreme poverty (56%) ... show more

3 Citations

Open accessJournal Article
12 Apr 2021-Scientific Reports
Abstract: Tuberculosis (TB) is the 10th leading cause of death worldwide, and since 2007 it has been the main cause of death from a single infectious agent, ranking above HIV/AIDS. The current COVID-19 is a pandemic which caused many deaths around the world. The danger is not only a coinfection as observed for TB and HIV for a long time, but that both TB and SARS-CoV-2 affect the respiratory organs and thus potentiate their effect or accelerate the critical course. A key public health priority during the emergence of a novel pathogen is the estimation of the clinical need to assure adequate medical treatment. This requires a correct adjustment to the critical case detection rate and the prediction of possible scenarios based on known patterns. The African continent faces constraining preconditions in regard to healthcare capacities and social welfare which may hinder required countermeasures. However, given the high TB prevalence rates, COVID-19 may show a particular severe course in respective African countries, e.g. South Africa. Using WHO's TB and public infrastructure data, we conservatively estimate that the symptomatic critical case rate, which affects the healthcare system, is between 8 and 12% due to the interaction of COVID-19 and TB, for a TB population of 0.52% in South Africa. This TB prevalence leads to a significant increase in the peak load of critical cases of COVID-19 patients and potentially exceeds current healthcare capacities.

Topics: Population (52%)

2 Citations

Open accessJournal Article
06 Oct 2021-Sustainability
Abstract: Innovative food production and food consumption entrepreneurship can be viewed as a recipe for delivering sustainable development goals to promote economic, human, and community growth among vulnerable and marginalised communities in South Africa (SA). This study critically analyses the trends and related issues perpetuating the development gap between privileged and marginalised communities in SA. It explores the link between innovative food production and food consumption entrepreneurship and underdevelopment based on sustainable development goals (SDGs). The study also generates a conceptual model designed to bridge the development gap between privileged and marginalised communities in SA. Philosophically, an interpretivism research paradigm based on the socialised interpretation of extant literature is pursued. Consistent with this stance, an inductive approach and qualitative methodological choices are applied using a combination of thematic analysis and grounded theory to generate research data. Grounded theory techniques determine the extent to which the literature review readings are simultaneously pursued, analysed, and conceptualised to generate the conceptual model. Research findings highlight the perpetual inequality in land distribution, economic and employability status, social mobility, gender equity, education, emancipation, empowerment, and quality of life between privileged and marginalised societies in SA. Underdevelopment issues such as poverty, unemployment, hunger, criminal activities, therefore, characterise marginalised communities and are linked to SDGs. Arguably, food production and food consumption entrepreneurship are ideally positioned to address underdevelopment by creating job opportunities, generating income, transforming the economic status, social mobility, and quality of life. Although such entrepreneurship development initiatives in SA are acknowledged, their impact remains insignificant because the interventions are traditionally prescriptive, fragmented, linear, and foreign-driven. A robust, contextualised, integrated, and transformative approach is developed based on the conceptual model designed to create a sustainable, innovative, and digital entrepreneurship development plan that will be executed to yield employment, generate income and address poverty, hunger, gender inequity. To bridge the gap between privileged and marginalised societies. The conceptual model will be used to bridge the perpetual development gap between privileged and marginalised societies. In SA is generated. Recommended future research directions include implementing, testing, and validating the model from a practical perspective through a specific project within selected marginalised communities.

Open accessPosted Content
03 Nov 2021-medRxiv
Abstract: The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) took the world by surprise. Following the first outbreak of COVID-19 in December 2019, several models have been developed to study and understand its transmission dynamics. Although the spread of COVID-19 is being slowed down by vaccination and other interventions, there is still a need to have a clear understanding of the evolution of the pandemic across countries, states and communities. To this end, there is a need to have a clearer picture of the initial spread of the disease in different regions. In this project, we used a simple SEIR model and a Bayesian inference framework to estimate the basic reproduction number of COVID-19 across Africa. Our estimates vary between 1.98 (Sudan) and 9.66 (Mauritius), with a median of 3.67 (90% CrI: 3.31 - 4.12). The estimates provided in this paper will help to inform COVID-19 modeling in the respective countries/regions.

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Open accessJournal Article
16 Jul 2021-
Abstract: COVID-19 has spread rapidly around the globe. While there has been a slow down of the spread in some countries, e.g., in China, the African continent is still at the beginning of a potentially wide spread of the virus. Owing to its economic strength and imbalances, South Africa is of particular relevance with regard to the drastic measures to prevent the spread of this novel coronavirus. In March 2020, South Africa imposed one of the most severe lockdowns worldwide and subsequently faced the number of infections slowing down considerably. In May 2020, this lockdown was partially relaxed and further easing of restrictions was envisaged. In July and August 2020, daily new infections peaked and declined subsequently. Lockdown measures were further relaxed. This study aims to assess the recent and upcoming measures from an epidemiological perspective. Agent-based epidemic simulations are used to depict the effects of policy measures on the further course of this epidemic. The results indicate that measures that are either lifted too early or are too lenient have no sufficient mitigating effects on infection rates. Consequently, continuous exponential infection growth rates or a second significant peak of infected people occur. These outcomes are likely to cause higher mortality rates once healthcare capacities are occupied and no longer capable to treat all severely and critically infected COVID-19 patients. In contrast, strict measures appear to be a suitable way to contain the virus. The simulations imply that the initial lockdown of 27 March 2020 was probably sufficient to slow the growth in the number of infections, but relaxing countermeasures might allow for a second severe outbreak of COVID-19 in our investigated simulation region of Nelson Mandela Bay Municipality.

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22 results found

Open accessJournal Article
Andrea Remuzzi1, Giuseppe Remuzzi2Institutions (2)
11 Apr 2020-The Lancet
Abstract: Summary The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.

Topics: Intensive care (63%), Global health (51%)

2,000 Citations

Open accessJournal Article
Abstract: The current outbreak of the novel coronavirus Covid-19 (coronavirus disease 2019; previously 2019-nCoV), epi-centered in Hubei Province of the People's Republic of China, has spread to many other countries. On January 30, 2020, the WHO Emergency Committee declared a global health emergency based on growing case notification rates at Chinese and international locations. The case detection rate is changing hourly and daily and can be tracked in almost real time on website provided by Johns Hopkins University [1] and other websites. As of early February 2020, China bears the large burden of morbidity and mortality, whereas the incidence in other Asian countries, in Europe and North America remains low so far.

Topics: Viral Epidemiology (62%), Betacoronavirus (59%), Pneumonia (56%)

1,188 Citations

Open accessBook
Andreas Horni1, Kai Nagel2, Kay W. Axhausen1Institutions (2)
09 Oct 2020-
Abstract: The MATSim (Multi-Agent Transport Simulation) software project was started around 2006 with the goal of generating traffic and congestion patterns by following individual synthetic travelers through their daily or weekly activity programme. It has since then evolved from a collection of stand-alone C++ programs to an integrated Java-based framework which is publicly hosted, open-source available, automatically regression tested. It is currently used by about 40 groups throughout the world. This book takes stock of the current status. The first part of the book gives an introduction to the most important concepts, with the intention of enabling a potential user to set up and run basic simulations. The second part of the book describes how the basic functionality can be extended, for example by adding schedule-based public transit, electric or autonomous cars, paratransit, or within-day replanning. For each extension, the text provides pointers to the additional documentation and to the code base. It is also discussed how people with appropriate Java programming skills can write their own extensions, and plug them into the MATSim core. The project has started from the basic idea that traffic is a consequence of human behavior, and thus humans and their behavior should be the starting point of all modelling, and with the intuition that when simulations with 100 million particles are possible in computational physics, then behavior-oriented simulations with 10 million travelers should be possible in travel behavior research. The initial implementations thus combined concepts from computational physics and complex adaptive systems with concepts from travel behavior research. The third part of the book looks at theoretical concepts that are able to describe important aspects of the simulation system; for example, under certain conditions the code becomes a Monte Carlo engine sampling from a discrete choice model. Another important aspect is the interpretation of the MATSim score as utility in the microeconomic sense, opening up a connection to benefit cost analysis. Finally, the book collects use cases as they have been undertaken with MATSim. All current users of MATSim were invited to submit their work, and many followed with sometimes crisp and short and sometimes longer contributions, always with pointers to additional references. We hope that the book will become an invitation to explore, to build and to extend agent-based modeling of travel behavior from the stable and well tested core of MATSim documented here.

Topics: Travel behavior (52%)

591 Citations

Open accessJournal Article
15 May 2020-Science
Abstract: The recent outbreak of coronavirus disease 2019 (COVID-19) in mainland China was characterized by a distinctive subexponential increase of confirmed cases during the early phase of the epidemic, contrasting with an initial exponential growth expected for an unconstrained outbreak. We show that this effect can be explained as a direct consequence of containment policies that effectively deplete the susceptible population. To this end, we introduce a parsimonious model that captures both quarantine of symptomatic infected individuals, as well as population-wide isolation practices in response to containment policies or behavioral changes, and show that the model captures the observed growth behavior accurately. The insights provided here may aid the careful implementation of containment strategies for ongoing secondary outbreaks of COVID-19 or similar future outbreaks of other emergent infectious diseases.

527 Citations

Open accessJournal Article
Abstract: The recent outbreak of COVID-19 in Mainland China is characterized by a distinctive algebraic, sub-exponential increase of confirmed cases during the early phase of the epidemic, contrasting an initial exponential growth expected for an unconstrained outbreak with sufficiently large reproduction rate. Although case counts vary significantly between affected provinces in Mainland China, the scaling law $t^{\mu}$ is surprisingly universal, with a range of exponents $\mu=2.1\pm0.3$. The universality of this behavior indicates that despite social, regional, demographical, geographical, and socio-economical heterogeneities of affected Chinese provinces, this outbreak is dominated by fundamental mechanisms that are not captured by standard epidemiological models. We show that the observed scaling law is a direct consequence of containment policies that effectively deplete the susceptible population. To this end we introduce a parsimonious model that captures both, quarantine of symptomatic infected individuals as well as population wide isolation in response to mitigation policies or behavioral changes. For a wide range of parameters, the model reproduces the observed scaling law in confirmed cases and explains the observed exponents. Quantitative fits to empirical data permit the identification of peak times in the number of asymptomatic or oligo-symptomatic, unidentified infected individuals, as well as estimates of local variations in the basic reproduction number. The model implies that the observed scaling law in confirmed cases is a direct signature of effective contaiment strategies and/or systematic behavioral changes that affect a substantial fraction of the susceptible population. These insights may aid the implementation of containment strategies in potential export induced COVID-19 secondary outbreaks elsewhere or similar future outbreaks of other emergent infectious diseases.