COVID-19 pandemic in South Africa

COVID-19 pandemic in South Africa
Confirmed active COVID-19 cases in provinces from March 2020 to July 2022.
Natural excess deaths (green) up to 2022-12-10 vs confirmed COVID-19 deaths (red) up to 2022-07-02.
Disease	COVID-19
Virus strain	SARS-CoV-2
Location	South Africa
First outbreak	Wuhan, Hubei, China
Index case	Hilton, KwaZulu-Natal
Arrival date	5 March 2020 (4 years, 1 month, 3 weeks and 4 days ago)
Confirmed cases	4,072,661[1] +1,358 as of 1 February 2022[update][2]
Active cases	6,118[2]
Recovered	3,946,943[2]
Deaths	102,595[1] +0 as of 1 February 2023[update][2]
Fatality rate	2.52%
Test positivity rate	12.7% as of 25 March 2023[update][3]
Vaccinations	24,209,938[1] (total vaccinated) 21,038,797[1] (fully vaccinated) 38,841,308[1] (doses administered)
Government website
https://sacoronavirus.co.za https://vaccine.enroll.health.gov.za

The COVID-19 pandemic in South Africa was part of the pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

On 5 March 2020, Minister of Health Zweli Mkhize had confirmed the spread of the virus to South Africa, with the first known patient being a male citizen who tested positive upon his return from Italy.^[4] On 15 March 2020, the President of South Africa, Cyril Ramaphosa, declared a national state of disaster,^[5] and announced measures such as immediate travel restrictions and the closure of schools from 18 March.^[6] On 17 March, the National Coronavirus Command Council was established,^[7] "to lead the nation's plan to contain the spread and mitigate the negative impact of the coronavirus".^[7][8] On 23 March, a national lockdown was announced, starting on 27 March 2020.^[9] The first local death from the disease was reported on 27 March 2020.^[10] On 21 April, a 500 billion rand stimulus was announced in response to the pandemic.^[11] Ramaphosa announced that from 1 May 2020, a gradual and phased easing of the lockdown restrictions would begin, lowering the national alert level to 4.^[12] From 1 June, the national restrictions were lowered to level 3.^[13][14] The restrictions were lowered to alert level 2 on 17 August 2020.^[15] From 21 September 2020, restrictions were lowered to alert level 1.^[16]

In December 2020, the country experienced a 2nd wave of COVID-19 infections,^[17] mostly with infections from the SARS-CoV-2 Beta variant.^[18] The lockdown was tightened from an adjusted level 1 to an adjusted level 3 starting on 29 December 2020. The lockdown was lowered from an adjusted level 3 to an adjusted level 1 starting on 1 March 2021.^[19] On 17 February 2021, the national COVID-19 vaccination program was officially rolled out.^[20]

On 8 May 2021, local cases of variants of concern Delta (first detected in India, which has a higher transmissibility than the dominant strain, Beta) and Alpha were reported.^[21] On 31 May 2021 the country was moved from adjusted level 1 to an adjusted alert level 2, due to a 3rd wave of infections,^[22] mostly with infections from the Delta variant.^[18] On 15 June 2021 the country was moved to alert level 3.^[23] On 28 June 2021, the country was moved to adjusted level 4, with the Delta variant fast becoming the dominant strain in the country.^[24] On 9 July 2021, sixteen months into the pandemic, doctors in Johannesburg described the system there as beyond its breaking point, with insufficient beds and barely enough oxygen.^[25] On 25 July 2021 the country was lowered to adjusted level 3.^[26] On 13 September 2021, an adjusted alert level 2 took effect,^[27][28] and on 1 October 2021 more restrictions were eased by moving to adjusted alert level 1.^[29]

On 26 November 2021, the World Health Organization (WHO) classified the Omicron variant, first identified in Botswana^[30] but first reported to the WHO by South Africa, as a variant of concern.^[31] Several countries announced travel bans from South Africa and its neighboring countries. The country was entering its 4th wave by 1 December 2021,^[32] mostly with infections from the standard BA.1 subvariant of the Omicron variant.^[18] On 4 February 2022 it was announced that South African scientists had replicated the Moderna COVID-19 vaccine.^[33] Further easing of restrictions came into effect on 23 March 2022, including dropping the requirement to wear masks outdoors though still required indoors in public vehicles and spaces, allowing proof of vaccination or a COVID-19 test not older than 72 hours as an alternative for entering certain venues, and reducing distancing to 1 metre except in schools.^[34][35] On midnight 4 April 2022, the National State of Disaster was terminated, though some transitional provisions remained in place for a period of 30 days.^[36]

A limited 5th wave^[37] from late-April 2022 was mostly from infections from the BA.4, BA.5, and BA.2 subvariants of the Omicron variant.^[18] Deaths were more decoupled from cases, likely due to high levels of population immunity from infection and/or vaccination.^[38] Eminent risk declined by mid-June 2022, and on 22 June 2022 all remaining health regulations regarding COVID-19 were ended.^[37]

During the first two years, 2020 and 2021, excess deaths were estimated at 292.3 per 100000 population.^[39] As of 2 January 2023^[update] there have been 341123 excess deaths of persons older than 1 years from natural causes since 3 May 2020,^[40] with 85%–95% of these excess deaths attributable to COVID-19, and the remaining 5%–15% probably mainly due to overwhelmed health services.^[41] In May 2023, it was announced by the WHO Director-General that COVID-19 was no longer a Public health emergency of international concern.^[42]