Across Gauteng, there is a feeling of change in the air.  

The weather is warmer, there is talk that the lockdown will soon ease, and, more importantly, that the Covid-19 peak might have come and gone.

New infection rates have been falling as has the number of Covid patients occupying hospital beds. On July 23, there were 7,000 Covid-19 hospital admissions in Gauteng; on Thursday that number stood at 4,091.

The storm Gauteng Premier David Makhura warned of just weeks ago, appears to be easing off.

But the experts disagree about whether Gauteng has seen the end of the surge or if the peak is yet to come.

On Thursday the Gauteng Provincial Command Council gave an update on where the province stood in the fight against the Covid-19 virus. As with the Western Cape, South Africa’s most populous province has seen a slowdown in infections.

However, Bruce Mellado, of Wits University’s School of Physics, said this was not yet the peak. He explained at the briefing that he, through the use of artificial intelligence, had come up with an optimistic and a pessimistic peak scenario. 

The optimistic scenario would see the number of infections in Gauteng peaking in December, or January 2021.

The pessimistic projection will be 20% higher in amplitude than the optimistic scenario and will peak earlier, in November/December.

He warned that changes in behaviour could result in a rapid rise in infections.

“Now, if, in August, we open the schools, immediately what happens is that the peak basically is brought forward, and the amplitude of the peak, the maximum number of cases basically doubles around 250-270,000, this basically speaks to the fact that the small changes in policy or behaviour do have a very strong impact, in outcome. So, everything that we do has to be done in a phased, and a gradual way,” he said.  

Others don’t agree with Mellado’s predictions.

Some experts Daily Maverick spoke to believe that there won’t be a massive peak and that Gauteng will follow what is happening in the Western Cape, where Covid-19 infection rates have stayed static.  

For Gautengers this will mean they will be in it for the long haul, seeing daily infection numbers hovering maybe at the 500/800 or 1,000 mark.

But others are more confident that the Covid-19 infection curve is finally descending.

“Well, first of all, how confident are we that there was a peak, and I think the evidence is good,” says Professor Alex Welte, of the South African Centre of Excellence for Epidemiological Modelling and Analysis, who wasn’t at the provincial briefing.

“Cases are down, although there has been some quibbling over testing becoming a bit more selective. It’s theoretically possible but very unlikely.”

Welte suggests that the virus might be burning itself out across South Africa, and that it is finding it harder to locate new bodies to infect.

“The turnaround could be from saturation or basically the loss of efficiency of transmission. Maybe taxi drivers who were good transmitters have all had it, so taxis are no longer much of a thing when it comes to transmission,” he explains.

But SA scientists are facing the same problem as those overseas. There are still a lot of unknowns about the Covid-19 virus.

At Thursday’s briefing, Makhura also highlighted the increased numbers of those who had recovered from Covid-19 in his province. Importantly, he said, many of them were healthcare workers.

Recently the US Covid-19 expert Anthony Fauci said that in his 40 years of dealing with viral outbreaks he had never seen a single virus where 20% to 40% of those infected have shown no symptoms.

The problem in South Africa, like elsewhere, is that no one knows how many people have been infected by the virus. Some scientists have suggested that perhaps over five million South Africans have come into contact with the virus, and that most of them had no inkling of their exposure.  

Overseas surveys have been conducted that test for Covid-19 antibodies in the blood. These have produced some surprising findings.    

In some Spanish and Italian towns these surveys have suggested that 10% of the population were exposed to the virus, while the official diagnostic rate was less than 1%, says Welte.

“And the most interesting figures I’ve seen recently are from Mumbai and Delhi which is very much like we are when it comes to impoverished shantytowns, and a younger population. They found that the population estimate is about 50% have antibodies.”

As yet it appears no one has done any antibody testing in South Africa.

The problem is that as yet no one knows how long those antibodies will protect people from the virus. As with everything else with the virus it is the big unknown.  

Some have suggested that it might just be a handful of months and a second wave of infections might be driven by a virus reinfecting those who once had the disease.

Or maybe this second time around, the virus will seek out those who weren’t exposed when it first arrived.  

At Thursday’s briefing, Makhura also highlighted the increased numbers of those who had recovered from Covid-19 in his province. Importantly, he said, many of them were healthcare workers.

“There was a period when I was Covid positive and interacting with healthcare workers in my area and they were saying that half of the healthcare workers were not at work, because they too were Covid positive. So a 78% recovery rate is good as it means that more healthcare workers are back at work,” he said.

He said the recovery rate was because of the hard work of the healthcare workers.

But he warned that there were still risks. 

“Whatever decisions are made by the national Cabinet about what the next move is, here in Gauteng we are still a highly vulnerable province, with high densities of people. With the numbers slower we need to be more cautious, because we don’t want a second wave that is more brutal.” DM/MC