Impact of level five lockdown on the incidence of COVID-19: lessons learned from South Africa

Felix Made; Wells Utembe; Kerry Wilson; Nisha Naicker; Nonhlanhla Tlotleng; Simbulele Mdleleni; Lusanda Mazibuko; Vusi Ntlebi; Phuti Ngwepe

doi:10.11604/pamj.2021.39.144.28201

Impact of level five lockdown on the incidence of COVID-19: lessons learned from South Africa

Pan Afr Med J. 2021 Jun 23:39:144. doi: 10.11604/pamj.2021.39.144.28201. eCollection 2021.

Authors

Felix Made^{1

2}, Wells Utembe^{3

4}, Kerry Wilson¹, Nisha Naicker^{1

2

4}, Nonhlanhla Tlotleng^{1

2}, Simbulele Mdleleni^{1

2}, Lusanda Mazibuko¹, Vusi Ntlebi¹, Phuti Ngwepe⁵

Affiliations

¹ Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg 2000, South Africa.
² Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg 2000, South Africa.
³ Department of Toxicology, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg 2000, South Africa.
⁴ Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2000, South Africa.
⁵ Foundation for Professional Development, Pretoria, South Africa.

Abstract

Introduction: the level five (L5) lockdown was a very stringent social distancing measure taken to reduce the spread of COVID-19 infections. This study assessed the impact of the L5 lockdown and its association with the incidence of COVID-19 cases in South Africa (SA).

Methods: data was obtained from the National Department of Health (NDoH) from the 5^th March to the 30^th April 2020. A basic reproductive number (R0) and a serial interval were used to calculate estimated cases (EC). A double exponential smoothing model was used to forecast the number of cases during the L5 lockdown period. A Poisson regression model was fitted to describe the association between L5 lockdown status and incident cases.

Results: a total of 5,737 laboratory-confirmed cases (LCC) were reported by 30^th April 2020, 4,785 (83%) occurred during L5 lockdown. Our model forecasted 30,629 cases of COVID-19 assuming L5 lockdown was not imposed. High incidence rates of COVID-19 were recorded in KwaZulu-Natal and Mpumalanga Provinces during the L5 lockdown compared to the other provinces. Nationally, the incident rate of COVID-19 was 68.00% higher in L5 lockdown than pre-lockdown for LCC.

Conclusion: the L5 lockdown was very effective in reducing the incidence of COVID-19 cases. However, the incident rates of LCC and EC were higher nationally, and in some provinces during the L5 lockdown.

Keywords: Basic reproductive number; estimated cases; forecast cases; laboratory confirmed cases.

Copyright: Felix Made et al.

MeSH terms

COVID-19 / epidemiology
COVID-19 / prevention & control*
Humans
Incidence
Physical Distancing*
Regression Analysis
South Africa / epidemiology