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President’s notes: Ramaphosa’s interview with editors

President Ramaphosa convened a virtual meeting with the South African National Editors' Forum.

President Cyril Ramaphosa. Picture: @PresidencyZA/Twitter

JOHANNESBURG - This engagement takes place on the eve of a new phase in our national response to the coronavirus pandemic.

The move to alert level 3 on Monday 1 June marks a significant shift in our approach to the disease, from lockdown to intensive public health management.

This is a useful opportunity to reflect on the progress that has been made, the current state of the pandemic and the road ahead.

This is also an opportunity to applaud and thank the media in South Africa for its indispensable contribution to the national effort to confront this crisis.

Through its reporting on the disease, the media has helped to inform and empower South Africans, stimulate public debate and promote accountability.

The media has had to fulfil this role under the difficult conditions of lockdown, which has required new ways of working and reaching readers, listeners and viewers. This at a time when most media organisations are no doubt facing financial challenges.

Like so many others in society, journalists have certainly ‘played their part’ in this momentous struggle to overcome the coronavirus pandemic – and continue to do so.

As you would be aware, our approach to this pandemic has been informed by the view from the scientific community that most South Africans are likely to be infected by the virus at some point.

While the overwhelming majority will have no symptoms or only mild symptoms, a small proportion of people infected will develop severe symptoms and need hospitalisation, and for a proportion of those people, the virus could be fatal.

As we’ve seen in many other countries, a very small proportion of a very large infected population can quite easily overwhelm even the best-equipped health system.

Our strategy has therefore been to prevent a massive spike in infections by delaying the rate of infections, and to simultaneously prepare our health system for the anticipated surge in cases and put in place broader public health interventions.

Now, after 65 days of lockdown, we can reflect on how effective this phase of our strategy has been.

Have we achieved what we set out to achieve?

We have started to flatten the curve.

The latest report is that South Africa has 30,967 confirmed cases.

Of those, around 52% of people have recovered.

The lockdown significantly reduced the rate of infection.

Before lockdown the doubling time of coronavirus cases was 2 days. During lockdown it was 15 days. During the easing of the lockdown – with the implementation of level 4 – it has reduced to 12 days.

The Western Cape has, so far, been hardest hit by the disease.

It currently accounts for nearly 65% of all confirmed cases, and the doubling time of cases is 9 days, as opposed to 12 nationally.

It is of the utmost importance that we reduce the rate of spread in the Western Cape and we do everything possible to prevent other parts of the country from following a similar trajectory.

South Africa has recorded 643 deaths.

This is a case fatality rate of 2.1%, which is far lower than the global average of 6.4% and the European average of 8.5%.

Our priority now must be to ensure that we have sufficient health system capacity to provide life-saving care to all those who may need it.

In the coming weeks, we should expect an exponential rise in cases, and we need to deploy all the means at our disposal to continue to flatten the curve.

We have strengthened our public health interventions.

Since we began our community screening, over 13 million individuals have been screened, and 188,000 of these have been referred for testing.

As people return to work, school and study, we will be significantly expanding the screening effort to all places where people congregate.

However, with such a high proportion of asymptomatic cases, we need to complement screening with a range of other preventative measures.

We also need to be more targeted in our testing due to the severe global shortage of test kits and supplies.

Another important element of our public health response is contact tracing. Nationally, around 96% of identified contacts are being traced, although this number is significantly lower in the Western Cape and Eastern Cape.

Still, this remains an area of weakness. We are currently identifying on average 2 contacts for each confirmed case, whereas countries like South Korea have been identifying around 20 contacts per case.

We have improved the capacity of our health system.

Guided by the modelling that has been done on the trajectory of the disease, we have been working hard to expand the capacity of our health facilities.

To date, over 27,000 beds in the public sector have been allocated to COVID-19 patients. The field hospitals that are currently being constructed will have around 13,000 beds.

With the assistance of various governments, companies and foundations, we have been able to mobilise significant quantities of personal protection equipment, other medical supplies and ventilators.

Our attention has not been limited only to South Africa, but have been working with other leaders to ensure that Africa has the resources it needs.

I have been in discussion with President Xi Jinping of China to secure diagnostic supplies, including 30 million testing kits, 10,000 ventilators and 80 million masks per month for our continent.

We continue to work with partners to import material when supplies are short. This week, we will be receiving a supply of 1 million masks from Huawei.

We are working to grow local production through our work with different industries in the country and through the support we are providing through the IDC, National Empowerment Fund and others.

Companies across the country have repurposed some of the production capacity to supply the country with alcohol for hand sanitisers, face shields and masks, ventilators and other essential medical supplies.

As I was walking yesterday, I spoke to a man who said that he used to import masks, but now he used the support we gave to small business to set up a company that produces masks locally. He now has 75 workers who are producing masks.

The coronavirus pandemic has not only presented us with enormous challenges. It has also created several opportunities, on which we must capitalise.

The pandemic has shown that the state which has always displayed signs of incapacity as I have stated before, when called upon to do so does have the capacity to implement programmes that improve the lives of people, from food distribution to the provision of water, from wage support to assistance to small businesses.

We have also during this period been able process the data of 6 million South Africans who have come forward to receive the Special Relief Grant and will be able to distribute that grant to some 3.5 million South Africans for the next 6 months.

Because of COVID-19, we have had to quickly improve our health system to be ready to serve everyone regardless of their ability to pay; which is a fundamental principle of the NHI.

We have increased our allocation to improve the health system. We have made massive investments in health infrastructure, improving the quality of existing buildings and movable assets.

We have invested in information technology to collect and manage data. For example, in two months we have built cellphone technology for household screening and to assist patients to visit health facilities or collect medicines. We have ramped up our capacity to monitor the performance of the health system in real-time.

We have quickly adapted to remote meetings, training courses and even Parliamentary committee meetings, reducing the time and cost of travel. The allocation of temporary spectrum during this period has eased constraints.

We are using this pandemic to fast-track the implementation of the District Development Model, ensuring that the different spheres and departments of government work more effectively together to fulfil a common mandate.

The Minister of health has said that the best way of tackling the pandemic and ensuring that our preventative health measures work is to implement all those interventions at the district level and to this end we will be deploying our Ministers and Deputy Ministers including directors-general to all the districts in our country and metros as District Champions. They will enable us to have a better and greater focus on all the districts and metros.

This will put our health interventions in a much stronger position particularly in the hot spot areas.

We have extended the special COVID-19 UIF benefit to unregistered domestic workers. This highlights the need to register all employees in private households.

When we declared the nation-wide lockdown, we knew that it would need to be limited in duration. Our economy would need to re-start and people and companies would need to start earning an income again.

We also knew that the lockdown would only delay – but could not stop – the spread of the virus, and that we would need to brace for a significant increase in infections after the lockdown.

The implementation of alert level 3 marks the start of the next phase of our strategy.

It involves a shift from extreme social distancing, which took the form of the lockdown, to a broader range of public health interventions. This is what we have called our ‘coronavirus toolbox’.

This new phase relies, in the first instance, on individual behaviour and the basic hygienic practices we are all now familiar with – wearing face masks, hand washing, cough etiquette, etc.

In the second instance, it relies on social distancing measures, sanitisation and strict hygienic practices in all places where people congregate, including workplaces, shops and malls, public transport, schools, universities and places of worship.

In the third instance, this phase focuses on public health interventions, including widespread symptom screening at workplaces, schools and other institutions, testing, contact tracing and quarantine.

We have introduced a differentiated approach between areas of high infection, known as hotspots, and areas of low infection, which require ongoing vigilance and surveillance.

Special interventions will be made in hotspots. Dedicated, multidisciplinary teams will be deployed to contain the outbreak, including epidemiologists, doctors, nurses and community health workers.

Each hotspot will be linked to testing and quarantine facilities, and additional hospital beds where necessary. There will be a close focus on tracing contacts and isolating them to prevent further transmission

Originally, the intention was to place hotspot areas at a higher alert level than other areas, but it became evident that this was going to prove impractical and would undermine our efforts to re-open the economy. Having different areas at different alert levels would disrupt supply chains, create a multiplicity of regulations to enforce and may even increase the movement of people between hotspot and other areas.

If it becomes necessary, and all the other hotspot interventions do not succeed in containing the spread of the virus, then some hotspot areas may be placed on a higher alert level.

The new phase of the strategy is in line with the approach that we outlined from the start. The first stage was preparation, even before we recorded the first case in the country, then primary prevention, then lockdown and surveillance and active case finding, and now hotspot intervention.

This is not a case of government stepping back from the crisis, but of government working with all social partners to intensify our efforts across a broad front of interventions.

We are re-opening most areas of the economy so that people can earn a living, and so that this immediate health crisis does not result in a permanent economic crisis. At the same time, we are retaining many restrictions on personal movement and gatherings to limit transmission.

Social and Economic interventions were largely made up of 5 components:

  1. support households and communities,

  2. protect workers,

  3. sustain businesses,

  4. strengthen public health interventions; and

  5. strengthen the economy.

Our initial interventions that had economic assistance measures came up to R1.7 billion. It clearly was not sufficient as it amounted to 0.01% of our GDP.

As the scale of social and economic hardship became apparent, the response had to be scaled up. The R500 billion assistance measures amount to 11% of GDP. This was in line with what a number of developed economies as well as medium income countries had done to shore up the economies

The return to economic activity will take place alongside the implementation of the R500 billion social and economic relief package.

A central part of that package is to support poor households and informal workers, whose incomes have been most affected by the lockdown.

Through the top-up of the social grant payments and the special COVID-19 grant, an additional amount of around R50 billion will be transferred to poor households over six months.

Establishing the Special COVID-19 Grant, which is targeted at unemployed people who do not receive any other form of state support, has been particularly challenging. Application, screening, approval and payment mechanisms had to be set up within a matter of weeks.

Of around 6.3 million applications, 117,000 grants have been fully processed and paid. Around 1.6 million applications have so far been rejected for not meeting the eligibility criteria.

The measures we have put in place to help companies in distress, mitigate the effect of the lockdown on cashflow and save jobs have been vital over this period.

Since it was established, the special COVID-19 relief scheme of the Unemployment Insurance Fund has paid out over R15.8 billion to 3 million employees from over 200,000 companies.

The various funds that we established to provide support for small businesses, including the initiatives of the Department of Small Business Development, the Department of Tourism, the Industrial Development Corporation and the South African Future Trust, have provided direct assistance to over thousands of enterprises.

A significant development has been the R200 billion Loan Guarantee Scheme, which is guaranteed by government, which has begun processing applications from small and medium-sized businesses.

Several commercial banks and insurance companies have also assisted the economic relief effort by, among other things, delaying or reducing instalment payments, providing debt relief, and waiving bank fees for grant beneficiaries.

These measures have been supported by over R70 billion in tax relief and a substantial monetary stimulus through the South African Reserve Bank.

As the economy returns to operation, many of these measures will need to be sustained as a lot of companies will continue to face difficulties. It is our intention to assist as many as possible to get back on their feet as quickly as possible.

While we are firmly focused on the task of fighting the pandemic and saving lives, we are also turning our attention towards a sustainable economic recovery.

As I have said before, we are resolved not merely to return our economy to where it was before the coronavirus, but to forge a new economy in a new global reality.

Our economic strategy going forward will require a new social compact among all role players – business, labour, community and government – to restructure the economy and achieve inclusive growth.

Among other things, we will accelerate structural reforms, promote localisation and industrialisation, repurpose state owned enterprises and strengthen the informal sector.

A key driver of this recovery will be a massive infrastructure build and maintenance programme that mobilises public and private resources on a significant scale.

Another focus will be a massive employment drive that will involve resetting our public employment initiatives, among other things, the expansion of current programmes like the National Youth Service, Community Works Programme and the Presidential Youth Employment Intervention.

Starting with the recruitment of community field workers to support the COVID-19 response, we are working on plans to create employment opportunities through activities such as building and maintaining community infrastructure, investing in the environment and strengthening schools, early childhood development and community care. This will take place alongside the work that needs to be done to unlock employment in the wider economy.

It is nearly three months since South Africa recorded its first confirmed case of coronavirus.

The measures we have taken since then have managed to significantly reduce the rate of infection within the population. At the same time, these measures have resulted in massive disruption in people’s lives and have placed livelihoods at risk.

As we steadily open up the economy and enable people to return to work, we are now entering the most challenging phase of our response to the pandemic, which carries the great risk for a massive and uncontrollable rise in infections.

The weeks ahead will be crucial and will require great vigilance, caution and effort from all South Africans.

From the experience of the last three months – from everything we’ve gone through, everything that we’ve achieved and all the hard lessons we have learnt – I am convinced that we will succeed in overcoming this pandemic.