The effect of lockdown regulations on SARS-CoV-2 infectivity in Gauteng Province, South Africa

Abstract

The rapid spread of COVID-19 has resulted in a global pandemic. [1] By 10 July 2020, 22 million cases had been reported worldwide, resulting in 580 000 deaths. Governments around the world have implemented variable lockdown regulations to curb the rapid transmission of SAR-CoV-2. The first South African (SA) case of COVID-19 was reported on 5 March. [2] On 26 March, the SA government initiated a 21-day national level 5 lockdown. [3] The strict regulations included restriction of population mobility and interaction, international and domestic travel restrictions, restriction of commercial and business activity, cancellation of events and gatherings, and closure of schools and universities. Essential services such as security, health and food distribution were permitted. [4] The lockdown was eased off and downgraded to level 4 on 1 May and to level 3 on 1 June (Fig. 1). Many businesses were allowed to resume operations, and the regulations allowed for workers to resume work. By 1 July 2020, 159 333 cases of COVID-19 had been reported in SA, 45 944 (29%) in Gauteng Province. [5] Gauteng is the smallest province in SA, accounting for 1.5% of the land area, but it is the most densely populated province (accounting for 26% of the country's population) and is widely regarded as the country's economic and industrial powerhouse. [6] The progression and impact of SARS-CoV-2 are dependent on the demography of specific geographical regions. While mortality is higher in the older age group, relaxation of strict lockdown regulations may affect the working age group because of their increased mobility. Knowledge of age-specific infectivity may therefore provide insights into the impact and future trends of SARS-CoV-2 that may assist in developing mitigation strategies to counteract viral transmission. The effect of lockdown measures on SARS-CoV-2 infectivity is currently unknown in SA. In this article, we analyse the effects of the lockdown measures initiated on 26 March 2020 on SARS-CoV-2 attack rates (ARs) in Gauteng during the first 4 months of the epidemic in SA. We also studied the effects of geographical region, gender and age on the AR. MethodsIn this retrospective cohort study, we used a comprehensive database from an independent pathology laboratory in Johannesburg, This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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