Dr Zweli Mkhize, South Africa’s health minister, said the government had been taken by surprise by the second wave: ‘The whole country is really under siege’ © Sumaya Hisham/Reuters

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South African officials have met to discuss the reintroduction of tighter coronavirus restrictions as a second wave of Covid-19 infections took the number of confirmed cases since the start of the pandemic to more than 1m.

The National Coronavirus Command Council held emergency meetings on Monday with officials from South Africa’s nine provinces as the surge threatened to overwhelm hospitals. South Africa recorded a daily record of 14,790 infections on Christmas Day and case numbers have remained above 14,000 for four days in a row.

“This wave has come up quite unpredictably,” Dr Zweli Mkhize, South Africa’s health minister, told the South African Broadcasting Corporation. “The whole country is really under siege.”

President Cyril Ramaphosa was expected to announce new curbs, although some provincial leaders are understood to be resisting a return to full-scale lockdown because of the economic impact. In the three months to June, when the lockdown measures imposed at the start of the pandemic were the most stringent, output plunged 16.4 per cent.

Most of the new cases in South Africa come from a new strain of Covid-19, known as 501.V2, identified in the country this month. But Dr Shabir Madhi, professor of vaccinology at the University of the Witwatersrand, said the surge was being driven largely by behavioural change rather than by the mutation.

“The major driver most likely is a complacency around behaviour, particularly in relation to mass gatherings,” Dr Madhi said. Indoor activities in crowded restaurants and bars were largely to blame, he said, calling for a ban on such activities.

“The country doesn’t have the economic power to go into highly restrictive levels of lockdown,” Dr Madhi added. “The economy is in tatters already and can’t absorb another shock.”

The second wave of infections began in Eastern Cape province and has spread to Western Cape. Experts worry that South Africans returning home after travelling for the holidays will bring the second wave back to Gauteng province, where the major cities Johannesburg and Pretoria are located.

Many South Africans had assumed that the start of summer in the southern hemisphere would ease the pandemic but Ridhwaan Suliman, a senior researcher at South Africa’s Council for Scientific and Industrial Research, said infections in the second wave were likely to exceed the numbers recorded in the first wave.

Mr Suliman said the number of cases was doubling every 14.5 days, though he noted that infections had passed their peak in Eastern Cape.

The situation in South Africa matches a second wave across much of Africa, which fared relatively well in the first wave but has seen a steady rise in infections since November. The number of daily infections across the continent has returned to levels recorded during the July peak, according to the World Health Organization’s regional office for Africa.

Dr Madhi at the University of the Witwatersrand said South Africa needed to vaccinate as many people as possible to be able to head off what he feared would be “a third and a fourth wave”. Plans to vaccinate about 10 per cent of the population, as currently expected in the next several months, would be insufficient, he added.

Dr Madhi urged the South African government to use the fact it was conducting clinical trials for two vaccines — from Oxford/AstraZeneca and Novavax — to strike affordable, bilateral deals with companies.

South Africa has so far chosen to buy vaccine supplies through the multilateral Covax scheme, largely because Mr Ramaphosa had championed multilateral solutions, he said.

“Optically it doesn’t look good for South Africa to engage in bilateral procurement,” Mr Madhi said, adding that the government’s reluctance could impair its capacity to bring the pandemic under control.

South Africa has recorded more than 26,000 deaths from Covid-19, out of some 63,000 official deaths in the continent as a whole.

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