How South Africa Flattened Its COVID-19 Curve

Using methods developed with help from the U.S., South Africa has deployed an army of 28,000 contact tracers to track the spread of the coronavirus, and has flattened the curve of infections.

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South Africa has just a fraction of the resources of a lot of developed countries but still it has managed to flatten its COVID-19 curve. The country says it has more than 3,600 cases, but officials say community transmission is under control, buying hospitals time to prepare if cases do spike. Here's NPR's Eyder Peralta.

EYDER PERALTA, BYLINE: Dr. Salim Abdool Karim, a preeminent expert on HIV, was given a prime-time slot on national TV to explain this epidemic to the country.

SALIM ABDOOL KARIM: We're just trying to get the slides up, so you can follow me.

PERALTA: The lecture went into how epidemics develop and how South Africa acted early locking down when there were few cases. Karim explained that when South Africa hit 100 cases, it should have snowballed, as it did in Europe or China. But the curve leveled off.

KARIM: No other country has reached that point and has been able to reach a stage where you get that kind of plateau.

PERALTA: Dr. Dennis Chopera, a virologist studying tuberculosis and HIV in South Africa, explains the success.

DENNIS CHOPERA: South Africa has made a lot of progress in combating both HIV and TB. And that experience is coming in handy with COVID-19.

PERALTA: Part of that experience is contact tracing. South Africa has one of the highest rates of HIV infections, and tuberculosis often comes with it. Like COVID-19, TB is a respiratory disease spread by droplets. Chopera says the government has had to run a big contact tracing operation to keep TB under control.

CHOPERA: The test now is there. The experience is there. There is no need to train people to actually, you know, start doing this kind of contact tracing.

PERALTA: Compared to wealthier countries, South Africa is doing little testing. But the government is sending 28,000 health workers to screen the population for symptoms to catch the virus in the community not when people show up sick to the hospital.

Emily Wong, an infectious disease doctor at Africa Health Research Institute, says that was an ambitious recommendation from scientists.

EMILY WONG: It feels like everyone's on the same page, really trying to do the right thing.

PERALTA: The messaging is clear and consistent, and she says citizens are onboard.

WONG: I think a lot of us here in South Africa kind of pinching ourselves because we remember in the early 2000s when it was such a different relationship between the scientific community and government.

PERALTA: Back then at the peak of the AIDS epidemic, South Africa's President Thabo Mbeki was an AIDS denier. HIV, he argued in front of Parliament, could not cause AIDS.

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THABO MBEKI: How does a virus cause a syndrome? It can't.

PERALTA: Of course, he was wrong. Scientists at Harvard University found that his recalcitrance contributed to the deaths of some 300,000 South Africans. Tom Frieden, who used to run the American CDC and has worked across the African continent, says these scars taught African governments and citizens the menace of disease and the importance of public health.

TOM FRIEDEN: There is an understanding that we have to take them seriously and have to do what works to limit the damage.

PERALTA: Frieden says those muscles have atrophied in places like the United States. Contact tracing isn't common, so the U.S. would have to train thousands to do it. And he says Americans have forgotten how horrific infectious diseases could be.

FRIEDEN: Public health in the United States and globally isn't given the kind of respect it needs.

PERALTA: The kind of respect it needs, he says, to defeat the coronavirus - the kind of respect it's getting in South Africa. Eyder Peralta, NPR News, Nairobi.

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