key: cord-0762422-1ot9wfnb authors: Stiegler, Nancy; Bouchard, Jean-Pierre title: South-Africa: challenges and successes of the Covid-19 lockdown date: 2020-05-27 journal: Ann Med Psychol (Paris) DOI: 10.1016/j.amp.2020.05.006 sha: a4fa84ca8389cfe248ba23922f555c24a28afbf7 doc_id: 762422 cord_uid: 1ot9wfnb Abstract At the beginning of March 2020, South-Africa (59 million inhabitants) was hit by the pandemic of Covid-19 and soon became the most affected country in Africa by the SARS-CoV-2 virus. From one single case on March 5th, the number of cases increased rapidly, forcing the South-African Government to swiftly react and place the country under strict lockdown for six weeks. The strategy of the South-African Government borne fruits with a contained spread of the virus. If the number of positive cases at the end of the lockdown reached 5647, the number of fatal casualties was limited to 103 deaths. The lockdown was overall well respected, even if serious problems of food supply soon occurred in informal settlements leading to riots and confrontation with security forces. Indeed, populations were obedient, but not being able to practice sport or outdoors activities appeared heavy. The constant fear of the poorest not to have enough money to pay rent and buy food (even if the Government organised food parcels’ distributions), and to find less and less work was echoed by the fear of losing jobs among those more privileged. Despite the risk of an economic crisis, the South-African Government has continued on the reasonable path of containing the pandemic with ending the lockdown at a slow pace, in five phases. D'un cas positif le 5 mars, le nombre de cas a augmenté rapidement, forçant le gouvernement sud-africain à réagir rapidement en plaçant le pays en confinement strict pendant six semaines. La stratégie du gouvernement sud-africain a porté ses fruits en limitant la propagation du virus. Si le nombre de cas positifs confirmés à la fin du confinement, le 30 avril, a atteint 5 647, le nombre de morts connus dû au virus s'est limité à 103. Le confinement fut en général bien respecté, même s'il a été entaché de sérieux problèmes de ravitaillement en nourriture dans les bidonvilles, donnant lieu à des émeutes et des échauffourées avec les forces de l'ordre. Les populations ont été obéissantes, même s'il fut dur de ne pas pouvoir sortir et pratiquer un sport ou des activités de plein air. La peur constante des plus démunis de ne pas avoir assez d'argent pour payer le loyer ou acheter de la nourriture (même si le gouvernement a organisé des distributions de colis de ravitaillement) et de ne pouvoir travailler a trouvé écho chez les plus avantagés qui redoutent de perdre leur emploi. La plus grande crainte était pour tous de tomber malade ou qu'un membre de la famille soit infecté. Grâce à l'interdiction des boissons alcoolisées, la violence domestique semblait avoir diminué, surtout dans les zones les plus pauvres. Les personnes qui étaient confinées avec des membres de leur famille étaient systématiquement plus optimistes que celles qui étaient confinées seules. Les confinées en famille avaient des journées remplies d'activités interpersonnelles (une fois qu'elles avaient fini de travailler/étudier à distance), alors que les personnes seules étaient plus impliquées dans des activités génératrices d'anxiété comme lire, regarder les nouvelles tout au long de la journée et réfléchir à la situation. Malgré le risque d'une crise économique, le gouvernement sud-africain a décidé de continuer sur la voie raisonnable du contrôle de la pandémie en déconfinant de façon très lente la population, avec un plan en cinq phases. Mots-clés : Afrique du Sud ; Contagion ; Confinement ; Coronavirus ; Covid-19 ; Déconfinement ; Épidémie ; Maladie infectieuse ; Pandémie ; SARS-CoV-2 ; Violence South-Africa has not been spared by the Covid-19 pandemic. In a context of global public-health disaster, it is interesting to see how the most affected country in Africa dealt with the crisis. South-African population is currently estimated at 59 million [17] .This population is rather young, with a median age of 27.6 years-old [16] , hiding important disparities between provinces. The Eastern Cape, the poorest province in the country is also the youngest one with a median age of 21 years-old, whereas, in the more developed provinces of Gauteng and Western Cape, the median age is at 29 and 28 years old, respectively. In the same vein, and because of its segregationist history, South-Africa is still the most unequal country in the world with a Gini-coefficient of 0.63 [20] . This translates, for instance, in 14% of South-Africans living in informal settlements [17] , without proper housing, limited access to sanitation and water and an overall unemployment rate of 29% [17] . It is in this context that South-Africa entered the fight against Covid-19 in March 2020, with the first declared positive case on March 5 th in KwaZulu Natal. This person, considered as "patient" zero, came back to South-Africa on 1 March from Milan, Italy. Faced by a rapid increase of cases in the following days, the South-African Governments wiftly reacted and imposed on 23 March a strict lockdown on the population for three weeks starting on 26 March. At that stage, the number of official positive cases had risen to 554, without any deaths. The lockdown, further extended to 30 April, was the most restrictive on the African continent, and one of the most restrictive in the world. Shops, restaurants and non-essential businesses were closed, the population was only authorised to leave home for essential grocery shopping and medical reasons; no social, outdoors activities, sports or dog-walking were authorised, and a total ban on alcohol and cigarettes was imposed. The lockdown was at the image of the country: diverse and contrasting. Among the middle class, the lockdown was particularly well respected [19] . People in general, stayed at home, managed to work remotely with access to the internet and families were often happy together. The situation was otherwise in poorest areas and informal settlements [12] . Promiscuity was a problem together with lack of proper sanitation [8] , which made everybody fear for a human catastrophe if the virus was to spread in these communities. In actual facts, the main issue residedin the lack of food and financial resources which lead to "hunger riots" [7] , shops looting [6] and confrontation with police [1] . Distribution of food parcels [15] for the poorest communities was organised, but it seems that for many it was not enough, even though several associations and individuals helped in providing food and helping with distribution [14] . Two trends in domestic violence were noted: sharp decline in domestic abuse due to alcohol, whereas domestic violence against women increased by the third week of lockdown [21] Wyatt T. Coronavirus: Gang kingpins in South Africa call truce to help community during pandemic, April 20,2020 .https://www.independent.co.uk/news/world/africa/south-africacoronavirus-lockdown-gangs-cape-town-a9474101.html(accessed April 30, 2020). [22] Xinhua. South Africa records drastic drop in violent crimes during lockdown, Apr 6, 2020. https://www.iol.co.za/news/south-africa/south-africa-records-drastic-drop-in-violent-crimesduring-lockdown-46340549(accessed April 30, 2020). 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