By: Dr. Puni Mamdoo

With more deaths than the 2009 Swine flu(18k), West African Ebola(11k) and London Plague (75k), COVID19 has called into question, not only global health and health system preparedness, but even what life will be like post -pandemic?

Finally, public health specialists and epidemiologists are no longer struggling to explain what they do or defend their rights to be called “real doctors” by relatives. Suddenly, South Africa and the world, understands the importance of health first.  Until the painful loss of lives, health worker fatality and an outbreak in a large hospital in Durban, our measures to contain the outbreak were focused on case and contact tracing. From here on out, the health system defence against COVID19 will become more apparent.

The Health Minister, Dr Zweli Mkhize, quoted modelling estimates suggesting that at least 60% of all South African will be infected by COVID19 which reminds me that “Your health is as safe as that of the worst-insured, worst-cared-for person in your society. It will be decided by the height of the floor, not the ceiling.”

The South African technology, digital health and IOT community has responded in tangible ways during this outbreak. One such example is of work done by Ruth Nelson, who used  geo-spatial analysis to understand the potential impacts of COVID-19 on Cape Town. Her findings suggest that there are only 9 public hospitals in the Cape Town Metropolitan area; only 5% of Cape Town Metropole is in walking distance of a hospital and some of the densest and poorest neighbourhoods of 60 000 people or more do not even have a hospital within them.

What this confirms, is that the social determinants of health such as living conditions, access to health services, the environment , spatial planning and poverty will determine clinical outcomes, not unlike the outbreak in the USA.

As the outbreak unfolds in South Africa, we are acutely aware of how these factors will increase our burden of disease; a concern doubled again as  experts worry about either the effect of HIV/TB on COVID19 or the effect of COVID19 on HIV/TB.

COVID19 will become yet another virus affecting human populations, but not without serious disruption to the status quo in every aspect of life.  The real question is whether this disruption can usher in the change we would like to see and improved determinants of health for all South Africans.

Dr. Puni Mamdoo is a Public Health Specialist and Data Impact Leader at Aviro Health


Sources consulted:

[] Madhukar Pai. Can we imagine global health in a post pandemic world? . Link: