Behavioural and health impacts of the COVID-19 pandemic in South Africa
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Private Bag X44, Pretoria, 0001, South Africa, ISIbalo House, Koch Street, Salvokop, Pretoria, 0002
www.statssa.gov.za, info@statssa.gov.za, Tel +27 12 310 8911
Behavioural and health impacts of the
COVID-19 pandemic in South Africa
Embargoed until:
30 April 2020
12:00
Enquiries:
Christine Khoza
Tel: 071-670-2672
Email: christinek@statssa.gov.za
Rika du Plessis
Tel: 012-310-2913
Email: rikadp@statssa.gov.za
Technical enquiries:
Niel Roux
Tel: 082-904-7919
Email: nielr@statssa.gov.za
Contents
1. Key findings................................................................................................................................... 4
2. Introduction ................................................................................................................................... 4
3. Background ................................................................................................................................... 4
4. Type of movement ........................................................................................................................ 7
5. Health information ........................................................................................................................ 8
6. Healthrelated risk behaviour........................................................................................................ 9
7. Perceived impact of COVID-19 .................................................................................................. 11
8. Knowledge and perceptions of the pandemic ......................................................................... 11
9. COVID-19 testing ......................................................................................................................... 13
10. Pre-existing health conditions................................................................................................... 15
11. Access to health care ................................................................................................................. 15
12. Conclusion................................................................................................................................... 16
13. Explanatory notes ....................................................................................................................... 16
13.1 Purpose of the study ............................................................................................................. 16
13.2 Statistical unit ........................................................................................................................ 16
13.3 Sample selection ................................................................................................................... 16
13.4 Limitations ............................................................................................................................. 17
13.5 Rounding off .......................................................................................................................... 17
13.6 Additional information ............................................................................................................ 17
2Tables
Table 1: Survey information ................................................................................................................ 4
Table 2: Percentage sample distribution by age group and gender ................................................... 4
Figures
Figure 1: Percentage distribution of respondents by education status ................................................ 5
Figure 2: Percentage distribution of respondents by employment status ............................................ 5
Figure 3: Percentage distribution of respondents by dwelling type ..................................................... 6
Figure 4: Percentage distribution of respondents by number of residents and number of rooms ....... 6
Figure 5: Percentage distribution of respondents who moved in the period between the
announcement and start of the lockdown period by type of movement ............................... 7
Figure 6: Percentage distribution of respondents by province of current residence and movement in
the period between the announcement and start of the lockdown period ............................ 7
Figure 7: Main sources of information about COVID-19 and current public health measures ............ 8
Figure 8: Percentage of respondents who were able to stay at home the whole time during the
lockdown period by dwelling type ......................................................................................... 9
Figure 9: Places visited by respondents who had to leave their homes during the lockdown period by
frequency of visits during the week before the survey. ........................................................ 9
Figure 10: Percentage of respondents who left their homes who managed to manage their risk of
exposure to the coronavirus by different means ................................................................ 10
Figure 11: Percentage of respondents who stocked up on essentials at the grocery store or pharmacy
before the start of the lockdown period by type of community they live in. ........................ 10
Figure 12: Percentage of respondents who hugged, kissed or shook hands with non-household
members outside their homes by age group. ..................................................................... 11
Figure 13: Concern about the impact of COVID-19 ............................................................................. 11
Figure 14: Percentage of respondents who would seek medical attention at a hospital, clinic or other
health facility for non COVID-19 related issues by type of community they live in. ........... 12
Figure 15: Knowledge about how COVID-19 is transferred ................................................................ 12
Figure 16: Knowledge about the symptoms of COVID-19 ................................................................... 13
Figure 17: Percentage of respondents who have possibly been in contact with an infected person, or
who are/were infected......................................................................................................... 13
Figure 18: Percentage of respondents who possibly had the coronavirus by whether they were tested
............................................................................................................................................ 14
Figure 19: Reasons for not being tested by suspected infection status .............................................. 14
Figure 20: Chronic conditions .............................................................................................................. 15
Figure 21: Percentage of respondents who wanted to access health care but who could not do so .. 15
Figure 22: Reasons for not visiting health care facilities...................................................................... 16
31. Key findings
Since the lockdown period for South Africa started on 27 March 2020, more than half (60,1%) of respondents
who participated in the online survey reported that they were very concerned or extremely concerned about
the impact of COVID-19 on their own health. As far as the economy was concerned, 93,2% of respondents
were very concerned or extremely concerned about the possible economic collapse of the country due to the
COVID-19 epidemic.
The majority of respondents (98,1%) indicated that they had changed their behaviour by leaving their houses
only to obtain essentials like food or medical supplies and services in the week of 13 to 26 April 2020.
2. Introduction
The COVID-19 pandemic has had a profound impact worldwide. The pandemic reached South Africa later
than most of the world, but despite the delay, it still had negatively impacted South Africa. The country has
been able to greatly contain the spread and impact through very harsh and decisive measures instituted by
the President who very early on announced a total lockdown of the country. This lockdown has in itself brought
along certain implications for all citizens in the country.
Statistics South Africa (Stats SA) is embarking on a series of three online surveys to measure the impact of
the COVID-19 pandemic on households in the country. This publication will be reporting on the first round,
which focused on health related aspects in terms of behaviour, knowledge and perceptions with regard to
COVID-19. The second survey will investigate the impact of the COVID-19 pandemic on income and
expenditure, whilst the third survey will report on the impact of the COVID-19 pandemic on education and time
use of households.
The survey was an online survey, housed on the Stats SA website. Any person who wanted to participate
could access and complete the survey.
3. Background
Table 1: Survey information
Survey objective To provide an early indication of the behavioural and health impacts of COVID-19
Selection criteria Convenience sample
Number of respondents 3 591
Reference period 13 – 26 April 2020 (In some questions, respondents were asked about their behaviour in the
week prior to the completion of the survey).
Limitations This survey used a non-probability sample and respondents who chose to respond to this survey
are not representative of the entire South African population. The results can, therefore, not be
generalised to the entire South African population.
Table 2: Percentage sample distribution by age group and gender
18–34 35–44 45–54 55–64 64–74 75+ Total Number
Gender
Male 21,9 34,3 25,4 13,4 3,9 1,1 100,0 1 529
Female 27,7 35,3 23,6 10,3 2,9 0,3 100,0 2 049
Other 23,1 23,1 30,8 7,7 7,7 7,7 100,0 13
Population group
Black African 32,5 42,4 20,5 4,2 0,4 0,0 100,0 1 296
Coloured 29,4 33,8 23,6 11,6 1,0 0,7 100,0 293
Indian/Asian 28,0 42,5 21,7 7,3 0,5 0,0 100,0 207
White 19,0 28,6 27,5 17,3 6,4 1,2 100,0 1 744
Other 15,7 31,4 29,4 21,6 0,0 2,0 100,0 51
Total 25,2 34,8 24,4 11,6 3,3 0,7 100,0 3 591
4The largest proportion (49%) of participants in the survey indicated their race as white; 36% indicated that they
associated themselves as belonging to the black African group and 8% and 6% classified themselves as
belonging to the Coloured and Indian/ Asian groups, respectively.
The gender distribution of the respondents was as follows: 57% females and 43% males.
Figure 1: Percentage distribution of respondents by education status
Less than Grade 12/
Matric Completed secondary
1% school/Grade 12/
Matric
18%
Tertiary or post-school
81%
In terms of educational status, the largest proportion (81%) of the respondents had tertiary or post-school
education. Only 1% had an education level of less than matric or Grade 12.
Figure 2: Percentage distribution of respondents by employment status
Self-employed 11,6
Retired 3,8
Full-time student 2,3
Home duties 1,5
Unemployed 8,1
Employed part time or informal sector 3,6
Employed full fime 69,1
0 10 20 30 40 50 60 70 80
Percentage
Based on self-reported employment status, more than two-thirds (69,1%) of respondents had a full-time job
(receiving a monthly salary); 11,6% of respondents were self-employed, whilst 8,1% were unemployed. These
figures are not directly comparable to official unemployment figures but they provide some insight into the
characteristics of the respondents.
5Figure 3: Percentage distribution of respondents by dwelling type
90
81,6
80
70
Percentage
60
50
40
30
20 12,6
10 3,4 0,9 1,5
0
Free standing house, Flat or apartment in a Formal flat / granny flat Informal dwelling / Other
townhouse, or cluster block of flats / servant quarters / shack
house room in the backyard
By far, most respondents (94,2%) were living in formal dwellings: either a free-standing house, townhouse or
a cluster house (81,6%), or in a flat or apartment in a block of flats (12,6%). Less than one per cent (0,9%)
lived in an informal dwelling.
Figure 4: Percentage distribution of respondents by number of residents and number of rooms
10+
5-9
2-4
Alone
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Alone 2-4 5-9 10+
1 Room 14,6 1,3 0,0 0,0
2 Rooms 21,7 7,3 1,8 0,0
3 Rooms 16,4 15,8 9,5 6,7
4 Rooms 18,2 21,8 15,2 10,0
5 Rooms or more 29,2 53,8 73,5 83,3
Figure 4 attempts to gauge residential density by measuring the household size and the size of dwellings they
were living in. Respondents were asked to indicate the number of rooms that the dwelling consists of – these
refer to the total number of rooms in the dwelling, including rooms used to sleep in.
The figures show that respondents who lived alone were fairly evenly distributed across the different dwelling
sizes. Households with two to four residents primarily lived in dwellings with four rooms (53,8%). Households
with five to nine residents primarily lived in dwellings with five or more rooms (73,5%). For larger households
comprising of 10 or more residents, 83,3% lived in dwellings with five or more rooms.
64. Type of movement
Figure 5: Percentage distribution of respondents who moved in the period between the announcement and start
of the lockdown period by type of movement
Yes, moved to another province 3,4
Yes, moved to a different area/suburb/town/village within the
3,3
province
Yes, moved to another dwelling in the same suburb 1,1
No, did not move 92,1
0 10 20 30 40 50 60 70 80 90 100
Percentage
The majority of respondents (92,1%) did not move in the period between the announcement and the start of
the lockdown period; 1,1% moved to another dwelling within the same suburb; 3,3% moved to another area/
suburb/town or village within the same province they normally reside and 3,4% moved to another province.
Figure 6: Percentage distribution of respondents by province of current residence and movement in the period
between the announcement and start of the lockdown period
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
WC EC NC FS KZN NW GP MP LP
Yes, moved from another province 1,8 3,1 8,6 5,5 6,6 12,6 1,6 7,0 20,9
Yes, moved to a different
area/suburb/town/village within the 3,5 6,7 2,9 1,8 4,0 3,2 2,7 3,5 7,0
province
Yes, moved to another dwelling in the
1,2 1,0 2,9 0,0 0,7 1,1 1,2 0,9 0,9
same suburb
No, did not move 93,5 89,1 85,7 92,7 88,6 83,2 94,3 88,6 71,3
Respondents residing in Gauteng were the least inclined to have moved from another province in the period
between the announcement and the start of the lockdown period. 94,3% of Gauteng residents remained in the
province. 20,9% of respondents who were currently residing in Limpopo indicated that they moved from
another province to Limpopo in the period between the announcement and the start of the lockdown period.
75. Health information
Figure 7: Main sources of information about COVID-19 and current public health measures
52,4
News outlets including local, national and international media
64,3
Social media e.g., Facebook, Instagram, TikTok, Twitter, 14,1
YouTube 16,0
National and Provincial Department of Health e.g., website, 13,1
public service announcements 7,4
Regular addresses by, and communication from the President’s 14,1
office 6,8
1,5
Place of employment
1,7
2,2
Health professionals
1,2
0,6
Family, friends or colleagues
0,9
Municipal information e.g., website, public service 1,0
announcements 0,7 Information about public health measures
1,0
None of the above
0,6
0,2 Information about COVID-19
Schools, universities, colleges
0,3
0 10 20 30 40 50 60 70
The majority of respondents said that they obtained their information on current public health measures from
news outlets, which includes local, national and international media. Information on current public health
measures such as washing of hands, how to practise social distancing, etc. was obtained in this manner by
52,4% of respondents. 64,3% of respondents obtained information on COVID-19 using news outlets. Social
media (including Facebook, Instagram and others) was the second most frequently used means of obtaining
information on both current public health measures as well as COVID-19 (14,1% and 16,0%, respectively).
86. Health related risk behaviour
Almost 60% (59,8%) of the respondents indicated that they had to go out on occasion, whilst 40,2% managed
to stay at home all of the time.
Figure 8: Percentage of respondents who were able to stay at home the whole time during the lockdown period
by dwelling type
42
40,9
40,2
40
38
Percentage
36,1
36
34,4
34
32
30
Free standing house, Flat or apartment in a Formal flat / granny flat Total
townhouse, or cluster block of flats / servant quarters /
house room in the backyard
Figure 9: Places visited by respondents who had to leave their homes during the lockdown period by frequency
of visits during the week before the survey
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Grocery store Pharmacy Place of work Any other public place
Daily or more regularly 0,7 0,1 4,9 0,0
3-5 times 7,0 0,6 5,0 0,3
Once or twice 83,2 43,8 13,0 0,7
Never 9,0 55,5 77,1 99,0
The majority of respondents who had gone out for grocery shopping in the past week prior to the survey did
so once or twice (83,2%) and 7,0% went grocery shopping 3 to 5 times. Few respondents managed not to go
out for grocery shopping at all (9,0%).
A somewhat different pattern is observed with regard to going to the pharmacy. The majority of respondents
(55,5%) managed not to go out to the pharmacy at all, whilst 43,8% went out to the pharmacy once or twice.
Less than one per cent (0,6%) went to the pharmacy 3 to 5 times.
Respondents’ responses indicated that they adhered to the call not to go out to public meetings, with almost
all (99,0%) reporting not attending any public events, e.g. church services.
By and large, the majority of respondents did not go to work in the week prior to the survey (77,1%).
Approximately 13,0% had to go to their place of work once or twice and 5,0% had to do so 3 to 5 times.
9Figure 10: Percentage of respondents who managed to minimise their risk of exposure to the coronavirus by
different means
Avoiding crowded places and large gatherings 98,7
Practising social distancing when in public places 98,4
Only leaving the house for essential reasons 98,1
Regularly washing or sanitising hands when returning from
98,0
being out
Regularly washing or sanitising hands when going out 97,7
Working from home 73,7
Wearing protective gear 66,2
0 10 20 30 40 50 60 70 80 90 100
Percentage
The majority (98,7%) of respondents indicated that they avoided going to large public meetings like church
services. Most of the respondents avoided exposing themselves by leaving their houses only for procuring
essential items (98,1%). Furthermore, the practice of social distancing when going out was a priority for 98,4%
of the respondents. Regular handwashing when going out (97,7%) and upon returning after one went out
(98,0%) was also important practices to most respondents.
Figure 11: Percentage of respondents who stocked up on essentials at the grocery store or pharmacy before the
start of the lockdown period by type of community they live in
Total 62,3
Farm 64,0
Suburb 63,3
Township 58,6
CBD 58,1
Rural (Traditional tribal area) 56,5
Informal settlement 46,7
0 10 20 30 40 50 60 70
Almost two-thirds (62,3%) of respondents indicated that they had stocked up before the lockdown.
64,0% of respondents living on farms, 63,3% living in suburbs and 58,6% living in townships had stocked up
on essential goods from the grocery store or pharmacy, between the announcement of the lockdown and
before the start of the lockdown.
10Figure 12: Percentage of respondents who hugged, kissed or shook hands with non-household members outside
their homes by age group
Total 4,7
65+ 1,4
Age group
55-64 1,9
45-54 3,5
35-44 4,0
18-34 8,5
0 1 2 3 4 5 6 7 8 9
Percentage
The majority of respondents (95,3%) avoided hugging, kissing or shaking hands with non-household members
in the week prior to the survey. The largest proportion of respondents who had hugged, kissed or shook hands
with non-household members in the week prior to the survey were in in the 18–34-year age group (8,5%).
7. Perceived impact of COVID-19
Figure 13: Concern about the impact of COVID-19
Contribute to economic collapse 0,9 5,9 22,1 71,1
On the health of vulnerable persons 1,5 9,7 29,0 59,9
Overload the health system 1,5 10,3 31,4 56,8
Contribute to civil disorder 2,6 17,7 35,5 44,2
On the health of a household member 7,9 23,9 28,8 39,4
On own health 8,7 31,2 26,0 34,1
Undermine ability to cooperate and support one another
4,6 26,7 39,7 29,1
during the crisis
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Not at all Somewhat Very Extremely
Respondents completing the survey seemed concerned about all the aspects they were asked about, to a
greater or lesser degree. Respondents were mostly worried about the possible economic collapse caused by
the COVID-19 virus. 93,2% indicated that they were very or extremely concerned about the possible
economic collapse; 88,9% were concerned about the health of vulnerable people like elderly family
members; 88,2% were concerned about the overload of the health system and 79,7% were concerned about
the civil disorder that may result as a consequence of the COVID-19 virus.8.
118. Knowledge and perceptions of the pandemic
Figure 14: Percentage of respondents who would seek medical attention at a hospital, clinic or other health facility
for non COVID-19 related issues by type of community they live in
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Informal Rural-traditional
CBD Suburb Township Farm
settlement tribal area
Unsure 32,5 29,8 26,7 13,3 25,2 20,9
No 35,0 38,8 47,5 73,3 42,0 47,7
Yes 32,5 31,4 25,8 13,3 32,8 31,4
Of those respondents residing in the suburbs, 38,8% indicated that they would not seek health care, 31,4%
would seek health care, whilst 29,8% were not sure if they would seek medical assistance if needed whilst
COVID-19 is a threat.
Figure 15: Knowledge about how COVID-19 is transferred
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Touching
Contact with pets or
Hugging and kissing Contact with stool contaminated objects Contact with blood
animals
or surfaces
Unsure 2,4 36,5 1,8 26,3 38,3
No 1,8 24,9 0,9 62,7 32,9
Yes 95,8 38,7 97,3 11,0 28,8
Knowledge about the two main means of transmission of the COVID-19 virus is high. 97,3% of participants
indicated that they were aware that the virus is transmitted through touching infected surfaces, whilst 95,8%
of respondents knew that the virus is transmitted through having contact with a person infected with the
virus. Fewer respondents were aware that the virus can transmit through contact with the stool of an infected
person (38,7%). A large proportion of people were unsure about the transmission of the virus through
contact with blood, stool and pets/animals.
129. COVID-19 testing
Figure 16: Knowledge about the symptoms of COVID-19
High fever 98,5
Difficulty breathing 97,6
Dry cough 92,2
Fatique 79,1
Pneumonia 48,6
Sneezing 46,8
Runny nose 35,7
Swelling joints 8,6
0 10 20 30 40 50 60 70 80 90 100
Percentage
Knowledge about the main signs and symptoms of the COVID-19 virus is almost universal. The bulk of
respondents indicated that:
a) having a high fever (98,5%);
b) having difficulty breathing (97,6%); and
c) having a dry cough (92,2%)
were the main symptoms of COVID-19.
Figure 17: Percentage of respondents who have possibly been in contact with an infected person, or who are/were
infected
5
4
3,6
Percentage
3
2,6
2
1
0
Physical contact with infected person Suspect that they have, or have had COVID-19
Respondents generally had minimal physical contact with infected persons (3,6%), whilst 2,6% of respondents
indicated that they suspected that they have or have had COVID-19 in the past 30 days.
13Figure 18: Percentage of respondents who possibly had the coronavirus by whether they were tested
100%
90%
80%
70%
60% 75,8
50% 96,8
40%
30%
20%
10% 24,2
3,2
0%
Suspect infection Do not suspect infection
Tested Not Tested
The majority (96,8%) of respondents indicated that they did not get tested since they were of the opinion that
they did not have COVID-19. Of those respondents who suspected that they might have been infected by
COVID-19, three-quarters (75,8%) did not get tested either.
Figure 19: Reasons for not being tested by suspected infection status
Reason for not testing
1,4%
I do not think I have it
6,8%
7,8% Do not know where to go for testing
Do not have money to get tested
Do not have transport/money for transport to go to the
testing facility
83,9%
For those respondents who indicated that they did not get tested, a follow-up question as to why they were not
tested was asked. The bulk of respondents (83,9%) indicated that they did not believe that they had the virus,
7,8% said they did not know where to get tested, whilst 6,8% indicated that they either did not have money to
get tested; or did not have transport or money for transport (1,4%) to get to the testing facility.
1410. Pre-existing health conditions
Figure 20: Chronic conditions
The majority of respondents (85,7%) indicated that they did not have any chronic conditions that affect their
lungs, heart or kidneys. Of the 14,3% that had some prior chronic condition, 92,2% were able to collect their
chronic medication. However, 7,8% of respondents indicated that they were not able to access their medicines.
The largest share of this group (45%) indicated that they were scared they would be infected. An additional
37,5% were scared to leave the house because they feared being arrested and/or fined. Approximately one-
fifth (17,5%) said that they did not have money to get to the pharmacy, clinic or health facility where they could
obtain medicines.
11. Access to health care
Figure 21: Percentage of respondents who wanted to access health care but could not do so
1,8 4,5
Wanted to visit but could not
Did not require health care
Don't know
93,7
Respondents were asked to indicate if they or members of their household wanted to access health care but
have been unable to do so since lockdown. The majority of respondents (93,7%) indicated that they or their
household members did not need to access health care, while 4,5% responded that they or a household
member needed to access health care but had been unable to do so.
15Figure 22: Reasons for not visiting health care facilities
60
54,1
50
40
Percentage
30 25,5
20
12,1
8,3
10
0
Scared that I might get Scared that I might get Do not have to money to go to Do not have transport to go to
infected with the coronavirus arrested or fined for being facility/clinic facility/clinic
outside my house
Those who had answered that they wanted to but could not access health care, indicated that they could not
do so because they were scared of contracting the COVID-19 virus (54,1%), and 25,5% were scared that
they might get arrested or fined for being outside their houses.
12. Conclusion
The survey measures the behavioural and health impact of COVID-19 on South Africans. Some limitations of
the survey are that results are mostly based on perceptions due to the qualitative nature of the survey. The
survey is based on a non-probability, convenience sample, and people who had access to technology (e.g.
smartphones and computers or the internet) were the only ones who completed the survey. This makes the
survey biased in the type of respondents that completed the survey. The number of responses obtained for
the survey was 3 591, which is in itself not representative of the general population of South Africa.
The advantages of using convenience sampling as used in the survey are that it provides a quick, convenient
and affordable way to gather data, particularly during a period where face-to-face visits are not possible.
13. Explanatory notes
13.1 Purpose of the study
The purpose of the survey was to provide information that could be used by government and other service
providers, to better understand the impact of the pandemic and to devise interventions to assist the population.
13.2 Statistical unit
The statistical unit for the collection and dissemination of information in this survey is the individual respondents
who selected to complete the Stats SA COVID-19 online questionnaire.
13.3 Sample selection
The survey used a non-probability convenience sample. The questionnaire was sent to individuals on the
Stats SA stakeholder list. It was also available on a variety of other social media platforms between 19 and 26
April 2020.
Despite the limitations, convenience sampling was selected since it provides a quick, convenient and
affordable way to gather data, particularly during a period where face-to-face visits are not possible.
1613.4 Limitations
The survey is highly vulnerable to selection bias and influences beyond the control of the researcher. The
respondents who chose to respond to this survey are not representative of the entire South African population
and the results can therefore not be generalised to the entire South African population. It is important to
understand that these findings only apply to this particular set of respondents and that it should not be
generalised to other populations. Due to the nature of selection, it is more difficult to identify differences
between subgroups.
13.5 Rounding off
Where figures have been rounded off, discrepancies may occur between the sums of the component items
and totals.
13.6 Additional information
The dataset can be made available on request. Please send requests to nielr@statssa.gov.za
17You can also read
