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A medical staff is reflected in a mirror as she attends to a COVID-19 patient at a special ward at Arwyp Medical Centre in Kempton Park, South Africa, Dec. 25, 2020.STRINGER/Reuters

South Africa has announced severe restrictions on businesses and public movement as it struggles with a surge of cases from a new COVID-19 variant that has forced many hospitals to ration oxygen, turn away patients and make agonizing decisions about who lives and who dies.

The new South African variant has been detected in recent days in Britain, Finland and Switzerland, triggering a wave of travel bans and restrictions from many countries worldwide, including Canada. The new variant is believed to be more contagious than previous variants, and it seems to cause illness equally in the young and the old.

In recent days, South Africa’s total confirmed cases of COVID-19 have passed the one million mark, and its daily positivity rate has climbed to a shocking level of more than 30 per cent, meaning that nearly a third of all tests for the coronavirus are returning positive. The surge is part of a huge second wave across Africa at a time when vaccines are still expected to be months away for even the most vulnerable of health workers.

“There is none among us who can claim we have not heard of anyone becoming ill or dying,” President Cyril Ramaphosa told the country in an emotional speech on Monday night.

He appeared on the verge of tears as he pleaded with the country to change its behaviour. “The number of new coronavirus infections is climbing at an unprecedented rate,” he said.

“This is a crisis that affects us all. The sooner we understand that it could very well be us in that ambulance speeding by, or us in that hospital bed, or us being buried at that funeral, the sooner we come to the reality of what we are facing right now.”

Instead of fireworks on New Year’s Eve, he said, South Africans should light candles for those who have died during the pandemic.

Under the new restrictions, a nightly curfew of 9 p.m. is being imposed, shops and restaurants must close by 8 p.m., alcohol sales are completely banned, and anyone failing to wear a face mask is liable to arrest and imprisonment for up to six months.

The alcohol ban is aimed at protecting hospitals, which are under severe pressure from alcohol-related accidents and violence in addition to the pandemic cases. An earlier alcohol ban during the pandemic’s first wave resulted in a sharp reduction in trauma cases in hospitals, freeing up health workers to focus on COVID-19 cases.

Mr. Ramaphosa said the measures were necessary because the country has fallen into an “extreme lack of vigilance” during the holiday season, with parties and other social gatherings becoming “superspreader” events.

Many of South Africa’s doctors and nurses are reported to be sick and suffering from exhaustion and burnout as the pandemic grows worse. In the public sector alone, more than 41,000 health workers have been infected with the coronavirus since the beginning of the pandemic, including 4,630 during December alone.

Mr. Ramaphosa quoted a tweet by a doctor at a South African hospital. “More than half my colleagues have COVID or are currently in quarantine,” the doctor said. “Hospital is FULL. No oxygen points. Private hospitals are FULL. Not accepting more patients. No beds anywhere.”

Many of the most badly hit hospitals are in Cape Town and the surrounding Western Cape province, governed by the Democratic Alliance, a pro-business party that has strongly opposed lockdowns in the past. But on Monday, even the DA Premier of Western Cape, Alan Winde, said he had asked Mr. Ramaphosa to impose new restrictions to save the hospital system.

Andrea Mendelsohn, a senior medical officer in the Western Cape health department, warned last week that hospitals are “rapidly approaching” the limits of their oxygen and bed capacity. After that, they will become “clearing stations for corpses,” she said in an open letter.

“A tidal wave is enveloping Cape Town,” she said. “This is my nightmare and yours.”

There were a number of reports of patients being transported from hospital to hospital, turned away at each door because each hospital was full.

While wealthy countries such as Canada and Britain are already rolling out their mass vaccine programs, there is no early prospect of vaccines in South Africa and other African countries, because of a lack of funds for vaccine purchases. Most are dependent on COVAX, a subsidized program to help the developing world, but COVAX is unlikely to provide any vaccines to South Africa until the second quarter of next year, Mr. Ramaphosa said on Monday.

Even then, the COVAX program would cover only 10 per cent of South Africans.

Mr. Ramaphosa said the government is seeking funds from South African businesses to help finance additional purchases from vaccine manufacturers.

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