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South Africa's third Covid-19 wave is hardly unexpected, yet the severity is arresting and the country's lack of preparation alarming, especially in the commercial hub of Gauteng. Africa reported more than 251,000 new cases of the illness last week even as it's widely believed that a lack of testing means the number is vastly below the real toll. Of those reported, more than half were in South Africa. That's as the more infectious delta variant of the disease becomes ubiquitous just as the arrival of mid-winter leads more people to gather indoors and little more than 6% of the national population has received at least one shot. The densely populated province of Gauteng, which includes Johannesburg and Pretoria, accounts for the bulk of the country's infections and hospital capacity is at risk of being breached. The situation has been exacerbated by the closing of one of the province's biggest hospitals after a fire in April and as a large field facility that had been set up to handle overflow was shut.  A woman receives a nasal swab in Johannesburg. Photographer: EMMANUEL CROSET/AFP This was just as President Cyril Ramaphosa's administration finally seemed to be getting its act together, signing contracts with Johnson & Johnson and Pfizer, setting up an electronic registration system and starting to administer shots to teachers and people aged 50 and older. Still, excess deaths rose to a second consecutive weekly pandemic-era record in Gauteng. The measure, which is seen as a more precise way of counting total fatalities from the coronavirus, shows the extent of the havoc being wreaked in Africa's richest area—and many are saying a large portion of the blame falls on the government, even as it imposed stricter lockdown measures almost two weeks ago. "Lockdowns, especially in South Africa, are not sustainable in any meaningful manner," said Shabir Madhi, a professor of vaccinology at Johannesburg's University of the Witwatersrand. "The blame is squarely on the shoulders of government for being completely delinquent when it comes to the rollout of the Covid-19 vaccine. If government got their act together in the first instance and we had already vaccinated 60% to 70% of the high risk individuals by now, we wouldn't be in this boat."—Janice Kew | 
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