With an expert flick of the wrist, nurse Bhelekazi Mdlalose collected throat swabs from young men lining up for coronavirus testing at a run-down hostel in downtown Johannesburg.
Health workers were sent to the overcrowded block of single-room flat as part of a mass community screening and testing (CST) campaign launched by the government last month.
Mdlalose, who is employed by Doctors Without Borders (MSF), left her family and usual job in Rustenberg in March to support community work in Johannesburg.
Aged 51, she trains government health workers to handle suspected coronavirus patients correctly, checking in on CST teams deployed to townships, offices and shopping malls.
"We identify those that are Covid-19 positive and those that have symptoms," said Mdlalose.
"These are vulnerable people," she added, pointing out that most would not even think to visit a clinic when sick.
"By being here we actually target the right group."
But as South Africa's coronavirus outbreak picks up pace - with confirmed cases creeping over 13 500 - Mdlalose and other health experts are beginning to see the limits of the country's lauded community screening strategy.
"It's definitely a very high resource activity," admitted MSF doctor Claire Keene, who monitors CST in Cape Town's sprawling Khayelitsha township.
"I think we are approaching capacity in what we can do, both to detect cases but also to follow them up."
Struggling labs
South Africa's aggressive Covid-19 screening and testing approach is modelled on years of experience fighting tuberculosis and HIV.
"We decided that we shouldn't just wait in hospitals for patients to arrive," said the government's top coronavirus advisor Professor Salim Abdool Karim. "We had to have a more proactive approach and go out there."
Around 28 000 health workers have been mobilised over the past month, aiming to test 10 000 people per day.
They have screened over nine million people so far, around 15% of the population, and tested more than 420 000.
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