The Gauteng Provincial Command Council gave a briefing on the Covid-19 pandemic and the province’s efforts to combat the virus.
The virtual briefing took place on 2 July and covered the province’s health response, ward-based interventions, an update on schools reopening as well as food security and social relief. To read more about this, click here. The efforts of the health department are outlined below.
Gauteng Premier David Makhura said that June was a difficult month for the province as coronavirus cases soared. “We have seen an exponential increase in the number of cases. That includes a sharp increase in active cases and a significant increase in the number of fatalities.”
He said that he expects July to be even more difficult. “We want our people to understand how the work being done by scientists is going to help reinforce the fight against Covid-19 to help us focus on the areas that matter most and also ensure our response is informed by data, evidence and science.”
Modelling the Covid-19 virus
Professor Bruce Mellado, from Wits University’s iThemba Labs, who is also a member of the Gauteng Command Council, outlined how they have modelled the pandemic in the province. Mellado explained that modelling a pandemic is a complex problem which needs to be done in a particular way.
He said that this work needs to be done by a large team of people. He added that it is important that the modelling is not just an abstract construction but rather that it reflects the situation on the ground. “The reality is that this pandemic is very different from other pandemics. It’s very contagious and there is a large number of subjects that are asymptomatic that don’t display symptoms but propagate the virus.”
He explained that there are two systems they are currently working with. The first is called the ‘latent dynamic’ where many people may be carriers of the virus but they don’t feel they have the virus and pass it on to others. Secondly, there is a community that is infected, feels symptoms and interacts with the healthcare system.
He added that the modelling is adjusted as the levels of lockdown change. He said that the use of artificial intelligence helps them learn from the complex data they receive. He said the hotspots will continue to change and the use of artificial intelligence helps predict these hotspots and give policymakers a more accurate picture.
Inform data-driven decision making
Dr Vukosi Marivate, the chairperson of data science at the University of Pretoria, said that through their work they try to ensure there is as much data as possible on the virus in South Africa that allows other scientists, researchers and the public to understand the spread of the virus.
“We do this by looking at the public releases of data, finding additional information that comes from official sources, putting it in one place, cleaning it, providing tools for data mining and then making it available on a data repository that we’ve been running since the beginning of the pandemic in South Africa.”
He added that this information is freely available to everyone, including in a range of languages to ensure that a wide range of people can understand the data and understand the response to the pandemic.
He added that through this data mining and modelling, they are able to inform decision-making. “We have to ask ourselves at multiple stages what actions need to be taken, such as the lockdowns and then the lockdowns being eased. We need to think of the health system and how it’s responding and what are the feedback timelines.
“As we are moving closer to our peak, we know that those timelines are getting shorter and shorter. Before we might have been able to wait a few days for a decision to be made but now we’re down to a day or two and maybe even hours for a decision to be made.”
How the Department of Health reacts to the data
Dr Mary Kawonga, a senior specialist in public health medicine, said that the Department of Health has had to use the data provided to decide what their approach should be. “We all knew that the cases were going to go up. The lockdown helped us to delay the peak but we knew that it was going to come so we had to start planning for the peak.”
She said that the focus is on the number of beds available to care for those who are sick. “Once an epidemic has gone into community transmission and transmission is widespread and containment hasn’t stopped the spread, it’s inevitable that we’re going to get people coming to hospital who require care and, as we’ve seen from other countries, they require critical care and ventilation.”
Kawonga said a key question for the department is how many beds they would need. She said that once they established where they would need to get to in terms of the number of beds necessary, they needed to ask what they currently had available and how many beds could be put aside to care for Covid-19 patients.
She explained that they then identified the resource availability gap and how they could bridge that gap and get the number of beds necessary. She said that the modelling then links to the department on the ground and helps them establish what they still need.
According to her, it was established through the modelling that, as of the end of June, there wouldn’t be enough hospital beds. “For the peak in early September, the gap is even bigger. What this was telling us is that we need to start creating capacity as we move forward.”
She said that the modelling showed that they would need 410 critical care beds and over 1 000 beds by the end of July.
Department of Health prepares for more beds
Gauteng MEC for Health, Dr Bandile Masuku, said that they realised there would be a glaring gap in the number of beds needed in July and as the country moves toward the peak in August/ September.
He explained that they knew they would need to create more space at current facilities and create field hospitals. There are a number of field hospitals that will be activated across the province to make up for the shortfall of beds at current facilities.
“Our aim is to make sure that all patients who require medical intervention should be able to get a space and get intervention.”
He added that as South Africa is in its flu season, there are many patients coming in with respiratory symptoms or illnesses and it’s important to determine whether they have Covid-19 or not.
Masuku said that the department is worried about the surge in cases. He addressed rumours that there are currently no beds available for Covid-19 patients and said that this is untrue. He said that fake news continues to be a problem.
He added that they have employed 4 000 healthcare workers and will deploy healthcare workers in different areas as necessary.
South Africa sees more trauma cases than war-torn countries
Professor Steve Moeng, the director of trauma surgery at Charlotte Maxeke Johannesburg Hospital and chairman and academic head of trauma at Wits University outlined how trauma departments are dealing with the Covid-19 pandemic.
He highlighted that many people are letting their guard down and not following safety measures and healthcare workers are facing the brunt of this.
Moeng said that in March and April, at Charlotte Maxeke Hospital, they were able to cope with only one ward to deal with people under investigation (PUI) for coronavirus and positive patients. “In the past 10 to 14 days, what we have seen coming in is we have gone from one dedicated ward to more than seven wards dedicated to PUIs and Covid-positive patients.”
He said that they have found that not every person presents with the classic symptoms and they need to change the way they approach patients.
Moeng added that they need to ensure that healthcare workers are also not at risk and they need to have as much protection and training as possible.
He added that the trauma load has gone up more and more as levels of lockdown are decreased. “This country sees more trauma than what you would find in a war-torn area and that trauma is preventable. That trauma is related to how we drive on the road and the element of alcohol.”
He said that healthcare workers cannot afford to deal with multiple pandemics at the same time. “All of us must face the reality that this problem is here, this pandemic is here for all of us. Every person needs to play a role.”
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