Infection peak rate will be lower than expected, Mkhize tells parliament

Both Gauteng and the Eastern Cape will reach their capacity when it comes to hospital beds for both ICU and non-ICU Covid-19 patients within the next four weeks. 

This is according to Health Minister Zweli Mkhize, who was giving a remote update in parliament on South Africa’s Covid-19 situation on Wednesday. 

“While the model projects a lower need for hospital (non-ICU) and ICU beds at a national level, bed capacity is still expected to be breached or overwhelmed in all provinces. Bed capacity (including all currently committed public and private sector beds) is expected to be breached in the next four weeks,” said Mkhize. 

According to the minister, hospital beds earmarked for Covid-19 patients in the Eastern Cape and Gauteng are projected to be insufficient for combined non-ICU bed demand and the overflow from ICU once ICU capacity has been breached.

On Tuesday, Mkhize told Cape Talk’s Refilwe Moloto that Gauteng had not yet reached capacity in terms of beds. 

To remedy this, the minister said that the department of health has developed and is implementing what it calls the “Surge Strategy” in anticipation of the peak. 

“This will ensure that the department increases capacity for Covid-19, while at the same time continuing to deliver other health services to the health care users. During this process, the Department repurposed a total of 27,467 beds for Covid-19, which has increased to 40,309 beds as the provinces started to experience a sudden increase in the number of cases.”

The country’s number of infections is still expected to peak in August, however, according to the minister, they will peak at a rate lower than expected due to the fact that “not that many people were infected in May and June,” when compared to earlier projection statistics. 

The minister confirmed that a total of 20 million people had been screened across the country, resulting in over 300 000 people being referred for testing. 

“For the period 01 March 2020 through to 6 July 2020, 1 907 532 laboratory tests for SARS-CoV-2 were conducted nationally. Four provinces including Western Cape, Eastern Cape, KwaZulu-Natal and Gauteng accounted for 82% of tests performed up to 06 July 2020,” said Mkhize.

The overall percentage testing positive was 11.8%. 

As of Wednesday the cumulative confirmed cases since the country’s first case was recorded in March, stood at 215,855. 

“To date 48% of the confirmed cases have recovered bringing the total to 103 934. Unfortunately, there have been 3,470 confirmed deaths. This brings the case fatality ratio of 1.6%. 

“The Western Cape continues to have the highest number of confirmed cases at 72,156 followed by Gauteng on 71,488, the Eastern Cape on 40,401 cases and KwaZulu-Natal on 16,743 confirmed cases. We however expect Gauteng to have the highest number of confirmed cases, thus making it the epicentre.”

As of end June 2020, 4 821 Health Care Workers (HCWs) were reported to have been infected with Covid-19 virus across the country.

“The Western Cape Province continues to account for the majority (68%) of infected Health Care Workers with 3,285 infections as at 29 June 2020. The leading number of infections are amongst nurses with 2,473 infections followed by other health professionals including community health workers reporting 1,971 and doctors recording 377 infections.”

Despite this, the minister assured parliament that there is sufficient PPE stocks available to meet the requirements of frontline healthcare workers.

The minister further explained that due to the increasing number of cases, the “less than 5 and greater than 5” number of active case definition of a hotspot will need to be revised. 

“We have used a differentiated approach in our response through a classification of districts as areas of ‘vigilance’ and ‘hotspots’. In all areas the focus continues to be on prevention of new infections, containment, mitigation and recovery.” 

Moving forward, the government’s overarching objective will be to strengthen the national and provincial mechanisms for timely detection, management and containment of the spread of Covid-19.

This will be done using the following strategic priorities or pillars, namely:

• Providing effective governance and leadership;
• Strengthening surveillance and strategic information;
• Augmenting health system readiness by assessing health system readiness against the epidemiological curve, identify gaps and planning to ensure health services availability according to need – focusing on the health workforce, beds, medicines, equipment and products; 
• Enhancing community engagement by ensuring effective communication to the public;
• Improving laboratory capacity to test by strengthening the National Health Laboratory Service (NHLS) and private laboratory capacity for SARS-CoV-2 testing to meet the requirements of the Covid-19 response and improve coordination between the public and private sectors;
• Clarifying care pathways in respect of case detection, management and clinical pathways and to align the hierarchy of facilities established or reconfigured for the Covid-19 response;
• Scaling-up Infection Prevention and Control (IPC) Measures;
• Strengthening capacity at ports of entry by enhancing screening capacity at key ports of entry and augmenting environmental health; and
• Expediting research and the introduction of therapeutics, diagnostics and vaccines by institutionalising mechanisms for Covid-19 related health products regulation and research coordination and building mechanisms for ongoing learning from research and experiences from other countries, to ensure that these inform the response at the frontline.

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