Covid: The worst is yet to come

The worst is yet to come when it comes to Covid-19 infections, with the second wave expected to have more impact in January and patients expected to be much sicker during the resurgence, experts say.

The country has officially entered the second wave of the Covid-19 pandemic, with over 6 000 new cases reported as of Wednesday afternoon and a 18% positivity rate.

And January could see a serious impact following the festive season, when many people would return home to rural areas and visit vulnerable elderly family members, said South African Medical Association chairperson Dr Angelique Coetzee.

“If there are no good health services there, especially for the elderly people, they will be in trouble. I foresee we will have a problem in January. That is when we will see a serious impact. The worst is yet to come,” she said.

Health Minister Zweli Mkhize flagged Western Cape, Eastern Cape, KwaZulu Natal and Gauteng as the key drivers for the new wave, with teens aged between 15 and 19 years being the age group contributing to most new cases.

Pandemic fatigue and lack of understanding of Covid-19 regulations could be the reason for the current second wave, said epidemiologist Professor Jo Barnes.

ALSO READ: Government does not intend to close down the economy, says Mkhize

“What we find with this second wave is worrisome because it is driven by young people.

“They ignore the limitations and they are in the age group where many of them don’t get quite so ill. But they take the illness home,” she said.

Current hospitalisations across South Africa. Graphic: Costa Makola

As in European countries like the UK, which have seen a resurgence and another lockdown, South Africans are seemingly experiencing pandemic fatigue, leading to them ignoring rules.

“This can be much worse. What we have got is much the same as what has happened in other countries – people are getting tired of the restrictions. When people saw what the [looming] vaccines can do for us, they thought we could go back to normal and start ignoring [regulations],” she said.

According to the National Institute for Communicable Diseases (NCID), 6 593 Covid-19 patients have been admitted to hospital, with 544 in ICU and 311 on ventilators.

Eastern Cape has the highest number of hospital admissions and patients on ventilation, with Gauteng having recorded the highest number of ICU patients.

Current hospitalisations across South Africa. Graphic: Costa Makola

The country’s treatment of the virus has improved. However, the Eastern Cape’s healthcare system remains a concern.

“We had lower death rates and so on [in the first wave], but like at Nelson Mandela Bay, where health services are getting overwhelmed, the number of deaths can shoot up,” said Barnes.

But patients in the Eastern Cape could be sicker in the resurgence, said Coetzee.

“The information that we are receiving from our members in the Eastern Cape is that patients are very sick. They are much sicker with the resurgence and the first wave that we saw,” she said.

Gauteng remained prepared for the influx of Covid-19 patients as the field hospital in Nasrec is still open despite previous reports of its closure, said Gauteng health spokesperson Kwara Kekana.

“It will serve patients where needed,” she said.

But South Africans need not panic about the announcement of a second wave as President Cyril Ramaphosa’s imposing of a hotspot declaration indicated a flexibility in dealing with the pandemic, said an economist.

“The president last week imposing the hotspot declaration of Nelson Mandela Bay was an indication of how flexible we can be in dealing with these things without making things worse,” said Professor Bonke Dumisa.

Fatigue sets in among healthcare workers

Healthcare workers in the front line were extremely fatigued, with the upcoming festive season expected to be more strenuous now that the country has hit a second wave of Covid-19 infections.

Epidemiologist Professor Jo Barnes was concerned that the healthcare system had taken strain during the past year, with a lot of healthcare workers succumbing to the virus.

“Also, nursing staff has been reduced over the years and it’s not something you can turn around in five minutes as it requires training. I am concerned that the health system is suffering pandemic fatigue and I don’t see enough investment in keeping it in good shape,” she said.

South African Medical Association chairperson Dr Angelique Coetzee agreed.

“They are really tired and a lot of people are going to go on leave and be at home, which could make things worse,” she said.

Health workers were experiencing low morale, particularly those who have been fighting for salary increases, said National Education, Health and Allied Workers’ Union (Nehawu).

“If we are to wage a serious war against the virus, we must pay them their due,” said Nehawu spokesperson Khaya Xaba.

– rorisangk@citizen.co.za

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