SA is definitely not out of the woods yet

Critical data on the Covid-19 infection rate expected to be released this week will be key in government’s decision on whether to continue with the hard lockdown, or ease disaster regulations to avoid an economic Armageddon.

According to Professor Salim Abdool Karim, the epidemiologist advising Health Minister Zweli Mkhize’s Covid-19 response, there was no way to escape the wrath of the virus, unless SA had a special protective factor or “mojo” not present anywhere else in the world.

In his interactive presentation detailing the technical aspects of the Covid-19 response on Monday evening, the prominent researcher candidly prepared the nation for the worst.

“It will be pretty difficult, it will be bad at its (Covid-19) peak and the people who will need medical care, thousands of them,” he told radio 702 yesterday.

Karim has cautioned that though government’s early implementation of the lockdown had resulted in a plateau level of infections, “our population will be at high risk again after the lockdown”.

Karim’s technical presentation on the Covid-19 response strategy also catered for fatalities, calling for the expansion of burial capacity, regulations on funerals and management of psycho-social management.

Government’s early response delayed the peak expected and was commendable in that it bought the nation time to prepare for the full burden of the epidemic, Karim said.

Karim said this was based on the mathematical model taken and assessed on various scenarios on demand for medical care, saying a ventilator was needed to treat Covid-19 and that this could only be done in Intensive Care Units (ICU), which were in short supply.

Top on the list of his concerns are the about 2.5-million HIV positive people not on treatment, as well as TB patients that may increase the severity of the virus. Karim said he was “concerned with this group because most did not even know they were HIV positive”, but emphasised that there was no evidence on how HIV positive people would respond to the virus.

He generally commended government’s response to the virus but said only the assessment of community transmission data could determine the decision on whether to continue with the hard lockdown or easing up.

Karim said if the basic reproduction rate of the virus could be shown to be below one (less than 90 cases a day), meaning it was not spreading at an out of control rate, the current lockdown could be eased. New infections for Tuesday, however, showed an increase of 145.

The virus is known to have a global reproduction rate of between two and three.

“If community transmission is low, cases decline…If community transmission is increasing then cases will increase and exponential curve will start again,” he said.

Karim’s briefing last night came on the backdrop of a raging public debate on whether to continue the hard lockdown or ease the Disaster Management Act regulations to open up some functions of the economy to avoid the real danger of starvation chaos.

The DA has drawn up a “smart lockdown” paper, submitted to President Ramaphosa on Monday, proposing a gradual phasing out of the current hard lockdown to supplement the State’s Covid-19 response effort, while protecting the economy and the livelihoods depending on it for survival.

According to the party’s interim leader, John Steenhuisen, the smart-lockdown approach would work similar to scheduled load-shedding, providing different stages of lockdown relative to the national infection rate for each sector of economy and society.

SOME GOOD NEWS:

The decline in the number of new Covid-19 cases in the last two weeks were the strongest indications that South Africa has time to flatten the curve even more.

Though overall testing was still below the targeted figure of up to 15,000 tests a day, the number of National Health Laboratory Services (NHLS) tests have increased and testing in people without medical aid has also increased.

According to Mkhize’s Covid-19 response advisory team, what put South Africa in a favourable position in its war on the highly contagious and deadly Covid-19 was that:

• SA has unique component to its response such as active case finding;

• Only SA has more than 28,000 community healthcare workers going house-to-house in vulnerable communities for screening and testing to find cases;

• New, quicker and simpler diagnostics, as well as treatments becoming available;

• SA had sufficient time to prepare for the medical care needs.

– siphom@citizen.co.za

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