Western Cape implemented Covid-19 strategy too late, experts say

The Covid-19 strategies may not keep up with the growing number of cases, with the exponential increases in infections and deaths in the Western Cape attributed to the province’s aggressive, comprehensive and proactive strategy being implemented too late, experts said.

On Monday, South Africa reached a major coronavirus landmark, with 50,000 Covid-19 cases and more than 1,000 deaths.

The Western Cape has consistently remained the Covid-19 hotspot in SA, with 33,568 cases – accounting for two-thirds (66%) of the country’s total cases and 829 deaths, more than 76% of the country’s total deaths.

A key message from the World Health Organisation is to test and trace widely, according to independent public health practitioner Dr Shakira Choonara, saying South Korea specifically employed a “test, trace, isolate” strategy.

It is referred to as a best-case scenario of reaping the benefits of wide-scale action in tackling the pandemic, she said.

“While this is the ideal, we are unfortunately in a situation where we have limited financial and human resources, coupled with equipment shortages as well. There are already reports of a testing crisis in South Africa. This has largely been attributed to coordination issues between private and public testing, but also the global shortage of testing kits,” she said. “Some of the latest reports also show that the stocks of the testing kits are dangerously low.”

She said her opinion of the Western Cape crisis was that the province saw masses of people flocking for walks as soon as lockdown restrictions were slightly eased. This, for example, could be a contributing factor, she said.

“In all likelihood the spread began before we began to tackle Covid-19 aggressively. The Western Cape is a top tourist destination and losing out on the initial days of the outbreak is what has led to the spread that was not contained early enough and which we are seeing.”

Reports show this was amplified by a spread in supermarkets and a pharmaceutical factory, Choonara said.

There is a need for a clearly set out strategy, defined per area or location, she added, saying there was already progress on identifying hotspot areas and also the need to consider the sectors, professions and populations that needed monitoring.

Professor Glenda Davison, head of the biomedical sciences department at Cape Peninsula University of Technology and honorary senior lecturer at University of Cape Town, said as the virus started to spread exponentially, it became very difficult and almost impossible to trace all the contacts as there were just too many.

“We have reached this point in the Western Cape. You then have to change strategy and use the available tests for those who really need it. People who are in hospital with symptoms, healthcare workers and those at high risk.”

Davison said she fully agreed that the process of fully tracking and tracing contacts was important and should be done in all provinces. This should be particularly important in the early stages of an outbreak so that healthcare workers could identify contacts and put them into quarantine before they spread the virus to others.

“At this point, particularly in provinces which have low infection rates such as the Northern Cape, this would be very important,” she said.

Davison said it was difficult to judge exactly what the cause of the high infections and deaths in the Western Cape, but said infections began far earlier in the province and so it had more time to infect people and take hold in communities.

“Another reason for the spread that has been put forward, is that certain hotspots were identified as encouraging infections during the early stages of the lockdown. These were factories where it is sometimes difficult to physically distance; shopping malls which also did not apply proper distancing protocols; and staff at tills in the supermarkets were not properly protected.

“Of course, once they had caught the virus from a customer or colleague, they went home and passed it on,” Davison said.

– siphom@citizen.co.za

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