HIV and TB show modest effect on COVID-19 mortality
Preliminary results from a study of 12 987 COVID-19 patients in South Africa indicate that HIV and TB have a modest effect on COVID-19 mortality, scientists Quarraisha Abdool Karim and Salim Abdool Karim said.
According to the experts, 12% and 2% of COVID-19 deaths are attributable to HIV and TB, respectively, compared to 52% of COVID-19 deaths attributable to diabetes in South Africa.
“The small contribution of HIV and TB to COVID-19 mortality is mainly due to these deaths occurring in older people, in whom HIV and active TB are not common. Integrated medical care for these three conditions is important, as COVID-19 patients co-infected with HIV or TB start attending healthcare services in larger numbers,” the scientists said.
Professor Salim Abdool Karim is the Director at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and the country’s chief Coronavirus scientist. Professor Quarraisha Abdool Karim is an infectious diseases epidemiologist and Associate Scientific Director at CAPRISA.
The lead scientists published a paper in Science Magazine on how South Africa’s TB and HIV infrastructure helped with a rapid response to COVID-19. However, they believe that the focus on COVID-19 has an “opportunity cost” to the enormous gains made against these conditions.
“We can’t afford to be complacent,” the scientists said.
Access to chronic medication
According to the pair, access to medical care for non–COVID-19 conditions was limited during the hard lockdown, with health facilities experiencing dwindling numbers of TB and HIV patients collecting their medication on schedule.
“In South Africa, 1 090 TB patients and 10 950 HIV patients in one province have not collected their medications on schedule since the start of the national lockdown.”
Meanwhile, 13.2% of the 19 330 individuals surveyed in the country indicated that their medication for chronic disease was inaccessible during the lockdown.
“Furthermore, hospital admissions for HIV and TB declined as a result of hospitals reducing non-urgent admissions in preparation for a surge of COVID-19 cases and owing to closures to reduce exposure to COVID-19 patients,” said the professors.
This could pose a threat and have substantial repercussions for both treatment and control, including the development of drug resistance for HIV and TB patients.
While the biological and epidemiological interaction of COVID-19, HIV and TB is not well understood, the two professors think that patients, whose immune system is compromised by HIV or TB, could be more susceptible to severe COVID-19.
South Africa’s COVID-19 lockdown regulations have also had a disproportional impact on women, many of whom are self-employed or day labourers without a safety net, research revealed.
“This may have a longer-term effect on increasing diseases associated with poverty such as TB and with gender, such as HIV, for which young women bear a disproportionate burden,” said the professors.
They also warned of the negative impact of the declining economy on HIV and TB programmes.
New and ongoing research
According to the professors, new and ongoing research on HIV and TB prevention and treatment have been affected by the pandemic.
South Africa has about 7.9 million people living with HIV and ranks among the worst-affected countries in the world for TB, with the fourth-highest rate of HIV-TB co-infection at 59%.
“At the initiation of the lockdown in South Africa, the National Health Research Ethics Committee suspended all medical research, including clinical trials.
“However, COVID-19 research efforts have increased collaboration and created new approaches to speed up therapeutic and vaccine development and testing, which will likely have long-term benefits for medical research beyond COVID-19,” said the professors.
South Africa has made steady progress since 2010 in controlling both diseases. Access to antiretroviral drugs for treatment and prevention of mother-to-child transmission of HIV has resulted in a 33% reduction in AIDS-related deaths between 2010 and 2018, the professors said.
In addition, the death rate among TB cases has declined from 224 per 100 000 population in 2010 to 110 per 100 000 population in 2018.
“Past investments in infectious disease training and research have generated handsome returns to the COVID-19 response, highlighting the importance of maintaining these investments in the future,” the professors said.
They said the resources built up over decades for the control of HIV and TB, and now redirected to control COVID-19, include diagnostic platforms, community outreach programmes, medical care access and research infrastructure.
However, the professors said the COVID-19 response also provides potential opportunities to enhance HIV and TB control.
SA records 11 362 new COVID-19 cases
After a two-day streak of cases below the 10 000 mark, South Africa’s new COVID-19 cases were at 11 362 on Wednesday.
This brings the total number of COVID-19 cases in South Africa to 471 123.
Gauteng tops the chart with 168369 cases recorded which accounts for 35.7% of the total infections.
The Western Cape comes in second with 98 737 cases followed by Eastern Cape with 75 872 cases.
Free State has 19207 cases, KwaZulu-Natal 71240, Limpopo 7840, Mpumalanga 12442, North West 18231, Northern Cape 4135, while 50 cases are yet to be allocated.
The country recorded a further 240 deaths bringing the total number of deaths to 7 497.
Eastern Cape accounts for 34 deaths, 156 from Gauteng, 27 from KwaZulu-Natal, and 23 from Western Cape.
“We convey our condolences to the loved ones of the departed and thank the health care workers who treated the deceased,” said Health Minister, Dr Zwelini Mkhize.
Meanwhile, the number of recoveries currently stands at 297 967 which translates to a recovery rate of 63%.
The total number of tests conducted to date is 2 873 163 with 42 528 new tests conducted since the last report.
SA records 190 more COVID-19 deaths
South Africa has recorded fewer than 10 000 new COVID-19 cases for two days in a row, for the first time in almost a month.
On Tuesday, the country registered 7 232 new infections, 112 fewer than the previous day.
This brings the number of people officially diagnosed with Coronavirus in the country to 459 761.
Gauteng accounts for 35.8% of the positive cases and remains the only province that has surpassed the 100 000 mark.
To date, the country’s economic hub has had 164 584 infections, followed by the Western Cape (92 983), Eastern Cape (75 067) and KwaZulu-Natal (68 101).
Free State has 18 134 cases, North West 17 791, Mpumalanga 11 552, Limpopo 7 502, Northern Cape 3 997, while 50 cases are yet to be allocated.
The death toll has climbed to 7 257 after 190 people succumbed to the disease in the last 24 hours, the Health Minister, Dr Zweli Mkhize, said.
Of the new deaths, 62 are from KwaZulu-Natal, 55 from Gauteng, 49 from the Western Cape, 13 from the North West and 11 from the Eastern Cape.
The total number of tests conducted to date is 2 830 635, while 287 313 people have recovered to date.
Also, the statistics show that women represent a vast majority of total infections.
According to the National Institute for Communicable Diseases, 264 176 of those infected with COVID-19 are female, 192 480 are males, while 3 105 are unknown.
Globally, there are now 16 341 920 COVID-19 cases and 650 805 deaths, according to the World Health Organisation.
IMF approves COVID-19 loan to South Africa
The International Monetary Fund (IMF) executive board has approved South Africa’s request for a US$4.3 billion (R70 billion) loan to overcome the COVID-19 pandemic.
The request for emergency financial support under the Rapid Financing Instrument (RFI) will help the country to mitigate the adverse social and economic impact of the pandemic.
In a statement issued on Monday, National Treasury said the additional IMF funding is a low-interest loan that contributes to government’s fiscal relief package, while respecting South Africa’s decisions on how best to provide relief to the economy and those worst affected by the current crisis.
“It will also pave the way for government to provide the necessary financial relief required to forge a new economy and mitigate further harm to the economy,” Treasury said.
South Africa, like many countries across the globe, has not been spared from the devastating impact of the deadly virus that has ravaged economies.
The COVID-19 crisis has forced government to come up with fiscal and monetary measures that respond to the struggling economy and contain its negative effects on society.
In his special adjustments budget in Parliament last month, Minister of Finance Tito Mboweni, outlined government’s key interventions to curb the pandemic.
These include support for health and frontline services, protection of the most vulnerable, supporting job creation efforts, unlocking economic growth through reforms and stabilising public debt.
“Government’s COVID-19 economic support package directs R500 billion straight at the problem. This is one of the largest economic response packages in the developing world.
“The South African Reserve Bank has reduced interest rates and made it easier for banks to lend money, and supported liquidity in the domestic bond market. Government spending and tax proposals, as well as the loan guarantee scheme and wage protection measures, are providing protection to workers and the poor while assisting to stay afloat during these tough economic times,” said Mboweni.
Going forward, government’s fiscal measures will build on policy strengths and limit the existing economic vulnerabilities that have been exacerbated by the Coronavirus pandemic, Mboweni said.
Meanwhile, both the New Development Bank and the African Development Bank have agreed to loans of $1 billion (R17.3 billion) and R5 billion respectively.
Easier access to COVID-19 Loan Guarantee Scheme
Tuesday, July 28, 2020. The COVID-19 Loan Guarantee Scheme has been reviewed to make it easier for businesses to access, National Treasury said.
The COVID-19 Loan Guarantee Scheme was set up to help ease some pressure off qualifying businesses, which are negatively affected by low economic activity following the global lockdown imposed to reduce the spread of Coronavirus.
In a joint statement with the South African Reserve Bank (SARB) and the Banking Association of South Africa (BASA), Treasury said some of the changes include that bank credit assessments and loan approvals will be more discretionary and less restrictive, in line with the objectives of the scheme.
In addition, clients are now being able to access the loan over a longer period.
The COVID-19 Loan Guarantee Scheme provides loans, substantially guaranteed by government but with some of the risk shared by banks, to eligible businesses to assist them during the COVID-19 pandemic.
Funds borrowed from this scheme, through the banks, can be used for operational expenses, such as salaries, rent and lease agreements, and contracts with suppliers.
The loans are granted at a preferential rate (prime) and repayment may be deferred for a maximum of one year after taking out the loan. Businesses will then be required to repay the loan over five years.
Government and commercial banks are sharing the risk of non-repayment of these loans.
“National Treasury initially provided a R100 billion guarantee to participating banks through the South African Reserve Bank, with the option to extend the scheme to R200 billion, if required. Government is engaging with non-bank lenders in order to possibly extend the scheme,” Treasury said.
The following changes have been implemented:
- Business restart loans will now be available to assist businesses that are able to begin operating as the economy opens up.
- Bank credit assessments and loan approvals will be more discretionary and less restrictive, in line with the objectives of the scheme. Banks may use their discretion on financial information required, for example, bank or financial statements, where audited statements are not available. Suretyships or guarantees may also be required. The provisions of the National Credit Act and Financial Intelligence Centre Act remain applicable.
- Clients can now access the loan over a longer period. The draw down period has been extended from three months to a maximum of six months. For example, a R6 million loan can be drawn down over six months, at R1 million a month if the business qualifies. The size of the loan is still calculated on operating expenses.
- The interest and capital repayment holiday has been extended. The interest and capital repayment holiday has been extended from three months to a maximum of six months after the final draw down. For example, in the case of the same R6 million loan, drawn down at R1 million a month for six months, repayments will only be required from month 13.
- The turnover cap has been replaced with a maximum loan amount of R100 million. Banks may also provide syndicated loans for loans larger than R50 million.
- The test for good standing has been made easier. This has now moved back to 31 December 2019 from 29 February 2020, which will accommodate firms which were already experiencing cash-flow problems in February.
- Sole proprietorships are now explicitly included. For sole proprietorships and small companies, salary-like payments to the owners (drawings) are included in the use of proceeds. Security, suretyships or guarantees are not explicitly required.
“Eligible businesses should contact their primary or main banker for further information on the scheme and the qualifying criteria,” Treasury said.
While this scheme operates through banks willing to take some of the risks of lending to client companies in distress, Treasury said government is also exploring the option of working with non-bank lenders willing to share the risks of lending to their client companies in distress.
Minister Mchunu to give details on SA APRM Council
Public Service and Administration Minister Senzo Mchunu, in his capacity as the African Peer Review Mechanism (APRM) Focal Point for South Africa, is expected to brief media on the Charter of the South African APRM National Governing Council.
The Minister will speak on this at a media briefing scheduled for 11.30am this morning.
At the briefing, which will be held at the Government Communication and Information System (GCIS) head office in Pretoria, the Minister will also announce the appointment of the Chairperson and Deputy Chairperson of the South African Peer Review Mechanism National Governing Council (NGC).
“Minister Mchunu will brief members of the media on the Charter of the South African APRM National Governing Council as well as what is to follow in terms of the NGC’s activities,” said the Ministry of Public Service and Administration ahead of Tuesday’s briefing.
Cabinet approved the formation of the NGC which comprises key stakeholder groups from government, civil society and the private sector, in line with the APRM principle of broad-based participation.
Through a virtual meeting which was held on 22 July 2020, the NGC elected its Chairperson and Deputy Chairperson, and also adopted the Charter of the South African APRM National Governing Council.
Thulani Tshefuta was appointed as Chairperson while Magdalene Moonsamy was appointed as Deputy Chairperson.
“The formation of the NGC paved the way for the preparation of the country’s 2nd Generation Review that the country is expected to undertake. The structure will be expected to lead this process of country self-assessment, ensures its credibility; and ultimately produces the Country Self- Assessment Report (CSAR) that will later be submitted to the continental body, APRM.”
The NGC structure is at the core of the functioning and success of the country’s APRM, as its key role is to mobilise and ensure participation of all stakeholders and citizens in general to the APRM processes.
Minister Mchunu will brief the media on what is to follow in terms of the NGC’s activities.
The APRM is a mutually agreed instrument voluntarily acceded to by African Union (AU) Member States as an African self-monitoring mechanism to foster good governance in the continent through a systematic peer learning and self-assessment mechanism.
South Africa is currently the Chairperson of the Committee of Focal Points of the APRM programme, a continental ministerial platform for all 40 APRM participating member states, which it took over early this year from the Republic of Chad.
298 people die of COVID-19 on Monday
There are now 452 529 confirmed COVID-19 cases in South Africa after 7 120 new infections were recorded on Monday.
Unfortunately, 298 people succumbed to the deadly virus, which brings the death toll to 7 067.
Of the additional fatalities, 91 are from the Free State, 77 from the Eastern Cape, 61 from Gauteng, 36 from Western Cape, 13 from Mpumalanga, 11 from the North West and nine from KwaZulu-Natal.
“We convey our condolences to the loved ones of the departed and thank the healthcare workers who treated the deceased,” Heath Minister, Dr Zweli Mkhize, said.
Gauteng remains the epicentre with 162 319 recorded infections since the outbreak, followed by the Western Cape (92 600), Eastern Cape (74 231) and KwaZulu-Natal (65 982).
The North West has 17 604 cases, Free State (17 222), Mpumalanga (11 386), Limpopo (7 260) and Northern Cape (3 875).
The number of those who have been cured is 274 925, which translates to a recovery rate of 61%.
Meanwhile, 2 802 211 test have been conducted, 28 433 of which were done since the last report.
According to the World Health Organisation, there are 16 114 449 cases and 646 641 deaths worldwide.
Seizing growth opportunities in turbulent times
President Cyril Ramaphosa says the advent of the Coronavirus pandemic has placed more impetus on South Africa’s plans to pursue new sources of growth within a fundamentally different context.
“Many of the areas we had identified before remain relevant and urgent, such as a growing small and medium enterprise sector, and an agricultural sector that delivers food security.
“Some sectors have taken on a new significance. We should, for example, use this opportunity to build a greener economy, with our entrepreneurs entering new fields such as hybrid cars, fuel cells, battery storage and waste beneficiation,” said the President in his weekly newsletter to the nation.
With an unemployment rate of 30%, which the President said will soon increase, South Africa must collectively work towards building an inclusive economy, based on a level playing field.
President Ramaphosa said he was confident that plans put in place prior to the pandemic, and those introduced to keep business buoyant in these turbulent times, will enable the reconstruction of the economy. However, this will require buy-in outside of government, and an undeterred commitment to action.
“In all the proposals put forward in recent weeks, there is a substantial emphasis on improving execution.
“The [proposals] all say that we should seek out pockets of excellence in the State, and support and deepen them. But they also say that we must look outside the State. We need to bring together the best available local skills, whether in business, academia or civil society to support our common programme,” the President said.
As far back as the State of the Nation Address in February, President Ramaphosa said South Africa would need to focus on three things to begin to turn the country’s fortunes around.
“First, we were going to fix the fundamentals. Second, we would pursue new sources of growth. Third, we would ensure that our actions are underpinned by a capable State.
“Many of the plans under discussion raise these fundamentals, such as reliable energy, access to broadband spectrum, competitive ports and efficient transport. Working with our social partners, we must speed up the pace of implementation so that we can rebuild the base of our economy,” President Ramaphosa said.
One of the pillars that the success of these recovery plans hinges upon is a strong commitment to a social compact – and the institutions necessary to support it – so that the reconstruction of the economy can be “a shared responsibility and a shared undertaking,” the President said. This is one way of ensuring that there are no forgotten sectors of society as the country forges a path to economic recovery.
A continental effort
In the year of South Africa’s chairship of the African Union, member States are planning vigorously for the activation of the African Continental Free Trade Area, which has been delayed by the pandemic.
President Ramaphosa said all social partners see the value of expanding trade in an integrated Africa, with concrete proposals on how to overcome the barriers that impede the ability of Africans to trade with one another.
He said South Africa’s strategies to promote local production, which is a common theme across the various recovery plans, should support efforts to create regional value chains on the continent.
“When we launched the economic stimulus and recovery plan nearly two years ago, we announced the establishment of an Infrastructure Fund that could blend different forms of finance to drive infrastructure development. This, we identified as the flywheel of economic growth.
“There is now general consensus that our recovery should be led by infrastructure development and maintenance.
“At the Sustainable Infrastructure Development Symposium organised by the Presidency a few weeks ago, business and government were of one mind on a new methodology to develop an infrastructure pipeline and deliver on it.
“Investors from the multilateral development banks, development finance institutions and the private sector all showed a strong appetite to make the necessary investments to meet South Africa’s extensive and diverse infrastructure needs,” President Ramaphosa said.
Saving jobs
In the coming weeks, the President said government will work with its social partners to finalise an economic recovery programme, which brings together the best of all the various proposals.
President Ramaphosa emphasised that the most important part of the programme must be the protection and the creation of jobs.
He noted that analysts have estimated the pandemic will cost the country millions of jobs.
The President said job preservation efforts, such as those through the Unemployment Insurance Fund (UIF) and tax measures, aim to prevent job losses in the private sector.
However, he said, if South Africa is going to recover from the worst effects of the pandemic, well-crafted, public employment schemes must be set up.
“Creating jobs for people that add value to their communities through maintenance, care work and other services, keeps people engaged in productive activity. It helps them to retain and develop skills.
“It gives many young people a chance to climb the first rung in the job market ladder. Such jobs complement employment created by businesses, as they start to recover and private investment returns.”
The President is optimistic that as recovery takes hold and the world gradually adjusts to a global economy marked by COVID-19, economic activity is expected to pick up.
“By then, our initiatives to reform and improve the business environment will establish a firm platform for industries with high potential to flourish,” President Ramaphosa said.
Since the onset of the pandemic in South Africa, President Ramaphosa said government’s strategy has been to provide whatever support it can, within the country’s constrained resources, to protect businesses and preserve jobs.
The President said now is the time to move quickly towards a robust programme of reconstruction and recovery, “and we must do so together”.
“Building on the vast areas of common ground among the proposals from social partners, we now have to put in place a clear, focused and ambitious set of measures to not only restore our economy, but to set it on a new path of inclusive and sustainable growth.
“We are faced with a health, social and economic crisis of massive proportions. But we are not daunted, nor discouraged. We will do what we must to build an economy that is resilient and dynamic, that creates work and opportunity, and that meets the needs of all our people.
“We have all the ingredients for an economic recovery; now let us work together to make it happen,” the President said.
Minister Patel tests positive for COVID-19
Trade, Industry and Competition Minister Ebrahim Patel has tested positive for COVID-19.
The Minister received his results on Saturday, 25 July 2020. This was the Minister’s second test since the outbreak of this virus.
“Minister Patel is in good spirits and is in self-quarantine, and will continue to work from home. Those that have been in contact with the Minister are also in self-isolation and have been encouraged to get tested,” said Minister in the Presidency Jackson Mthembu.
On Friday, Minister Patel participated in the virtual parliamentary budget vote debate on the revised budget for the Department of Trade, Industry and Competition (DTIC).
As part of his budget debate speech on Friday, the Minister announced that every directorate of the DTIC and every agency within its mandate will prioritise saving firms and jobs during this period.
“As we wish the Minister a speedy recovery, we extend the same well wishes to the thousands of South Africans and their families who are also battling Coronavirus.”
“To defeat this virus, we must all continue playing our part in observing all health protocols of washing our hands regularly, properly wearing a mask when in public and practicing physical distancing. Together, we can beat the coronavirus,” said Mthembu.
Defence channels R3 billion for COVID-19 operations
Defence Minister Nosiviwe Mapisa-Nqakula says the department, which has deployed most of its forces and operations to the frontlines of the Coronavirus pandemic, has allocated R3 billion to COVID-19 operational costs.
The Minister said this when she presented the department’s spending priorities during a virtual sitting of the National Assembly.
On 24 June 2020, the Minister of Finance announced that the Defence Special Budget Allocation for the fight against COVID-19 was an amount of R3 billion. These funds will be for the operational costs associated with the fight against the pandemic, as well as the procurement of personal protective equipment.
“For our purposes, this will go through costs already incurred and others still underway, including repatriation flights, quarantine costs, deployment of reserve forces, air support operations, quarantine clinics, medical equipment and ambulances,” she said.
Providing the last defence at the eye of the storm
Addressing MPs, Mapisa-Nqakula said the department’s role has been to ensure support for the fight against the pandemic through the Department of Health by providing the required expertise inherent in our South African Military Health Services (SAMHS).
The military health services have provided health professionals across the spectrum in all the provinces, drawn from the regulars, reserve forces and volunteers.
“The health care professionals provide services to our own members and the National Health Department – through primary health care teams for screening, testing and tracing purposes across the country; mass quarantine sites in KwaZulu-Natal, Western Cape, Gauteng and Limpopo respectively; decontamination teams, to mention but a few.
“As I speak on this debate, a team of our military health professionals have been deployed to the Eastern Cape at the request of the Premier and provincial government.
“That is just one part of a range of deployments we have been involved in,” she said.
The deployment of forces was an integral part of the enforcement of the national state of disaster.
“In addition to the military health elements, there are a range of capabilities that have been deployed,” she said.
This includes engineers for bridge building and water purification in various communities; air defence and maritime capabilities; landward capabilities for security and direct support to the police services and other entities of government.
“We have since the beginning of the declaration of national disaster, by means of lockdown, run all these operations related to the COVID-19 under the rubric of Operation Notlela, Lockdown!”