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Health Minister, Dr Zweli Mkhize, has urged the elderly and those living with comorbidities to take extra precaution, avoid leaving home and ensure their chronic conditions are managed.

Citing the National Institute for Communicable Diseases’ report released on 21 June, Mkhize said it confirmed that these population groups are most vulnerable.

“This report brings all these issues home and gives us a sense of the burden we have faced, how the system has coped and marries these lessons to the projections that have been modelled of the coming surge,” he said.

According to the NICD report, 10 700 COVID-19 patients have been admitted from 269 public and private facilities between 5 March and 21 June 2020.

The study revealed that the median age of COVID-19 admissions was 50 years, 338 were patients who are 18 years and younger and 1 386 older than 70, while 5 778 were female.

In addition, 8 245 patients had comorbid conditions, 2 810 had one and 3 126 had two or more underlying illnesses.

“Of the 5 836 patients who had a comorbid condition, the most commonly reported were hypertension 3 419 and diabetes 2 813 and there were 1 116 patients admitted with HIV, 240 with active tuberculosis and 579 patients with the previous history of tuberculosis.”

Clinicians also noted obesity as a risk factor in 297 patients.

“Of the 10 700 admissions, 3 260 patients were in the hospital at the time of the report, 5 925 patients were discharged alive or transferred out, and 1 515 patients had died,” Mkhize added.

Mkhize noted that some of the factors associated with in-hospital mortality were older age groups; male sex; and having comorbid hypertension, diabetes, chronic cardiac disease, chronic renal disease, malignancy, HIV and obesity.

“We wish to detail them for the public to demonstrate the connection between science and the recommendations that we make,” Mkhize said.

Facts about COVID-19 illness caused by SARS-CoV-2

Mkhize said he was pleased with how clinical and epidemiological knowledge around this disease has developed at an extraordinary rate.

Meanwhile, a vaccine has already advanced to the human trial phase, he said in his statement on Tuesday.

“This is how determined we are, collectively, to beat this virus and minimise its impact on us as humanity.”

The Minister said they are constantly learning more about the behaviour of the virus when it enters the body.

“We have since learnt that the virus is shed through the airways and spreads by infected droplets passing from one individual to another.”

Mkhize added that the virus has also been detected in saliva, tear fluid, stool, and men’s semen with acute infection and some male patients who have recovered.

“Having said that, sexual transmission of the virus has not been recorded,” he explained.

There have been intense studies into the duration expulsion and release of the virus as well as determining how long Coronavirus survives on surfaces.

The duration varies from hours to days depending on the severity of disease or the nature of the study itself.

He said COVID-19 ranges from asymptomatic or mild symptoms to severe illness and death.

“Symptoms may develop between two days and two weeks following exposure to the virus.”

Clinical characteristics of COVID-19 include fever and symptoms typical of a viral respiratory tract infection including coughing, sore throat, loss of taste and smell, nasal congestion, and even conjunctivitis.

“Further, gastrointestinal symptoms of nausea, vomiting, and diarrhoea are also common with COVID-19.”

He said the virus could progress to cause lower respiratory tract infection resulting in, pneumonia and its complications.

“Acute Respiratory Distress Syndrome (ARDS) is a serious complication of COVID-19. The lungs may become stiff and difficult to ventilate,” he said, adding that ARDS is associated with a high mortality rate.

Mkhize said there have been two major advancements in the case management of severely ill patients who require ventilator support.

“First is the advent of dexamethasone which has shown that deaths can be reduced by a third for patients on ventilators and can also help patients who only need supplemental oxygen.”

He said they are now recommending early administration of this drug to critically ill patients who require oxygen support.

“Evidence increasingly supports the avoidance of invasive ventilation strategies as far as possible.”

The Minister said they are expecting the Ministerial Advisory Committee on COVID-19 to issue advisories on the use of high flow oxygen for patients who are very ill but can be managed without intubation and ventilation.

Washing hands, cleaning surfaces and wearing a mask a must

Mkhize has once again emphasised the importance of frequent hand washing, avoidance of touching the face and cleaning of surfaces.

“We have recommended social distancing based on the fact that droplets traverse a certain distance from person to person.”

Also, wearing of facemasks reduces the amount of exhaled Coronavirus, he said.

“We also now know that one can shed the virus days before showing symptoms and for days after they recover from their symptoms – and so by wearing facemasks, one can literally save someone else from acquiring the virus. If that person is elderly or living with comorbidity, you can save that life.”

Mkhize emphasised the need to establish and keep new habits and turning them into traditions, customs and working lives forever.

“This is proving to be particularly difficult for South Africans to sustain and we appreciate that it is not easy to become accustomed to a new way of life,” he admitted.

The Minister said government was doing their best for the message to reach the people.

“These are the things that will prevent one from being admitted into hospital in the first place,” he said.

“But for those unfortunate ones who do become ill and need hospitalisation, we should be assured our doctors and nurses in facilities are doing a terrific job.”

He has praised the medical practitioners for keeping the morbidity and mortality rates lower than the global average.

No decision about another lockdown

According to Mkhize, there has not been any decision taken to have another lockdown.

“And certainly the National Coronavirus Command Council does not take lightly a decision of that nature. There may be a need in some areas for restrictions; it may not be national but localised. But no such decision has been taken as yet.”

He has pleaded with the public to work together to fight COVID-19.

“We are riding into the storm, but, together, we will prevail.”

The Department of Health has condemned the dumping of medical waste next to the road between Mdantsane and East London in the Eastern Cape.

“The inappropriate dumping of medical waste is dangerous for public health. It can lead to infectious diseases,” the department said in a statement.

The department said the medical waste has been identified as the property of the National Health Laboratory Services (NHLS).

“What is worrisome is that this was not just medical waste but specimens. These specimens have identity numbers and contact details of individuals.

“In our view, this is an intentional criminal act which must be condemned strongly. It is a violation of people’s rights and dignity when the test kits containing their personal information are found next to the road,” the department said.

The department said it is working with the Eastern Cape Departments of Health and NHLS to establish how the medical waste ended up where it was found.

“The courier company that was contracted must be traced and provide answers as to what happened to get to the bottom of this situation. We are hopeful that an investigation will be done and those found responsible for this be held accountable,” the department said.

The Passenger Rail Agency of SA (PRASA) today resumes limited operations after a COVID-19 enforced lockdown saw its operations ground to a halt in March.

In a statement, the agency uurged commuters to arrive at stations earlier than usual to accommodate time for screening and hand sanitisation on the premises.

During this period, PRASA says informal traders will not be allowed to operate outside the station gate, inside the station, on the platforms and inside the trains.

“Furthermore, no eating or drinking will be allowed inside the stations and trains,” said PRASA.

Passengers, who are exhibiting symptoms associated with COVID-19 will not be allowed inside the stations. They will be placed in a holding facility, where health authorities will attend to them.

“Commuters are urged not to travel if they are feeling unwell, but instead they should stay at home and seek medical advice,” said the agency.

The deep cleaning of operational trains, as well as high-volume areas at the stations, will be conducted on a continuous basis.

PRASA encouraged passengers to observe the one seat social distance markers inside the train, as well as the social distance markings next to the ticket office and at the platforms at all times.

“PRASA will strictly adhere to the COVID-19 hygiene protocols, which include social distancing on platforms and inside trains. The wearing of face masks covering the mouth and nose will also be strictly enforced,” said the agency.

Operationally, PRASA will gradually introduce a limited service nationally. As a start, only four lines in total will be operating, namely:

Gauteng – operating between Piennarspoort and Pretoria Stations.

– Morning peak service will be between 05:00 – 09:00.

– Afternoon peak service will be between 15:00 – 19:00.

Western Cape – operating between Cape Town and Retreat Stations.

– Morning peak service will be between 05:00 – 09:00.

– Afternoon peak period will be between 15:00 – 19:00.

Eastern Cape – operating the East London and Port Elizabeth lines, respectively.

– Morning peak will be between 05:15 – 08am.

– Afternoon peak will be between 15:30 till 18:40pm.

The South African Social Security Agency (SASSA) is reassessing rejected applications for the COVID-19 R350 grant, which is meant to help those who are unemployed and receiving no other assistance.

The agency believes it is wise to reassess applications before subjecting them to an appeal process, which comes at a cost and delays.

SASSA said it is treating the issue as a matter of urgency, as it pushes to help the poor, who have been hit hard by the national lockdown.

Last month, SASSA said it was receiving many grievances about the declined R350 grant applications. The agency at the time said the majority of applicants were already on the Unemployment Insurance Fund (UIF) database or were qualifying to receive it.

“In early June, close to 50% of processed applications did not qualify, in terms of the criteria. Over 70% of those that did not qualify were either receiving or qualifying for UIF benefits, according to the database that SASSA was using then to sift through the applications,” SASSA explained.

However, SASSA decided to request an updated database to reconsider the declined UIF cases, instead of advising the aggrieved applicants to follow the appeals route.

“Out of this reconsideration process, it emerged that 85% of the UIF cases, which were previously deemed not to be qualifying, actually qualify. They have been approved and are being made aware of this development individually, as and when such favourable decision is reached.”

SASSA said everyone affected would receive a SMS requesting them to provide their banking details.

“It is important to respond to the SMS as quickly as possible and to follow the link provided. Approved applicants are reminded that the link cannot be shared with others, as it is linked to a specific ID number for security reasons,” the agency stressed.

Meanwhile, more than 2.5 million applicants have already received payment from over 3.2 million individuals, who applied for the COVID-19 grant.

“Updating the UIF database has brought such a relief to us and the affected beneficiaries. The numbers will rise daily until we have paid all deserving individuals who were previously declined,” said Totsie Memela, the SASSA CEO.

She said SASSA was working with the Department of Social Development to finalise the appeals process for applicants who still feel that their applications were rejected unfairly.

The appeals function will be added to the www.srd.sassa.gov.za website as soon as the relevant framework has been approved.

Plans are underway to welcome back more pupils to schools across the country as the Basic Education Department continues with its phased reopening of schools amid COVID-19.

In just five days, pupils in Grades R, 1, 2, 3, 6, 10 and 11 are set to return to school on 6 July 2020.

Earlier this month, Grade 7 and 12 pupils returned to the classroom as government implemented the phased reopening of the country and the economy.

Briefing Parliament’s Portfolio Committee on Basic Education, the department’s Director-General Mathanzima Mweli said while the department is prepared to welcome back 52% of pupils next week, it will consider the trend of infections.

“Although we are saying 52% of learners, we are not fixed to bringing the 52%. We have heard that community infections are flaring up, we discussed this last night with unions, and we are saying our plan is extremely flexible.

“We are not going to push for 52% to come if we can see that there is danger. The community infections that are happening might spill over to schools. We are very cautious of that,” he said.

Since the reopening of schools on 8 June, the Education Department noted that 523 pupils, 1 169 staff members and 775 schools have been affected by COVID-19.

Mathanzima said, while the department is prepared to welcome pupils, it is also mindful about the capacity of the health sector.

“We not only look at our capacity to run the system but also have to be mindful about the capacity of the health sector to deal with the flaring up of infections in communities because those schools are located in communities, so we are alive to that reality.”

Rotational school attendance

In an effort to maintain social distancing at schools, Mweli presented the department’s plan to amend the timetable to ensure that only 50% of the total learner enrolment is present at a given moment.

Under the plan, the department suggests that learners either attend school on a bi-weekly basis, rotate to be present ever second day or all learners attend on a particular day.

Correctional Services Deputy Minister Nkosi Phathekile Holomisa has made a full recovery from COVID-19 and he is back at work.

The Deputy Minister is also expected to participate in a Parliamentary session today.

Holomisa had been in self-isolation at home since 12 June 2020, and “made it his mission to religiously follow what was prescribed to him”, his department said.

Although in good spirits, Holomisa said that a recovery should never induce complacency, as the infectious disease is at its peak.

“It is vital that every citizen continue to fully adhere to and diligently implement protective measures in order stop the spread of the virus,” Holomisa said.

This is a plea aligned to government’s call for social distancing in the fight against COVID-19 and for the continued use of face masks in public.

South Africa’s COVID-19 cases are on a sharp and steady increase with 6 130 new cases reported on Monday, bringing the total number to 144 264.

A further 73 COVID-19 related deaths were reported, bringing the total to 2 529. Of the 73 new deaths reported, 1 was from Mpumalanga, 5 from Limpopo, 2 from North West, 6 from Gauteng, 10 from the Eastern Cape, 6 from KwaZulu-Natal and 43 from the Western Cape.

“The numbers are picking up and the surge is on the way. Particularly in Gauteng, the numbers are locking up faster than anticipated.

“Western Cape started surging numbers very quickly. Western Cape in June went up by 40 000 people, but in Gauteng as of last night we are close to 3 000 per day,” said Health Minister Zweli Mkhize.

With the rapid increase in infections posing a threat of overwhelming health services, Mkhize pleaded with citizens to observe health protocols and maintain social distancing.

“The problem is too many people getting sick at the same time. We want to plead to people to use the masks, hand washing, social distancing.

“During the month of July we are going to see larger numbers getting infected, going into August. We are hoping to manage the situation during this time,” said the Minister.

While the numbers continue to surge, Mkhize said no decision has been taken to have another lockdown.

“There has not been any decision taken to have another lockdown and certainly the National Coronavirus Command Council does not take lightly a decision of that nature.

“There may be a need in some areas for restrictions. It may not be national but localised. But no such decision has been taken as yet,” he said.

Dumped COVID-19 test kits

On Monday, reports surfaced of COVID-19 test samples found dumped in Mdantsane in East London. Following the discovery of the dumped samples, the Health Minister announced the suspension of the courier company responsible.

“The tests lying on the road was disappointing. It seems to be the courier company. We’ve asked these services to be suspended. We cannot have this type of negligence. We are grateful to those who spotted and reported this matter,” said the Minister.

Officials deployed to E Cape

Noting the challenges of staffing and capacity in the Eastern Cape, the Health Department has deployed officials to the province to boost capacity.

“Eastern Cape has a number of challenges, part of it is to strengthen their management capacity. We have deployed officials to assist. I have seen improvements in the past six weeks. We do know there are challenges of staffing.

“We’ve sent a number of people to the Eastern Cape. We are sending reinforcements to the province and keep going there to inspect the progress. We are seeing changes and are monitoring the situation,” said the Minister.

Continue with treatment

On people with comorbidities, Mkhize urged people with comorbidities to continue taking their medication and encouraged them try to get a multi month supply of medication.

“Where possible they should work from home, if not to seclude themselves at work,” he said.

Arts and Culture Minister Nathi Mthethwa is expected to issue directions on the reopening of cinemas and theatres, subject to a limit of 50 persons or less and strict adherence to all health protocols and social distancing measures.

The Minister’s directions will also allow for the reopening of museums, galleries, libraries and archives, subject to strict adherence to health protocols.

“The above mentioned places must apply to the Minister within 14 days after the publication of the directions and will be approved, subject to compliance with protocols, which will be published in the Minister’s directions in the next few days,” the ministry said on Tuesday.

The department will deploy officials to monitor compliance with the directions, and these officials will be given special identity documents.

“The department is very appreciative of the cooperation of the sector in fighting the spread of COVID-19 and ensuring that the sector is not responsible for the spread of Coronavirus.

“As passionate as we are about the advancement of the art and culture sector, we are equally as committed to ensuring that lives come first,” Mthethwa said.

It has been widely reported that the country has been facing a shortage of personal protective equipment (PPE) in the last few months. This equipment is crucial for healthcare workers to protect themselves from contracting COVID-19 while attending to patients.

Many sectors of society, including business, responded to the shortage by donating PPE equipment to the national Department of Health as well as provincial departments of health.

Katekani Ngobeni, a senior researcher at the Council for Scientific and Industrial Research (CSIR), has been at the forefront of advising officials on whether the protective gear is safe for use, and if it offers sufficient protection for nurses and doctors.

This is at a time when the main response to the pandemic has been guided by the implementation of preventative measures. These measures include social distancing, the regular washing of hands with soap and the wearing of facemasks.

Technical advice is essential in this period of uncertainty on the appropriate protective equipment healthcare workers should use.

“We know that a lot of us were caught off-guard with COVID-19 and we were not prepared for the challenges,” she said in an interview with SAnews.

“So what we did as the CSIR, we offered support to all these different provinces – be it via Zoom (conference calling platform) or via the telephone. [This is] because a lot of people were panicking, especially with the issue where there was a global shortage of respirators.”

Ngobeni said it was expected that there would be some questions and fear from the provincial health departments on how to properly manage COVID-19.

“There were also questions about how to interpret all these constantly updated guidelines and the recommendations that are being reviewed and updated almost on a weekly basis.

“People are receiving donations of respirators that they have never used before and it is not properly regulated in South Africa. Therefore, people are in a state of panic to say how  do we manage this to ensure that our healthcare workers are adequately protected,” she said.

Since the outbreak of COVID-19, the young researcher has been providing ongoing workshops to various provincial health departments struggling to cope with the new reality brought about by COVID-19.

“We have been giving that type of technical support and guidance where provinces come and enquire about how to interpret guidelines, and how to adequately protect employees.”

She carries out these advisory responsibilities by developing and maintaining close working relationships with government departments and implementing partner organisations.

This is in order to ensure that programme activities are carried out within the recommended practice standards based on evidence and international guidelines.

Ngobeni has also facilitated a COVID-19 preparedness course for the South African National Defence Force (SANDF).

In February, Ngobeni presented her work at the first South African COVID-19 Conference.

Held in Pretoria, the gathering was attended by over 250 healthcare professionals who obtained free scholarships from the Health and Welfare Sector Education and Training Authority (HWSETA), co-sponsored by the Foundation for Professional Development (FPD).

“Healthcare workers need critical information about respiratory protection. Hospitals across South Africa are running out of N95 masks, which filter at least 95% of particles that are 0.3 microns or larger, including the new Coronavirus.”

In response to continued respirator shortages, many countries, including South Africa, have resorted to the use of KN95 masks.

“However, currently, there are no specific guidelines in South Africa on which criteria apply for the use of the product, including evidence demonstrating that the respirator is authentic.

“In addition, there is conflicting guidance about the application of these respiratory masks. In order to continue providing technical assistance and capacity building to healthcare workers during this lockdown period, we collaborated with the FPD to provide online training,” she said.

The 34-year-old’s work on Tuberculosis (TB) and personal protective equipment has set the foundation for her as a key player in the fight against the spread of COVID-19.

Of her other achievements, Ngobeni was selected to attend the Building Design and Engineering approaches to Airborne Infection Control training hosted by Harvard University in the United States.

In 2013, she was a runner-up for the JD Roberts Award for emerging researchers under the age of 35 to recognise and celebrate the contributions of younger colleagues within the CSIR.

As Youth Month draws to a close, the young professional has urged young people to play a role in the fight against the virus.

“There is an urgent need to address the challenges in the spread of COVID-19 in South Africa. Young people have a huge role to play during this pandemic. We need to educate ourselves and others, especially those in disadvantaged areas, about the importance of hygiene and living a healthy life.”

This as the number of COVID-19 confirmed cases in South Africa stands at over 144 000 to date. In addition, reports have pointed to healthcare workers who have tested positive for the virus to be at just below two percent.

While the Western Cape and the Eastern Cape have been identified as hotspots for COVID-19, Ngobeni was not at liberty to say which provinces have required the most technical advice on the use of PPEs.

“We are supporting all provinces but obviously there were some provinces that had more challenges than others. It is just that some provinces struggle more than other provinces or they might need more technical assistance and attention as opposed to others who might have resources and have access to such knowledge and information at their disposal,” she said.

Ngobeni and her colleagues at the CSIR form part of several work streams advising on the fight against the virus.

“We have committees at the national Department of Health; we also form part of committees with different regulatory bodies.”

However, the journey to where she is today has not been an easy one for the young woman born in Ka’Ndengeza, which is located outside Giyani in Limpopo.

With her parents in Gauteng, Ngobeni spent life with her grandmother until the third grade. She then joined her parents in Protea Glen, Soweto and attended school at Alpha Primary school. With the relocation, Ngobeni found herself having to repeat Grade 3, due to her not understanding a word of English at the time.

To remedy the situation, her mother bought children’s books for her and in six months’ time, Ngobeni’s fluency in English had improved a great deal.

She went to high school at Lenasia Secondary School, south of Johannesburg, and found inspiration in a young female environmental health practitioner, who was a friend of her mother.

Ngobeni remembers how meeting her mother’s friend sparked the desire to want to follow in the same career path and after matriculating, she enrolled for a National Diploma in Environmental Health with the University of Johannesburg.

Instead of doing her year of community service immediately, she opted to complete her B Tech (equivalent to a degree qualification).

She then completed her year-long community service with the City of Johannesburg, after which the city appointed her as an environmental health practitioner on a full-time basis, servicing health facilities in Johannesburg.

With her career flourishing, Ngobeni moved to the Gauteng Department of Health where she took up the position of chief healthcare officer focussing on waste management in 2010.

She joined the CSIR in 2011 as an infection control specialists focusing on infection, prevention and control.

As part of her work at the CSIR, Ngobeni also hosts workshops for architects to help them design safer buildings as far as infection control is concerned.

“A chunk of our work has been focussed around TB since 2011. We have been solely focussing on TB infection control helping architects [to] design buildings and infrastructure to better create a healthier environment and protect their workers. The challenge currently is that most of our architects are not trained on infection control.”

Architects, she said, were likely to design buildings for aesthetics, not considering the health impact of those designs.

“So we go out to train architects and engineers to now start thinking about how to design a building that looks good but at the same time, start creating a healthy environment for the occupants of that building,” she said.

Since joining the CSIR, Ngobeni has pursued a Master’s degree through the University of Johannesburg, exploring the use of respiratory protection devices in low-income healthcare settings.

While much is still being discovered about COVID-19, young South Africans are putting up their hands alongside healthcare professionals, in the fight against the pandemic.

The Gauteng SAPS has announced the temporary closure of the Diepsloot police station after one of its members tested positive for COVID-19.

In a statement, the provincial head office said during this period, the station’s Community Service Centre would operate from the metro police department office, opposite the station.

“The community is advised to call 10111 for all emergencies and complaints which needs to be attended by Diepsloot police station,” read the statement.

During this period, the station’s telephone lines at the Community Service Centre will not be accessible.

“The building will be undergoing decontamination and the community will be informed when the station will be operational again,” said the SAPS.

The SAPS management apologised for any inconvenience that may arise from this.

The Station Commander can be contacted at:  082 828 5767. Relief commander: 082 558 1355.