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The Minister of Health, Dr Zweli Mkhize, says South Africa stands to benefit from the arrival of the Cuban medical brigade, as the country fights the outbreak of COVID-19.

Unpacking the country’s COVID-19 situational analysis on Tuesday evening, Mkhize welcomed the arrival of 217 Cuban doctors from various disciplines.

Mkhize said the Cuban doctors have a particular strength in the case of community medicine, and their presence is very helpful in approaching situations such as the outbreak of COVID-19.

He said the doctors have been allocated to various provinces on the basis of the weight of the outbreak, where they will work alongside South African medical professionals.

“We have 26 [doctors] who are going to be allocated to the Western Cape. These [include] 18 family physicians, who are in the community health field,” Mkhize said, adding that epidemiologists, health technologists and biostatisticians, among others, also form this cohort of medical practitioners.

The doctors will help to analyse the outbreak trends on the ground and help the department to structure its strategy.

Twenty-nine Cuban doctors will be allocated to Gauteng, 28 to KwaZulu-Natal, Eastern Cape 20, Free State 17, Mpumalanga 13, Limpopo 13, North West 13 and Northern Cape 11.

Placement of doctors looking for jobs

The Minister stressed that the Cuban doctors are not here to fill vacancies, but are in the country to help contain the outbreak.  He called on local doctors who are looking for placements to contact their own provinces and submit applications, as the country is looking for additional doctors.

“Because of COVID-19, we understand there is going to be additional pressure. We are going to be taking more people in, and we’ve even called on some of the retired or volunteers to come on board, even if it is for the short-term,” Mkhize said.

However, the Minister said qualified foreign national doctors, who are not registered through the Health Professions Council of South Africa and could not pass entry exams, cannot be employed until they are registered and have passed the exam.

South Africa’s prudent decision to institute a countrywide lockdown has circumvented an exponential explosion of cases of the worldwide COVID-19 pandemic within the borders of the country, the Department of Health said on Tuesday.

The Minister of Health, Dr Zweli Mkhize, said while the lockdown will not spell the end of new infections, it has, however, significantly delayed the peak of the virus. This has bought the country precious time to beef up its response, and prepare health facilities for the management and treatment of those infected with COVID-19.

As of Tuesday, 28 April, the country had 4 996 confirmed COVID-19 cases, with 93 deaths.

Mkhize revealed that from 6 March, the country has conducted 185 497 tests. During this period, over six million people have been screened for symptoms and have had temperature checks. During this process, 11 000 were referred for COVID-19 tests.

Between 6 and 12 March, the country had done 413 tests. The tests doubled the following week, steadily increasing over the subsequent weeks to the extent of 25 000 tests done in the past week.

The Western Cape, with 1 870 cases, has become the country’s epicentre of the outbreak. Gauteng and KwaZulu-Natal follow with 1 387 and 919 cases, respectively. With 616 cases, the Eastern Cape follows. While the Free State has 113 confirmed cases, the remaining provinces all have less than 40 cases each.

Speaking extensively on the impact of the lockdown, which came into effect on 27 March (and was extended by a further two weeks on 9 April), Mkhize said this intervention stopped an exponential increase in cases. Furthermore, South Africa has announced an elaborate, phased easing of the lockdown, which is categorised according to risk levels. This, President Cyril Ramaphosa has said, will allow the country to resume economic activity, while safeguarding human life.

In dealing with the lockdown, the Health Department’s epidemiologists considered three scenarios, which included “nothing being done”. Under this scenario, the virus would have peaked in July. With a three-week lockdown, the virus would have peaked in August. With a five-week lockdown, the experts say the peak has been staved off until September.

“This lockdown stopped a huge movement of people and stopped an exponential rise [in cases].

“Because people were congregating, they were close to one another… in big meetings, sport gatherings, trains, taxis and so on. That would have actually made the outbreak rise pretty fast. In this case, we were able to delay it,” said Mkhize.

Mkhize said the department is pleased with the development and is confident that its duration is sufficient to flatten the curve of infection.

“The [epidemiologists’] model shows that even if we made the lockdown longer, it would have not put down the curve further than what it is,” said Mkhize.

The lockdown, he said, is being eased based on scientific projections and calculations stating that a Level 5 lockdown would be of no further benefit.

Risk factors

The Minister said a trend has emerged of fatalities mostly having the underlying challenge of comorbidities. These include hypertension, diabetes, obesity, asthma and lung diseases.

However, Mkhize pointed out that South Africa has a unique challenge that is not as prevalent in other countries that have combatted the virus.

The Minister said a study by the University of the Witwatersrand revealed that approximately one-third of South Africans suffer from hypertension – the highest prevalence in southern Africa. In addition, the country has millions of people with diabetes.

“Over 4.5 million people in South Africa have diabetes. Over 70% of women and 40% of men are overweight or obese,” Mkhize said.

All these factors, the Minister said, are important to take into account, as they are considered in the COVID-19 infection.

“We still have unknown factors when it comes to HIV and Aids, and tuberculosis. Unfortunately, South Africa has the largest numbers and therefore not in a position to learn from other countries because they have less of a challenge than us,” he said.

The country, unlike some countries in Western Europe, was fortunate that the mortality rate has stayed at a low 1.9%.

This, he said, could be attributed to that most of the country’s infections were among mostly healthy people. “That tends to make them recover pretty quickly.”

Mkhize said testing can be classified into three groups i.e. tests conducted at private facilities, public hospitals, as well as public screening campaigns.

A departmental analysis, he said, has revealed that tests have increased between 6 and 26 March.

“From then on, the rate of numbers in positive tests started to decline, but it has remained constant among those who have been referred to hospital because of their symptoms,” he said.

The rate of positive cases from those identified in public screenings was between 3% and 3.8%.

National Treasury on Tuesday announced the replacement of measures relating to COVID-19 emergency procurement.

“National Treasury is replacing measures relating to COVID-19 Disaster Management Central Emergency Procurement Strategy, namely Instruction Note 3 of 2020/21 and Circular 101. The new measures will be Instruction Note 5 of 2020/21 for PFMA [Public Finance Management Act] institutions and Circular 102 for MFMA [Municipal Finance Management Act] institutions,” it said in a statement.

The replacement, said Treasury, follows on various representations that have raised concerns about the procurement process.  Treasury said the approach adopted had excluded a number of domestic suppliers and that it covered too wide an array of goods, especially goods that can be manufactured locally.

The new instruction note and circular will provide measures to put in place for COVID-19 emergency procurement, as well as open the supply of these products to all suppliers conforming to the specifications and registered on the Central Supplier Database (CSD) of government.

The instruction note and circular will also outline the required personal protective equipment (PPE) item specifications, according to the Department of Trade, Industry and Competition, national Department of Health and World Health Organisation requirements.

It will also outline the maximum prices at which government will procure PPE items, and outline the emergency procurement, monitoring and reporting requirements.

In the statement, Treasury said it is committed to the Constitutional objective of having fair, equitable transparent, competitive and cost-effective procurement processes, which take into account the need for procuring essential health products required to fight the pandemic.

“These processes should be compliant with the country’s imperatives of promoting structural transformation and broadening participation in the economy to strengthen economic development and empowerment of previously disadvantaged groups and individuals,” it said.

The instruction note and circular will be published on the National Treasury website soon.

South Africans have for the first time since the advent of democracy marked Freedom Day under a lockdown to curb the spread of the Coronavirus pandemic.

The country commemorates 27 April 1994 as the historic occasion in 1994 when all citizens were allowed to cast their vote and usher in their first democratic elections.

But with South Africans confined to their homes in a bid to curb COVID-19, President Cyril Ramaphosa, through a virtual broadcast, delivered the Freedom Day address under the 2020 Freedom Day theme – “Solidarity and triumph of the human spirit in challenging times”.

The President’s address called on citizens to reflect on not only their hard won freedoms, some of which have been restricted under lockdown but also on the lessons presented by the COVID-19 pandemic.

“The true lessons of this experience will not just be about the necessity of social distancing, proper hand washing and infection control. They will also be about whether we have the ability to turn this crisis into an opportunity to invest in a new society, a new consciousness and a new economy.

“In this new society, the privileged cannot afford to close their eyes to the plight of the poor and sleep peacefully at night. This is the time when we should actively work to build a fair and just country,” said the President.

Before this pandemic arrived on South Africa’s shores, government was at work to address poverty, underdevelopment, unemployment and a weak economy but the pandemic could set these efforts back by many years.

The pandemic and by extension the imposed lockdown forced the country to confront the great inequalities that continue to characterise the country 26 years after the attainment of freedom.

“Though we are certainly all braving the same tide, we have not been impacted in the same way by this pandemic. Some people have been able to endure the Coronavirus lockdown in a comfortable home with a fully stocked fridge, with private medical care and online learning for their children.

“For millions of others, this has been a month of misery, of breadwinners not working, of families struggling to survive and of children going to bed and waking up hungry,” said the President.

The President described this as the greatest form of injustice and a “stain on our national conscience”.

In this regard, the President said the promise made on the 27th of April 1994 can no longer be deferred.

“We must make real the right of all our people to health care, food, shelter, water, social security and land,” said the President.

In this final decade of the National Development Plan, President Ramaphosa called on citizens to change the pace of social and economic transformation.

“Even as we turn the tide on the Coronavirus pandemic, we will still have to confront a contracting economy, unemployment, crime and corruption, a weakened state and other pressing concerns.

“We will have to find new, exceptional and innovative ways to overcome them. This is not something government can do alone,” said the President.

While government alone cannot rebuild the economy and the country, the President said recovery can be achieved through collaboration business, labour and civil society.

But with the country still consumed with containing the virus, the President called on South Africans to respect each other’s rights and adhere to the lockdown regulations.

“Respect for the rights of others is the beating heart of freedom. Violating the Coronavirus response provisions and exposing others to a potentially fatal illness is the worst form of disrespect for others,” he said.

President Ramaphosa called on South Africans to unite against the pandemic and use the crisis to reaffirm the resolve to fundamentally change society.

“Let us emerge from the coronavirus pandemic a better country, a more equal country. This year, we are celebrating Freedom Day apart, each of us confined to our homes.

“Next year – through your determination, through your courage and through your actions – we will once again celebrate Freedom Day together,” said the President.

President Cyril Ramaphosa on Monday welcomed Cuban health professionals who have arrived in the country to support efforts to curb the spread of COVID-19 in South Africa.

In total, 217 Cuban health specialists and workers arrived in South Africa today. This followed a request made by the President to President Díaz Canel Bermúdez of Cuba.

The group consists of the following:

• Experts in the fields of epidemiology, biostatistics, and public health;
• Family physicians to guide interventions through door-to-door testing and to assist local health workers in health promotion and disease surveillance at the community level;
• Healthcare technology engineers to assist in maintaining the inventory, deployment and repair of aged medical equipment; and
• Experts to provide technical assistance working with local experts.

In 2019, South Africa and Cuba celebrated 25 years of cordial, mutually beneficial diplomatic relations and constructive cooperation at both bilateral and multilateral levels.

The SA-Cuba Agreement on Cooperation in the Fields of Public Health and Medical Sciences has registered much success.

Over 732 South Africans, many from previously disadvantaged communities, received their first five years of medical training in Cuba and have qualified as doctors since the inception of the Nelson Mandela/Fidel Castro medical training programme in 1997.

Many others continue receiving medical training in Cuba and will also provide in the coming years much needed primary healthcare services to their local communities.

“The strong and historic relations between the two countries has seen bilateral agreements and technical cooperation in many areas, including health, human settlements, public works, infrastructure, water resource management, sanitation and basic education, among others.

“The deployment of Cuban doctors, engineers and technical experts in all the provinces of South Africa rendering important services, is a demonstration of the strategic partnership and solidarity between South Africa and Cuba and a good example of South–South cooperation,” the Presidency said in a statement.

The Department of Water and Sanitation (DWS) has delivered a further 141 water tanks across needy areas of Gauteng to push back against the rising tide of the novel Coronavirus pandemic.

So far, 1 926 water tanks have been distributed in the Cities of Joburg, Tshwane and Ekurhuleni and the Sedibeng and West Rand District Municipalities.

Until recently, Gauteng was the epicentre of the virus before the Western Cape saw a spike in the number of cases related to the virus.

Following President Cyril Ramaphosa’s announcement for government to devise and implement extraordinary measures to slow the spread of the virus, the department has deployed officials who are at the forefront of delivering water tanks to different areas in the country in a bid to cushion the impact of the virus on the most vulnerable.

The water tanks will assist communities in water-stressed and densely populated informal settlements to wash their hands to ward off the virus.

Head of DWS in Gauteng, Sibusiso Mthembu, said a failure to provide water to needy communities would put them at the brink of a crisis of contracting the virus and that it was therefore important for them to access water to be able to wash their hands regularly.

Mthembu said there was an optimistic sign in Gauteng that the call for people to say at home and thw washing of hands was having a positive impact as the province has moved away from being the epicentre of the virus.

He said the department was especially aiming to protect the health of communities that were susceptible to the virus because it was most likely to spread in crowded environments.

Mthembu added that more work still needed to been done to curb the spread of the virus as it was accelerating fast but was more difficult to slow down, identifying dense environments as the feeding ground of the virus.

“There is still a long way to go to deal with the virus. So, the delivery of water to communities remains our absolute priority. The fact that Gauteng is no longer the hardest-hit province should not lull us into believing that we are out the wood. In fact, we still face some very difficult days ahead and thus we must double our efforts,” said Mthembu.

Police Minister Bheki Cele has issued an apology to the Muslim community for blasphemous remarks made by an officer during the arrest of worshippers at a Mosque on Saturday.

The video of the arrest, where a police officer can be heard making the remarks during the arrest in Masibekela, Mpumalanga, has been doing the rounds on social media. Police had initially said the arrest was made in Pretoria.

The group of worshippers was arrested for contravening the COVID-19 Disaster Management Lockdown Regulations, which prohibit gatherings, including religious assembly.

“Minister Cele has issued an apology to the Muslim community for the blasphemous remarks during the arrest, a matter that is currently under an urgent investigation by the SAPS to establish the identity of the person behind such sacrilege,” acting Police Ministry spokesperson, Brigadier Mathapelo Peters, said in a statement.

Peters said the police have a constitutional obligation to enforce the laws of the country, a duty to be executed within the confines of the same laws, applied with no prejudice against any gender, race or creed.

Workers facing distress due to the COVID-19 lockdown continue to find relief, thanks to the Unemployment Insurance Fund (UIF).

According to the Employment and Labour Department, the fund has made progress towards the COVID-19 Temporary Employer/Employee Relief Scheme (TERS) while ramping up normal benefits to ensure that workers are not inconvenienced during the lockdown.

“Just today [Wednesday], the Unemployment Insurance Fund has disbursed R92 million, which brings the total paid to date from April 16 to just under R1.8 billion. These payments cover up to 790 150 workers. In some cases, the claims have been paid within 24 hours of presentation,” said the department in a statement.

Meanwhile, Employment and Labour Minister Thulas Nxesi said the fund will continue to process payments for ordinary benefits such as pregnancy, retrenchments and other paybacks – which have amounted to R804 million since the beginning of April

“As enjoined by the President, we continue making sure we ease the load of lockdown. We still appeal to more employers to ensure that they apply for relief for their employees to ensure we do not leave anyone behind,” he said.

The Department of Mineral Resources and Energy has issued a directive to all mining operations to ensure safe start-up procedures as the sector prepares to ramp up to 50% of capacity.

“The directive was issued to ensure compliance with Section 5(1) of the Mine Health and Safety Act (Act No. 29 of 1996), as amended, which requires that every employer must as far as reasonably practicable, provide and maintain a safe working environment,” the department said.

The start-up procedures must also address measures to be taken to prevent the spread of COVID-19, as well as actions to provide a safe working environment, especially following the prolonged closure of some operations.

These measures, in line with the latest disaster management regulations, should include:

• Rigorous screening of all employees, including contractors, prior to accessing the mine;
• Testing of employees with symptoms of Covid-19;
• Adequate social distancing;
• Provision of quarantine facilities for employees showing signs of COVID-19;
• Establishment and maintenance of a personal hygiene programme; and
• Provision of appropriate Personal Protective Equipment (PPE) including face masks.

The directive also encourages employers to systematically phase in workers at the mines. Mining companies must, in consultation with labour unions in the respective operations, develop the start-up procedure, and provide a copy to the department, prior to ramp-up of operations.

“The nature and extent of the COVID-19 pandemic is dynamic, unpredictable and changes almost daily as new scientific research about the virus becomes available. This calls for an equally dynamic response from Government and society as a whole.

“The department will therefore continue to introduce specific and appropriate measures for the sector when required. Stakeholders are urged to continue participating in this process as they have done to date, through the established consultative forums,” the department said.

The department continues with scheduled and unannounced visits to mining operations to monitor compliance with the lockdown regulations, guiding principles on prevention and management of COVID-19, as well as the start-up procedure.