Coronavirus morning recap: Return to Level 3 'not true', and second wave likely to be rural

LATEST SCIENCE AND RESEARCH

READ | Some Covid-19 patients are attacked by their own immune systems – a new study explains why

Some people are at greater risk of severe Covid-19, the disease caused by SARS-CoV-2. According to a recent study, autoreactive antibody production may explain why this happens.

The study, which was published in preprint server medRxiv, while awaiting peer-review, explains that instead of targeting disease-causing microbes, these immune proteins, called autoantibodies, target the tissues of patients suffering from severe Covid-19.

The researchers explained that their findings have a potential impact on both acute patient care and infection recovery.

Harvard Health explains that autoantibodies attack several different parts of the body, resulting in inflammation and tissue damage in the joints, skin, kidney, nervous system (brain and spinal cord), blood, and heart, among others.

More than this, they can also attach themselves to body chemicals and form abnormal molecules (known as “immune complexes”) that trigger additional inflammation when they are deposited in the body’s organs and tissues.

Previous studies during the earlier stages of the pandemic found that abnormal blood clotting in Covid-19 patients is more likely to lead to complications and admissions to the intensive care unit (ICU).

In the recent study, the four researchers highlight that these autoantibodies play a role in dangerous blood clots forming in these Covid-19 patients, and that, more recently, they have also been found to inactivate important components of viral immune defences in a large number of patients with severe Covid-19.

READ | Coronavirus and the immune system: SA study to shed light

Understanding how the immune system responds to SARS-CoV-2, the virus that causes Covid-19, and why some individuals are affected more severely than others, have been on researchers’ agenda  since the very beginning of the pandemic.

Now, a team of researchers led by Associate Professor Wendy Burgers, a viral immunologist in the Division of Medical Virology at the University of Cape Town (UCT) will be working to gain insight into how long immune responses to the virus last; how strong those immune responses are; as well as understanding whether prior exposure to other related coronaviruses helps patients build a level of immunity to Covid-19.

“We’re trying to understand whether those patients who have been exposed to the common cold viruses (viruses related to Covid-19) build a level of immunity.

“In this case, T cells that can recognise SARS-CoV-2 might protect patients from contracting severe Covid-19,” Burgers said in a news release by the university.

The current study builds on previous research led by Dr Stephen Makatsa, a postdoctoral fellow in the Division of Medical Virology.

The study spanned three months (May to July 2020) and involved 77 participants. The research team established that an antibody assay (a biochemical test that measures the presence or concentration of antibodies in a patient’s blood) recognises the Covid-19 virus, and signals that infection has occurred and an immune response has formed.

“Results show that our test works really well in measuring antibodies in people who have been infected,” Burgers said.

The goal now, Burgers commented, is to use that same test to measure antibody responses and see how long they last in patients who have been previously infected.

The team is also studying the immune responses of healthcare workers who were infected with Covid-19, as well as a group of their peers who have not been infected with the virus.

READ | Lockdown, pandemic effects: Soweto study re-emphasises need for better access to mental healthcare

Mental health experts have warned that the Covid-19 pandemic and national lockdown are having a negative impact on people's mental health, and new research looking into the impact this has on people in Soweto, has found a significant link between symptoms of depression and how likely people feel they could be infected.

"South Africa's national lockdown introduced serious threats to public mental health in a society where one in three individuals develops a psychiatric disorder during their life," wrote Dr Andrew Wooyoung Kim (and colleagues) of Northwestern University, who co-directed the study for the Developmental Pathways for the Health Research Unit at the University of the Witwatersrand (Wits).

The team also found that the perceived risk of infection and the likelihood of depression and anxiety were also higher among people who had suffered childhood trauma, as well as among those already suffering the effects of poverty and deprivation.

Their findings were published in the journal Psychological Medicine.

Although previous studies looked at the link between depression and issues such as hunger, violence, poor healthcare, and high rates of poverty, the researchers wrote that theirs was the first to look at the mental health effects of the pandemic and national lockdown in South Africa under those conditions.

For their study, the researchers spoke to more than 200 adults who were already part of a long-term health study in Soweto, surveying 957 people in the months prior to the pandemic.

CORONAVIRUS CASES LATEST

SA cases update: 

The latest number of confirmed cases is 717 851.

According to the latest update, 19 053 deaths have been recorded in the country.

There have been 647 833 recoveries.

So far, more than 4.7 million tests have been conducted, with 17 472 new tests reported.

Global cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Early on Wednesday morning, positive cases worldwide were close to 43.8 million, while deaths were over 1.1 million.

The United States had the most cases in the world - more than 8.7 million, as well as the most deaths - close to 227 000.

WHAT'S HAPPENING IN SA

Latest news:

READ | Ramaphosa dismisses rumours of a return to lockdown Level 3 as 'simply not true'

It is "simply not true" that a move back to lockdown Level 3 is imminent, President Cyril Ramaphosa told the National Council of Provinces (NCOP) on Tuesday.

However, he will be studying a new report and said the government has observed some worrying trends.

While answering a question about Covid-19 corruption, DA MP Tim Brauteseth slipped in a question about whether the rumours that a move back to Level 3 lockdown, or even Level 5, was true.

Chairperson of the NCOP, Amos Masondo, warned the members to stick to the original question.With a smile, Ramaphosa said: "Thank you, honourable chair, for seeking to save me there."

Ramaphosa said the government continues to analyse and manage the situation with the assistance of the medical advisory committee."We are seeing some signs that are of concern to us," he said.

He said too many South Africans are not adhering to the preventative measures to prevent the spread of Covid-19.

He added that there had been some gatherings which were super-spreader events. Ramaphosa said he received a report earlier in the day.

"I want to look at the report very closely, and also then have an opportunity in the coming days,possibly next week, to address the people of South Africa on what we now need to do in light of what we are going through.

READ | Covid-19 corruption: The political hyenas are never far from the door - Steenhuisen

Interim DA leader John Steenhuisen has likened those accused of Covid-19 corruption to a pack of heartless hyenas feeding off a helpless, dying springbok.

On Tuesday, MPs debated a Steenhuisen-sponsored debate around Covid-19 corruption in the National Assembly.

"Mr President, you may have been 'shocked' that your party could plumb such depths of depravity. But we weren't shocked. Because we'd seen this movie before, with the arms deal, former president Mandela's funeral, state capture and other grand-scale theft by connected cronies.

"Every time there is a big government procurement, the political hyenas are never far from the door," Steenhuisen said.

He added the DA, from the outset, had pushed hard for Covid-19 accountability mechanisms to be put in place even during the lockdown.

The Special Investigating Unit (SIU) told Parliament last week of the R15.6 billion total Covid-19 expenditure between April and August, R10.5 billion was under investigation.

Of the R10.5 billion under investigation, around R223 million is currently in the Special Tribunal to set aside contracts and recover losses.

Minister in the Presidency Jackson Mthembu said the Cabinet remained resolved to leave no stone unturned in strengthening controls around resources.

"Cabinet further affirmed the independence of law enforcement agents and that they must execute their duties to our nation without prejudice, fear or favour as custodians of the laws of our country."

As reported to the Standing Committee on Public Accounts by the Hawks, significant progress has been made to ensure that every cent stolen is recovered," Mthembu added.

READ | SA’s second wave likely to be rural, scientists warn – which makes it a transport problem

If South Africa is headed for a second wave of coronavirus infections – as has happened dramatically in countries around the world, it could have a rural flavour, local scientists have cautiously suggested.

And that could make for a very different set of problems to those South Africa faced during the initial wave of Covid-19.

The Scientists Collective group has made the argument most directly, albeit with several caveats. If the first wave was biggest in urban centres, where the virus spread fast through high-density populations, those metropolitan areas should have more limited transmission in any immediate second wave – even if the proportion of people who have already had SARS-CoV-2 is still high enough for herd immunity.

"Put another way, a resurgence in settings where there was a high force of infection during the first wave, is likely to be of a lower magnitude than experienced with the first wave," said the group, which includes some of the most eminent experts in infectious disease and public health in SA.

"Conversely, communities with low rates of infection in the first wave, may be disproportionately affected during a resurgence of Covid-19."

Complicating factors include the lack of results for a national seroprevalence survey promised by President Cyril Ramaphosa in September. Small-sample data from urban centres suggest many more people have had the coronavirus than have been identified through testing, but there is no comparative information for rural areas.

And with a correlation between poverty and a limited ability to self-isolate and maintain social distance, it is not inconceivable that some rural areas too have had the pandemic sweep silently through, leaving behind a somewhat more resistant population.

WHAT'S HAPPENING IN THE REST OF THE WORLD 

Latest news:

READ | Covid-19: Hard shutdown not the answer, says Anthony Fauci, admitting SA response better than US

Shutting down a country is not the way to go about fighting Covid-19, said leading US infectious diseases expert Anthony Fauci, who admitted that South Africa appeared to have done better than his home country.

Instead, he said, there should be a unified response to the pandemic and that safer socialisation should be encouraged.

"We have got to get away from the mentality of either shutting down completely or 'the hell with it, do anything you want to do without any precautions' [approach].

"It is same way back in the days of HIV when we would say just say no to drugs or no sex at all. It doesn't work that way."

Fauci is the director of the National Institute of Allergy and Infectious Diseases and has advised six presidents in 36 years.

He was addressing a webinar on Monday night, which University of Cape Town professor, Linda Gail Bekker, hosted.

Bekker is also the COO of the Desmond Tutu HIV Foundation and the former president of the International Aids Society.

Fauci said he was puzzled by people who didn't take Covid-19 seriously.

"Covid-19 is so different because [of] the spectrum of disease, from 40% of people who have no symptoms to those who have symptoms, and 80% [who] have mild symptoms. And then you have 15 to 25% who [are] severe or critical, leading to the high degree of morbidity and mortality."

READ | Covid-19 wrap: Unrest as Europe imposes restrictions, Mexico City mayor tests positive

Mexico City Mayor Claudia Sheinbaum said on Tuesday she had tested positive for Covid-19 but was feeling well and had not developed symptoms of the disease, Reuters reports.

"I will continue to work and coordinate all activities from a distance, with the same commitment as usual," she said on Twitter, where she announced her positive test.

In other international news, European governments prepared on Tuesday to introduce new restrictions to try to curb a growing surge of coronavirus infections and provide economic balm to help businesses survive the pandemic, Reuters reports.

Hundreds of protesters took to the streets across Italy on Monday to vent their anger at the latest round of restrictions, including early closing for bars and restaurants, with demonstrations in some cities turning violent.In the financial capital Milan, youths hurled petrol bombs at police, who responded with volleys of tear gas.

In nearby Turin, luxury shops had their windows smashed and some were ransacked,leading to the arrest of 10 rioters.

Prime Minister Giuseppe Conte was expected to approve measures to help companies hit by the new curbs introduced at the weekend after daily infections increased eight-fold in less than a month.

In France, Interior Minister Gerald Darmanin warned the country to prepare for "difficult decisions"after some of the strictest restrictions currently in place anywhere in Europe have failed to halt the spread of the disease.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

Image credit: Getty Images

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