Coronavirus morning update: Concern over Western and Eastern Cape infection rates

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 4 793.

According to the latest update, 90 deaths have been recorded in the country.

So far, 178 470 tests have been conducted  - nearly 10 000 news tests.

READ MORE |All the confirmed cases of coronavirus in SA

Latest news:

Outbreaks among essential workers have led to the Western Cape overtaking Gauteng as the epicentre of the Covid-19 pandemic in South Africa, while funerals and an outbreak in the correctional services system drove up the Eastern Cape's figures.

This is according to Health Minister Zweli Mkhize, who had a virtual meeting with the Parliamentary Portfolio Committee on Health and the Select Committee on Health and Social Services on Monday morning.

"We're seeing changes in the outbreak on a day-to-day basis," he said. "When we started with the outbreak, Gauteng province was the highest, things have shifted with the Western Cape now the epicentre."

He said there has been a change in pattern.

"The pattern that we're seeing is happening in workplaces which were originally identified as essential services.

"It looks like we need to find additional support to strengthen the response of the province in that area."

He said he has been in contact with Western Cape Health MEC Nomafrench Mbombo and will be visiting the province again soon.

"We are going to be increasing the number of kits that are going to the Western Cape, he said.

"We'll also be working very closely with the clinicians treating patients to see what assistance they need, we'll get them their PPEs (personal protective equipment)."

READ MORE | Mkhize: Essential workers in Western Cape, funerals in Eastern Cape driving infection rates

South Africa is counting on accessing R95 billion ($5 billion) from the International Monetary Fund, World Bank and New Development Bank to help finance a R500 billion economic stimulus package.

The money from the multilateral lenders is available only for Covid-19-related measures and the government would have to adhere to some broad agreements, including on what the funding may be used for and repayment terms, National Treasury director-general Dondo Mogajane said in an interview with broadcaster eNCA on Sunday.

The agreements should not compromise the country's sovereignty, Mogajane said.

President Cyril Ramaphosa on April 21 unveiled the fiscal package to help fight the pandemic, provide aid to the poor and shore up an economy that the central bank projects will contract 6.1% this year. The package includes a R200 billion loan-guarantee programme, tax-relief measures and R130 billion that will be diverted from existing budgets.

READ MORE | SA seeks R95 billion from IMF, World Bank, NDB

The Democratic Alliance (DA) says it is in support of a much wider opening of the economy, and will also challenge the nationwide curfew in its submissions to the government's risk-adjusted strategy.

The opposition party on Monday said the move to level 4 of the lockdown is intended to allow more economy activity to take place – but is not distinguished enough from level 5.

"Firstly, there is no evidence to say why this should not happen. There has been little to no transparency around that data or the analysis being used to guide government's response," DA leader John Steenhuisen said in a statement on Monday.

"Secondly, a wider opening can still achieve the same level of public safety if the government changes its approach from one based on force to one based on trust," he added.

READ MORE | Level 4 lockdown: DA calls for more economic activity, opposes curfew

Ratings agency Moody's foresees the South African economy going into recession and the gross domestic product (GDP) contracting 6.5% in real terms in 2020.

This is as a result of long-standing structural challenges and the severe hit to economic activity caused by the coronavirus, Constantinos Kypreos, senior vice president at Moody’s Investors Service, said in a banking system outlook update released on Monday. He foresees that the temporary lockdown of the country will reduce production and cut household consumption. Furthermore, he foresees that the transport, hospitality, mining and manufacturing industries will be particularly hard hit.

Moody's expects a material deterioration in the credit risk exposure of South African banks.

The ratings agency has changed its outlook for the South African banking system to negative from stable, it said on Monday.

READ MORE | Moody's sees SA in recession, outlook for banking system negative

WHAT'S HAPPENING IN THE REST OF THE WORLD 

Cases update:

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

Late on Monday night, positive cases worldwide were more than 3 million, while deaths were more than 210 000.

The United States had the most cases in the world - just short of 984 000, as well as the most deaths - close to 56 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Doctors in the UK have reported a serious new coronavirus-related condition emerging in children, with growing numbers now requiring intensive care.

An "urgent alert" sent out to general practitioners in London in the last three weeks warns of "an apparent rise in the number of children of all ages presenting with a multisystem inflammatory state requiring intensive care" according to a report by the Health Service Journal.

The alert warned that "there is a growing concern that a [Covid-19] related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases."

A separate alert, sent out by the Paediatric Intensive Care Society, urges doctors to "please refer children presenting with these symptoms as a matter of urgency," according to the HSJ.

READ MORE | A serious new coronavirus-related condition may be emerging in children, UK doctors say

WhatsApp seems to have successfully put a leash on messages going viral on its platform.

A spokeswoman told Business Insider it's seen a huge reduction in viral forwarded messages.

"Since putting into place this new limit, globally there has been a 70% reduction in the number of highly forwarded messages sent on WhatsApp. This change is helping keep WhatsApp a place for personal and private conversations," she said.

The private messaging service announced in early April that it was placing limits on the mass-forwarding of messages in an effort to stop misinformation about the coronavirus winging its way around the world.

READ MORE | WhatsApp says viral message forwarding is down 70% following new limits

A new analysis of the coronavirus death toll across 14 countries found the official death tolls are likely massively undercounting the true scale of the pandemic.

The Financial Times studied the number of deaths that occured in week-long periods across 14 countries in March and April.

It then compared that figure to the average for the same period between 2015 and 2019, before the pandemic. It concluded that the difference between the two is a reasonable estimate of how many extra deaths the pandemic had caused.

The FT found that the death toll calculated this way was more than 60% higher than adding up various countries' official death tolls.

READ MORE | Massive undercounting of global coronavirus deaths, according to new analysis

LATEST RESEARCH

Who should be eligible for Covid-19 testing in South Africa? The answer is different depending on who you ask. While the current eligibility criteria for testing is clear, there are some working in the field who feel these criteria are too restrictive and should be broadened.

Testing is central to the Covid-19 strategy in South Africa and in many other countries. Once a person tests positive, they can isolate, and the risk of further onward transmission from that person can be reduced.

Apart from this benefit for the community, earlier testing also makes it more likely that individuals with Covid-19 will receive the healthcare services they need in time should they become seriously ill.

The current criteria according to a National Institute of Communicable Diseases (NICD) brief, dated 9 April 2020, the criteria for persons under investigation (PUI), i.e. those who should be tested for Covid-19, are: Persons with acute respiratory illness with sudden onset of at least one of the following: cough, sore throat, shortness of breath or fever [> 38 degrees Celsius (measured) or history of fever (subjective), irrespective of admission status]. 

According to Professor Adrian Puren from the NICD the “case definitions used by the NICD are informed by consultation with South African or international experts in the field and guidance from reputable organisations such as the World Health Organisation.

The final definitions are reviewed by the Ministerial Advisory Committee and signed off by the National Department of Health. In the case of community screening, the current criteria are (having) two respiratory symptoms,” he says. 

But is there merit in broadening these criteria, for example, for anyone displaying even one symptom or for all persons admitted to hospital regardless of respiratory illness status? “The NICD has revised its criteria for testing as the epidemic has evolved,” says Puren.

“The NICD took pragmatic decisions based on the knowledge available at the time as well as the availability of resources (both human and testing reagents/platforms). The case definition is a guide and the doctor and patient will always review risk and make a decision on whether to test or not on an individual case by case basis.”

READ MORE | Covid-19: Is SA’s testing criteria too restrictive?

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.

READ MORE: Coronavirus 101 

Image credit: Getty Images
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