Coronavirus morning recap: Gastro symptoms, final exams update, and 'can't afford another lockdown'



READ | Some Covid-19 patients may only show gastrointestinal symptoms, new review suggests

Radiologists have been urged to remain observant, as almost one in five Covid-19 patients may only display gastrointestinal (GI) symptoms, a new review of academic studies has found.

The 36 studies analysed by the research team from the University of Alberta's Faculty of Medicine and Dentistry were published in July.

The findings of the review were published in the journal Abdominal Radiology.

The researchers also discovered potential signs radiologists should look out for when performing abdominal imaging, as this could be evidence of Covid-19 infection, they wrote.

“Gastrointestinal manifestations and imaging manifestations of SARS-CoV-2 infection are increasingly reported and warrant specific attention during abdominal imaging,” the authors reported.

The gastrointestinal symptoms associated with Covid-19 vary widely, the researchers indicated, but may include loss of appetite, nausea, vomiting, diarrhoea, and generalised abdominal pain.

Their review notes that 18% of patients presented with such symptoms, while 16% of cases may only present with GI symptoms.

In addition to gastrointestinal symptoms, the team also found potential signs radiologists should be on the alert for while carrying out abdominal imaging, as these may serve as evidence of Covid-19 infection.

Those signs include inflammation of the small and large bowel, air within the bowel wall (pneumatosis), and bowel perforation (pneumoperitoneum).

READ | Covid-19 in South Africa: Who should get tested, and what’s available

South Africa has passed the peak of the infection curve, but the danger of a resurgence remains real. At the same time new tests are becoming available. Ina Skosana asked Glenda Mary Davison to provide a guide about who should go for testing, and what’s available.

When should I consider being tested?

South Africa’s National Institute for Communicable Diseases recommends that all individuals who present with symptoms of Covid-19 or an acute respiratory infection should be tested for SARS-CoV-2 using the gold standard RT-PCR test.

The advice remains that people without symptoms should not be tested – even if they have been in close contact with someone diagnosed with Covid-19. There are categories of people where there this doesn’t apply.

This includes health care workers and residents of a care home and those being admitted to hospital. If someone has been in contact with an infected person they should self-quarantine for 10 days and be monitored for any respiratory symptoms rather than rush out for a test.

But if reasons like the need to travel arise, then it’s best to go for a PCR test between five and eight days after the initial contact. Going any earlier increases the risk of a false negative result.

What’s available?

PCR: This is a molecular test based on the reverse transcription polymerase chain reaction. It has been developed expressly to detect SARS-CoV-2, the virus that causes Covid-19. This test has been used for Covid-19 diagnosis since the onset of the pandemic.

The tests are considered to be highly accurate. The downside is that they require skilled and experienced laboratory professionals and as well as expensive equipment.

For now, this remains the go-to test for Covid-19.

Antibody test: Many countries, including South Africa, are approving the use of antibody or serology tests. These are very useful in detecting whether someone has previously been infected.


SA cases update: 

The latest number of confirmed cases is 732 414.

According to the latest update, 19 677 deaths have been recorded in the country.

There have been 671 579 recoveries.

So far, more than 4.9 million tests have been conducted, with 23 942 new tests reported.

Global cases update:

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

Early on Friday morning, positive cases worldwide were more than 48.3 million, while deaths were over 1.2 million.

The United States had the most cases in the world -  9.5 million, as well as the most deaths - exceeding 234 000.


Latest news:

READ | South Africa cannot afford another lockdown, warns Winde

South Africa cannot afford to go into another lockdown, Western Cape Premier Alan Winde said on Thursday.

"Our economy cannot afford it. We're getting poorer, we are losing jobs - we need to recover now," he said during his weekly digital press briefing.

"We will only recover, only make sure we claw back those jobs and the economy that we've lost, if we make a safer environment for this to happen.

"We have to make sure that we manage Covid-19. We must not let down our guard."

He said it was "very interesting" to see what was happening in the northern hemisphere in terms of lockdown, maintaining that back home, "we must learn the lessons".

"Germany being seen as the country that really has managed Covid-19 in Europe the best, and still themselves having to go into further lockdown... We have to avert this. We have to make sure that we don't. SA cannot afford it."

Germany this week shut its restaurants, bars, gyms and entertainment venues, while schools, shops and workplaces would remain open.

According to the BBC, this "lockdown light" was not as restrictive as the one in March and food outlets could still provide takeaways.

Public meetings were restricted to 10 people from two households, while private parties were banned.

Winde said there had to be a "deal" between citizens and government to work together to avoid another rise in infections.

"If we get this right, then we can avert that second wave. We can focus our energy on recovery,instead of spending too much time focusing, managing and preparing for a second wave."

READ | Matric 2020: Pupils deemed fit after testing positive for Covid-19 allowed to write exams, says DBE

Pupils who test Covid-19 positive will be allowed to continue writing their final NSC examinations, the Department of Basic Education has said.

This, after the department came to an agreement with the Department of Health on Wednesday.

Initially, guidelines issued by the department stipulated that pupils who tested positive would not be allowed to write.

The department said it received representations from parents and pupils who requested government to review the protocols.

The health and education departments then agreed that candidates who tested positive, and were deemed fit to write the examination, would be allowed to continue writing, but in isolation with secure conditions, in compliance with examination regulations.

The departments would work jointly to ensure that candidates confirmed to be positive were given an opportunity to sit for the exams, while ensuring that safety was observed.

Speaking at Sekano-Ntoana Secondary School in Soweto on Thursday, Basic Education Minister Angie Motshekga said the health department would step in as soon as there was an identified case.

She said the agreement came as a relief as those pupils who would not have written due to testing positive, would only have had a chance to write next June - meaning 2020 would have been wasted for them.


Latest news:

READ | Covid-19 wrap | WHO warns of 'explosion' of virus cases in Europe, Sweden deaths pass 6 000 mark

Sweden, whose pandemic strategy of avoiding lockdowns has gained international attention, reported a record increase in new Covid-19 cases on Thursday as health officials said it was seeing a marked rise of patients in intensive care.

Sweden registered 4 034 new coronavirus cases, health agency data showed, the latest in a string of records set in recent days amid a pandemic resurgence that has struck the country later than many other parts of Europe, but which now appears to be rapidly gaining momentum.

The Health Agency has said the outbreak was likely more severe during the spring when Sweden periodically suffered some of Europe's highest per capita death tolls though limited testing at the time had meant many infections went undetected.

"There is continued increase in the number of cases in all regions except one," said Karin Tegmark Wisell, head of the microbiology department at the agency.

"We are now also beginning to see a fairly significant increase on the number of intensive care patients.

"The intensifying outbreak has seen Sweden tighten the mostly voluntary recommendations on which it relies across much of the country and Tegmark Wisell said the percentage of positive tests had climbed to 9.7% last week from 5.6% the week before.

Earlier on Thursday, Swedish Prime Minister Stefan Lofven said he was self-isolating and getting tested after he learned a person close to him had met someone who was later confirmed to have Covid-19.

READ | Denmark to cull 17 million mink after finding mutated Covid-19 strain - it infected 12 people

Denmark will cull its entire mink population – up to 17 million animals – after scientists found some were carrying a mutated strand of Covid-19 that the government fears could "restart" the entire global pandemic.

The new strain, which originated on mink farms, has infected at least 12 people, the Danish government said, quoting research from the country's infectious disease authority the State Serum Institute.

The country's prime minister said the new strain could "undermine" the impact of a future Covid-19 vaccine.

The scientists have observed cases of the virus in mink farms in Jutland, northern Denmark, for several months, but the cases are now spreading rapidly among humans.

In total, almost 400 human cases appear to be linked to the country's mink farms, the government said.

"The virus has mutated in mink. The mutated virus has spread to humans," Prime Minister Mette Frederiksen said at a press conference Wednesday.

The mutated virus could mean "the effect of a future vaccine will be weakened or, in a worst case scenario, be undermined," she said.

This is because the mutated virus can weaken the body's ability to develop antibodies, according research by the State Serum Institute. As a result, it could make Covid-19 vaccines currently in development ineffective.

Denmark will deploy its police, army, and home guard to cull the animals. As one of the world's biggest producers of mink fur, Denmark has more than 1 000 mink farms, and up to 17 million of the animals.

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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