- With a national backlog in Covid-19 tests, the Western Cape is prioritising testing for the most high-risk groups, for now.
- These groups include people who are already in hospital, healthcare workers, people older than 55 and people who have comorbidities.
- Premier Alan Winde has pleaded for patience as they wait for more test kits to become available.
The Western Cape government is rationing its Covid-19 testing in Cape Town, prioritising people it considers to be most at risk amid a nationwide backlog in test results and increased demand as it approaches its Covid-19 peak.
It is asking people in the Cape Town metro who experience mild symptoms and who are not part of one of the at-risk groups, to assume they are Covid-19 positive, and isolate themselves until more test kits are procured.
This was explained this week during the province's weekly "digicon" to update the public on its Covid-19 fight.
"That does mean that explicitly, we have had to make the call that if you are under the age of 55 and you don't have comorbidities, that at this point in time, if you present yourself for testing, we will be doing screening to say to you, 'if you've got the symptoms, please isolate yourself and assume that you've got Covid[-19]'," he head of the provincial Department of Health, Dr Keith Cloete, said.
"Isolate yourself at home, look after yourself [and] look after others that's with you," he added.
This week, the province said that due to the testing backlog, it took between seven and 12 days to get results. By then, the person who was tested could be close to recovery.
As it stood, the government was already asking anyone who has symptoms to self-isolate and stay away from work. Cloete said.
"We've had the reality of people going through all of this... and by the time they get their test results back, it's been 14 days already."
In the last publicly available figures, it emerged that the country had a backlog of nearly 1 00 000 test results, with the Western Cape standing at 28 000.
On Saturday, the City of Cape Town accounted for more than 24 000 of the province's 29 136 positive cases and of those, 8 888 were active cases, with 15 352 recoveries*.
Who are the most vulnerable?
Cloete said people regarded as the most vulnerable and who are at high risk are those who are more likely to develop the moderate-to-severe form of Covid-19 and that was why they were being prioritised for testing.
These are people who are already in hospital; healthcare workers; people older than 55; people of any age who have comorbidities, including diabetes, hypertension, heart disease, HIV, TB, cancer, chronic lung disease; and people who are in homes for the aged and retirement villages.
The province said 90% of the people who contract the virus will not require hospitalisation and will be able to treat themselves at home.
What to do if you think you have mild symptoms and do not meet the criteria for a test
Cloete said screening for symptoms at work was important and that anyone under the age of 55 who displayed mild symptoms should go home to self-isolate.
If the symptoms persist, go to a testing facility, where you will be screened.
Symptoms include fever (a temperature of 38°C and above), a dry cough, difficulty breathing, tiredness, headaches and loss of taste or smell.
Call the sacoronavirus.co.za hotline on 0800 029 999 for more information.
When is it safe to go back?
According to Cloete, the health department regarded confirmed cases as "recovered" after 14 days (unless there are complications). The National Institute for Communicable Diseases puts the full recovery period at around 14 days.
So, 14 days after the onset of the symptoms, you are regarded as recovered.
If you have tested positive, but are asymptomatic, count 14 days after taking the test.
If you are or were in hospital, count 14 days after the day of stabilisation to the day you are considered to be recovered.
Many studies showed that after eight days, an infected person was less likely to be infectious to others and by 14 days, there was virtually no infection capability, according to Cloete.
The Department of Labour initially said a negative test was needed for people to go back to work, but the Western Cape health department advised that a letter and certificate from a healthcare worker would do.
"And we have had no problem with that," added Cloete.
Changing behaviour when your guard is down
The virus has already taken its toll on the health sector, and will continue to do so as the province reaches its peak.
Asked on Thursday how it is possible for people to still contract the coronavirus, given the strict adherence to mask wearing, sanitising and social distancing, Cloete said behavioural change was complex.
He added that it depended on the context of each person's life and whether that context allowed for behaviour change.
Cloete said one study found that in hospitals, where hospital workers are the most at risk and are exposed to Covid-19 patients and have their personal protective equipment on, staff did absolutely everything required regarding the risks and requirements.
As a result, they have even found one-on-one transmission is probably lowest in one-on-one exposure between a Covid-19 patient and healthcare worker.
However, a single inadvertent lapse can change things.
"What we've found is when people are out of that context and they go to the tea room, they take the mask off, they share a cup, they share the surface, [a] lot of infections [were] in that unguarded moment in terms of that," he said. "There's lots that we can learn about when you believe you are at risk as opposed to when you perceive that the risk is lower and how does that influence your behaviour in that specific setting."
Decision 'not taken lightly'
Western Cape Premier Alan Winde said in a statement this week that the province had petitioned President Cyril Ramaphosa and Health Minister Zweli Mkhize to address the backlog, adding that the lack of test kits was a strain globally.
"Nevertheless, until such stage as extra testing capacity is made available, this decision is the only remaining solution available to ensure early detection in those individuals who we know are the highest risk of dying from Covid-19.
"Indeed, if we can get a test back within 24 to 48 hours, we can ensure early treatment and if need be, hospitalisation, of those people who we know will deteriorate rapidly as the infection progresses. For some of our residents, it might be the difference between living and dying.
"I fully understand that every single person who starts developing symptoms wants to get tested so that they know if they have Covid-19.
"This gives you a level of calm and certainty. I assure you that this decision was not taken lightly and after careful consideration of the very serious testing challenges we face in South Africa.
"I ask for your patience and understanding as we act decisively to save the lives of the most vulnerable in our communities," said Winde.
*Note: Due to different reporting times, provincial statistics will differ from national statistics by a few cases on a given day.