- Health Minister Zweli Mkhize says his department will recommend easing lockdown restrictions further.
- This is owing to declining numbers of reported Covid-19 cases countrywide.
- Mkhize says a high level of immunity may already exist in SA.
Health Minister Zweli Mkhize said his department would make recommendations to Cabinet to ease lockdown restrictions, such as those relating to the curfew, the sale of alcohol, religious gatherings and travel.
In a statement on Monday night, Mkhize said the number of detected cases countrywide continued to decline.
"Since 22 August, we have reported under 3 000 cases per day - at the height of the epidemic during the month of July, we would report anything between 10 000 and 15 000 cases per day. Supporting this decline is also a demonstrable decline in persons under investigation, general ward admissions, ICU admissions, deaths and excess deaths," the minister said.
"Consistency across these indicators reassures us that indeed, we are in the midst of a trough in the pandemic."
Mkhize said the department previously committed to review restrictions periodically as it reassessed the state of the South African epidemic.
"And this is indeed what we have done. Having observed evidence that suggests a sustained decline in coronavirus transmission, as the Department of Health, we have considered easing restrictions in various aspects - such as the curfew, sale of alcohol, religious gatherings, and travel restrictions - for the National Coronavirus Command Council (NCCC), which will make final recommendations to Cabinet.
"Whatever decisions are made, it is important to emphasise that the risk of spreading and contracting Covid-19 still remains and that non-pharmaceutical interventions remain important as we learn to co-exist with the coronavirus," Mkhize added.
By Monday, the department had recorded a cumulative total of 650 749 confirmed Covid-19 cases in South Africa, with 579 289 recoveries and 15 499 fatalities.
NICD analysis - case management
Mkhize said the National Institute For Communicable Diseases' (NICD) COVID Surveillance in Selected Hospitals Report of 11 September outlined analyses of data collected from 459 public and private facilities nationally.
"This report shows a clear shift in the behaviour of the epidemic with downward trends in general ward and ICU admissions and deaths. In total, 66 515 patients were studied with 4 314 currently admitted. The discharge rate from hospital was 75% while the in-hospital case fatality ratio was 17.5%. The median age for admissions was between 50 and 59 and the median age for deaths was between 60 and 69. At the height of the epidemic, these sample hospitals were reporting between 6 400 and 6 800 admissions per week," Mkhize said.
"South Africa has benefited significantly from the contributions of the World Health Organisation (WHO) surge team that has come to reinforce our team in responding to the Covid-19 pandemic," Mkhize added.
"The WHO surge team has released a situational report on 10 September, reflective of the 37th week of our epidemic, which confirms the decline as reported by [the] NICD. This report showed a 42% decline of detected cases in the preceding two weeks and a 28.9% decline in deaths in the same period.
"Admission to critical-care wards increased by 13.9% during this epidemic week, but conversely, admissions into general wards decreased by 43% in the same period. The median test positivity rate was recorded at 9.8%, compared to 11.4% in the previous week."
Bed occupancy and oxygen demand declining
Bed occupancy and oxygen demand is also declining, according to Mkhize.,
The percentage of beds occupied by Covid-19 patients nationally is less than 10% for non-ICU beds and less than 30% for ICU beds.
"The benefit that we have seen during this period is that there has been an increased acquisition of ventilators with 5 444 procured or received through donations and 2 848 currently awaiting delivery. This has assisted us to improve our facilities as ventilators were in short supply and there would have been a delay in providing the required healthcare to patients who needed it the most.
"It also drove us in the direction of increasing local manufacturing capacity, which resulted in South Africa manufacturing ventilators for the first time in history."
The minister said 20 000 ventilators are expected to be produced through the National Ventilator Project.
"We also have reports from Afrox, indicating that oxygen demand has decreased nationally in the past few weeks."
No PPE, no work!
The protection of frontline workers in the health sector remains of paramount importance, Mkhize said.
"We re-iterate: no PPE (personal protective equipment), no work! We continue to track the numbers of health workers who are infected in each province. Our system now has direct linkage with the PERSAL system, so that any health worker who is diagnosed with Covid-19 is immediately identified.
"As of 11 September, a cumulative total of 32 429 healthcare workers had been detected with the coronavirus. Sadly, 257 succumbed to Covid-19. We convey our condolences to all the loved ones of the deceased and thank the colleagues who took care of our heroes in their final hours," Mkhize said.
Mkhize said he was pleased that occupational health and safety (OHS) committees were established in 3 849 public health facilities.
"As per the previous directive, members of unions must be represented in all these structures. This will assist in constant monitoring of issues affecting health workers, including where there is [a] shortage of PPE."
Non-compliance with PPE procurement processes
"We note with concern the findings of the Auditor-General, which include that there were deficiencies and non-compliance with PPE procurement processes, insufficient controls to ensure receipt and payments of PPE and the level of quality of PPE, delays in the delivery of PPE as well as evidence of price gouging and [a] failure to procure PPE at market-related prices. This cannot be accepted. This must be condemned and, once all the investigations have been concluded, there must be consequence management for any officials that may be implicated in wrongdoing or irregularity," Mkhize warned.
Reconfiguring Ministerial Advisory Committee
With the changing pattern of the pandemic, it has become necessary to reconfigure the Ministerial Advisory Committee (MAC) on Covid-19, the minister said.
"The new MAC will take into account the need for the inclusion of social and behavioural scientists, among other factors.
"In addition to the multi-sectoral MAC focusing on community mobilisation, another MAC has been created to focus on coronavirus vaccine development (MAC on vaccine). This MAC will advise us on all matters pertaining to the coronavirus vaccine development and rollout - from monitoring and reporting on progress on our candidate studies, to advising on our purchasing options and our capacity to potentially manufacture vaccines in future. This will ensure that the Department of Health and government are kept abreast of all critical developments internationally relating to the vaccine," Mkhize said.
The new committee will be chaired by Professor Barry Schoub, an expert in vaccinology and virology.
High level of immunity may already exist in SA
According to Mkhize, South Africa has seen the surge receding, consequently raising the question of the level of immunity that may already exist in society.
"Initial seroprevalence studies from convenience samples have shown seroprevalence of between 29% and 40%. Interestingly, the revised models currently predict that there are probably about 12 million South Africans in total (detected and undetected) infected with the coronavirus- this translates to about 20% of the population.
"We are currently embarking on a national seroprevalence study which should take us closer to the actual seroprevalence of coronavirus antibodies and will give us a more accurate indication of our status of national immunity. Once the national study has been concluded, we will communicate those results to the public.
"Undeniably, an important contributor to the decline we are witnessing in the transmission of the coronavirus are the actions of ordinary South Africans who continue to adhere to non-pharmaceutical interventions. This nation has shown that with concerted effort and solidarity, it is possible to beat the coronavirus," the minister said.
"However, I must continue to advise caution as we move towards the new normal: If we are to maintain this status quo of low transmission rates, we must continue to concentrate on the simple things that keep the coronavirus at bay - washing or sanitising hands at every opportunity, maintaining a safe distance between each other, regular cleaning and sanitisation of surfaces we come into contact with, and wearing of masks whenever we are in public spaces.
"The threat of a resurgence that could be more devastating than the first wave of infections remains very real. We must always remember this. Most importantly, we must encourage and remind one another that these simple interventions remain an important part of our new lives," Mkhize said.