With numerous nations entering into a second lockdown, the concern is growing that SA may follow suit. Dr Daniel Israel explains how a surge in Covid-19 cases can be avoided.
By Dr Daniel Israel: Medical expert
A cautious diabetic man entered my office and instead of unveiling his usual collection of diabetes questions in order to receive my reassurance, today he had only one query: “Is COVID-19 under control in your practice Doc, and is it going to stay that way?”
This patient is not alone. This is perhaps the foremost question in all of our minds today. Its answer has direct and far-reaching consequences.
I can report that the percentage of COVID positive PCR swabs we are receiving pales into insignificance compared to the last six months.
My practice has assisted 205 COVID-19 positive patients this year – many through telemedicine. The last month has seen only six cases contribute to this number.
Lest you scroll on now and walk away from this article with a skewed idea that COVID-19 is over, let me quickly state that as optimistic as I am, I am equally concerned. Let’s dig a little deeper into the statistics to develop a balanced view of the situation.
The synopsis of the current COVID-19 situation in South Africa is a wonderfully positive picture, but with a very possible future threat.
At the height of the pandemic in July, the COVID-19 doubling time was eight days. Every eight days, the number of actively infected individuals would double.
Today, the doubling time is 79 days. At the height of the pandemic, our country saw 13000 new cases a day.
We are currently seeing 1000-1800 new daily cases. I conducted a poll across Gauteng GP’s over the past 4 weeks.
80 GP’s took part (including many of Johannesburg’s bigger GP practices). Reassuringly, 65 percent of doctors (primarily in Northern Johannesburg) have not seen any COVID-19 cases in the last four weeks.
The few recent COVID positive patients in my practice all contracted COVID-19 at family gatherings.
Worldwide trends bear evidence to this concept. Europe has seen a dramatic escalation in infections since mid-August.
Public health experts have explained these escalations by increased travel over Europe’s summer and by younger people wanting to return to normal life and therefore increased socialising.
Israel has followed suit and adjusting for population size, has recorded 4 times more than the highest daily numbers we have seen in South Africa.
Interestingly, Italy, which saw arguably the most devastating COVID-19 outbreak with the most deaths in the infancy of this pandemic, initially had a relatively smaller second wave.
This low infection rate was not attributable to herd immunity, which is still unreachable, but to the voluntary public adherence to social distancing, sanitisation and mask-wearing.
The left-wing government and right-wing opposition in Italy united in their promotion of these behaviours.
It was thought that the Italian public, scarred by the memories of bodies being transported out of cities that couldn’t cope with the deaths in the first wave, continue to wear masks and carry sanitisers in outdoor areas, both of which were not obligatory practices. Self-imposed personal lockdown measures continue, with restaurants empty and life purposefully not ‘back to normal.’
Sadly, even with these measures, Italy is also now experiencing a high caseload in its second wave, with over 30,000 cases reported recently.
Approximately 120 countries have already hit a second wave. Half of these countries are experiencing a larger number of cases than during their first wave.
The mean time from the peak of the first wave to the second wave is 55 days. Prof Abdul Karim, Chair of the MAC on COVID-19, and expert epidemiologist recently predicted that since South Africa’s cases peaked in mid-September, a second wave on our shores may occur in mid to late November. This would be minimised by sustaining our non-pharmaceutical preventative measures.
So what practical behaviour must we continue to adopt to prevent a second wave?
Ideally, we should not spend sustained time with anyone who does not live under the same roof. Certainly ‘staying home saves lives’.
However, no statistic - however alarming - will influence a grandmother pining for her grandchildren to stay away indefinitely.
We have indeed had one of the highest adoptions of social distancing in suburban communities across the world. We should be proud of this and continue to practice it.
But I believe it is incumbent upon the healthcare leadership to guide the community in terms that are achievable for its members.
The following basic concepts should apply:
- Limit your social contact as much as possible and where you decide social contact is necessary, ensure it is only with asymptomatic people in well-ventilated spaces with masks being worn.
- Masks have unequivocally been shown to reduce the spread of COVID-19, despite anti-maskers begging differently
- Cleaning hands remains mandatory. Meals are the most challenging interaction and should only be attempted after screening the attendees, and in large enough spaces with excellent ventilation. Food and drink should be pre-dished and not passed between people. Eating and drinking should only occur when seated around a table at a safe distance.
- Standing in bars is considered a high-risk activity
Let us keep up our guard and minimise a second wave. We’ve experienced enough trauma as a community to enable us to keep up safe behaviour. This is the only way to prevent further COVID-19 spikes.
Earlier, Briefly.co.za reported that Gauteng's Covid-19 statistics are causing some alarm in the province, with records showing that the heavily-populated economic hub has fewer active cases than any other region.
Official data suggests that there is a major issue with the statistics, showing that the province has fewer than 250 active cases, while around 1 600 citizens are receiving hospital treatment for the virus.
Jack Bloom, DA Shadow MEC in the province, has slammed the data as ludicrous and highlighted the importance of accurate figures:
“Gauteng can’t fight COVID-19 with fake figures. They are becoming more and more ludicrous, providing little guidance in tracking the epidemic to prevent hotspots from developing further. According to the latest figures from the National Health Department, there are only 243 active cases in Gauteng, the lowest in the country despite having the highest population.”
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