Cape Town - Health Minister Zweli Mkhize on Friday raised the spectre of introducing severe movement restrictions on coronavirus hotspots if health interventions failed to reduce transmission of the disease.
Mkhize declined to list the exact criteria for returning to hard lockdown levels, but said if it became apparent that patterns of movement or social behaviour was making it impossible to contain the spread of Covid-19, the government would resort to draconian steps.
"If it means no movement, we will have to deal with it like that," he told a media briefing with a panel of advisors and health experts.
The minister cited the example of measures implemented in China's Wuhan province, where the Covid-19 pandemic began, that included prescribing when people were allowed to leave their homes to shop for essentials.
The government this week declared seven metropolitan areas and five districts hotspots because they had five or more Covid-19 cases per 100,000 people. Cape Town has by far the highest incidence, with 127 cases per 100,000 people, and is at the centre of the department's containment effort.
Mkhize said when deciding whether to escalate a zone to a higher alert level, factors such as the availability of medical staff and hospital beds would be considered, as well as the reasons for the concentration of cases.
If "social contact, movement of people or behavioral attitudes" were found to be contributing factors, then restrictions would have to apply.
South Africa as a whole moves to alert level 3 on Monday to allow most of the economy to reopen and the Western Cape, which is home to almost two-thirds of the country's confirmed cases, has resisted suggestions that it should be on a higher alert level.
Mkhize's special advisor on Covid-19, Professor Salim Abdool Karim, said the surge of infections in Cape Town could be traced to transmission in malls and supermarkets in the last weeks of level 5 of the lockdown and was likely caused by so-called "super-spreading events".
Karim said the number of cases in the Western Cape were now doubling every nine days, compared to Gauteng's doubling rate of around 24 days and the Eastern Cape's 12 days. At the height of the Covid-19 epidemic, the figure will double every four to five days.
The province was "simply an early indicator" for the progression of epidemic in other provinces, he said, but with some luck the health services could glean important information here that could be applied to mitigate the impact of Covid-19 on other provinces.
The hotspot intervention will see health care workers try to contain outbreaks in pinpointed areas by screening and isolating potential cases, if necessary in quarantine facilities.
"We have to look for the flames and douse them before they become raging fires," he said.
But Karim added that more outbreaks were to be expected as the epidemic progressed.
"We will see outbreaks, we have seen one in the last few days at the mines, but it is not a reason to panic, it is not a reason to shut everything down," he said.
The latest regulations that the government has published this week, explicitly allows for the National Coronavirus Command Council (NCCC) to decide, upon recommendation by the minister, to move an area back to level 4 or 5 lockdown restrictions if all other interventions fail to have the desired effect.
But unlike Germany, for example, the government has not specified an infection ratio as the point at which restrictions would be tightened in a region.
Karim has praised the efforts of the Western Cape, which is in opposition control, particularly in pinpointing areas of high community transmission to prevent the outbreak widening.
The province will be given priority when the health department receives the next consignment of testing material, according to Doctor Kamy Chetty, the CEO of the National Health Laboratory Services.
Chetty has confirmed that the country has a backlog of 83,767 processed specimens because of a shortage of diagnostic material. Because of international demand, the country is receiving, in a week, roughly the amount of material it needs daily.
The number of outstanding test results for the Western Cape is about 15,000.
Mkhize said, however, that the department did not see a shortage of diagnostic material as an insurmountable hurdle to its containment strategy in the Western Cape or elsewhere. He reiterated that it would, where necessary, do its surveillance and confinement of those at risk "on a clinical basis".
Mkhize told the briefing the total number of new infections in the past day was 1,837, bringing the number of confirmed infections nationwide to 29,241, of which 18,906 cases were recorded in the Western Cape.
Karim stressed that the key precautions to infection remained hand-washing and distancing.
He issued a stern caution that spraying people to decontaminate them was potentially harmful and provided very little benefit since the virus did not enter the body through intact skin, but through the respiratory tract and eyes. "This should simply not be permitted," he said.
"Putting humans through fumigation tunnels is potentially harmful. There is little to no proof for the safety of the material used."
The briefing heard from Karim that the latest evidence showed that those who became infected with Covid-19 produced anti-bodies but that it was not clear if this prevented them from falling ill if they caught it again.
"It is an open question," he said.
African News Agency (ANA)
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