The Stormers rugby team spent Friday at the Brackengate temporary hospital helping to put the finishing touches on the facility. Picture: Western Cape Government
The Stormers rugby team spent Friday at the Brackengate temporary hospital helping to put the finishing touches on the facility. Picture: Western Cape Government

100 days of lockdown: How the Western Cape has responded

By Alan Winde Time of article published Jul 4, 2020

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Today marks 100 days since South Africa went into lockdown in order to slow the spread of the coronavirus and give us time to prepare our healthcare systems. Since then, the country has moved through levels of lockdown, which have slowly opened up more areas of our economy, seen the return of some learners to school and the opening up of more services.

A pandemic of this nature has effects that go beyond the healthcare response, which is why, in addition to working to prepare our hospitals and our healthcare systems, we have also developed the hotspot and risk-adjusted strategies to reduce infections where they are occurring and in our most vulnerable citizens, rolled out the biggest communications campaign on record in the province, provided support and materials to schools, care facilities, businesses, public transport operators and to municipalities. 

We have developed responses to the humanitarian need that came about as millions of South Africans were unable to work. We have lobbied to have certain sectors reopened with the utmost care so as not to add to the burden of infection.

A response of this nature requires the efforts of thousands of people and I would like to pay tribute now to the healthcare workers, hospital staff, principals, teachers and school administrative staff, the law enforcement officers, social workers and the thousands of dedicated public servants who went to work every day to ensure that service delivery could still continue, that members of the public who were confused and concerned had answers to some of their questions and that the concrete actions detailed below had a tangible effect on their lives.

I would also like to thank the NGOs, the private sector donors, and the volunteers who have put in time, effort, money and love to ensure that they were able to help their fellow citizens.

And finally, to the citizens who have acted with responsibility, who have worn their masks even though they’re uncomfortable sometimes, and washed their hands until they’re dry, who have stayed at home even though they miss their loved ones. Every single one of these acts has been an act of kindness. This lockdown has been hard. It has been a completely new experience for each and every one of us. It has been confusing and scary and frustrating. We thank you for doing it anyway. And for trusting us in our response.

We still have a long way to go still. Our peak is likely to be later, and flatter – but also longer. This means it remains as important as ever to change our behaviour, so that we keep ourselves safe, and our families safe. When we do this, we will save lives. I know it is hard, and we are tired – but I have faith in every person in this province to play this in important part in our pandemic response.

Since our last update on 19 May (available here: https://coronavirus.westerncape.gov.za/news/western-cape-has-prepared-its-healthcare-system-peak-and-must-move-level-3-conjunction-targeted) we have made more strides towards preparing our systems and protecting our residents.

Healthcare systems

We have opened the Hospital of Hope at the CTICC and, in partnership with the MSF, the Thusong Hospital in Khayelitsha, providing nearly 1000 additional beds in the metro. Since June 1, the Hospital of Hope has provided care to over 600 patients, with over 300 discharged by 30 June.

Construction at the Brackengate facility which will create an additional 330 beds is complete and final fitting of beds and equipment is underway. The hospital is due to accept its first patients on 10 July.

The first 63 beds of 150 at the Sonstraal Facility in Paarl will come online in July.

We have implemented a bed bureau system which allows us to monitor and track the availability of beds throughout the system.

We have completed 19 temporary testing and triage centres at hospitals across the province. Work on a further 16 is underway, with completion dates for the beginning of July.

We have implemented the use of high flow nasal oxygen in both Tygerberg and Groote Schuur. A total of 121 machines required for this are available, with 43 more on order.

The department has finalised service-level agreements with the private sector for critical care, and referred its first three patients to private hospitals.

Our experts have determined, using available data, that diabetic patients are the highest risk group and we have implemented a new strategy, which includes daily check-ins with Covid-19 patients with diabetes, as well as hospital admission at the CTICC for those diabetic patients which are the highest risk.

We have developed the protocols for the use of steroids in line with international recommendations.

We have recruited over 400 temporary healthcare workers in order to help us meet the increased need in the province and have created a database of over 2000 volunteers.

We have implemented a training course for nurses to upskill them in intensive care management.

We have tested over 316 000 people for Covid-19 in the province.

We have to managed screening and testing for Covid-19 and implemented a sophisticated system to support people with positive results and do contact tracing, to curb transmission from the outset.

We have bolstered our tracking and tracing by bringing the Western Cape Government call centre online to assist with this. The call centre team has made contact with almost 6 000 individuals for tracking and tracing between 1 June and 2 July. In each of these calls, quarantine and isolation in one of our facilities is offered.

Since April, our healthcare workers have been delivering medication to stable chronic patients at their homes. Between 1 April up to 11 June, 243 385 home deliveries have been done in the metro

The Western Cape Government Health in conjunction with Aviro Health has developed an automated Chatbot application system on WhatsApp, which confirms delivery of chronic medication to our clients’ homes. It also allows high-risk chronic patients to confirm an existing appointment before accessing services at their healthcare facility, which means they do not have to wait in long queues when going to a facility. 

We have decongested primary care facilities and hospitals in preparation for being able to deal with patients with COVID-19, and re-organised the way we render health care services.

We have developed a sophisticated data system to track infections over time and develop a data-led strategy in our fight against Covid-19 in this province. We share our daily data update via a public dashboard to keep our citizens informed of our progress.  

We have brought 41 public and privately-owned quarantine and isolation facilities online providing a total of 4766 beds. We have identified many more sites to be activated, creating more beds should these be needed.

The Department of Cultural Affairs and Sport has offered its various cultural facilities across the province to add capacity to the province’s quarantine and isolation facilities.

Governance and management

We have held nearly 50 cabinet meetings during this time, initially meeting daily, and now holding full cabinet meetings, attended (digitally) by representatives from our municipalities, SAPS and law enforcement, twice weekly.

Our hotspot management teams meet regularly and report back to cabinet weekly. 

We hold regular budget meetings to ensure that spending is carefully tracked and monitored, as COVID-19 related costs are expected to exceed R5 billion in the province.

Humanitarian assistance and social support

In response to the Covid-19 lockdown, the Western Cape Government established a humanitarian relief workstream to coordinate humanitarian relief efforts in the province.  

This workstream comprises representatives from various provincial departments, municipalities, SASSA, and the Solidarity Fund, and reports into a provincial council established as per the COGTA Disaster Management regulations. 

The workstream reported that over 130 000 food parcels (each food parcel feeds a household of 4 to 5 people), and nearly 200 000 daily cooked meals have been provided to beneficiaries in the province by a combination of civil society organisations, faith based organisations, private donors, SASSA, the Solidarity Fund, the Provincial and National Departments of Social Development, the Western Cape Education Department, municipalities and businesses. 

In total, the Provincial Government has allocated over R70m to food relief during this period. 

Community food gardens have been established in each hotspot area and the Department of Agriculture has made food garden starter packs available to some residents. 

The Department of Agriculture has facilitated donations of fruit, dairy and other food from farmers which have been distributed in communities.

The Department of Social Development has reprioritised its budget to make an additional R1.755 million available to its funded old age homes for the management of Covid-19, over and above existing funding allocations. Other support includes:

* The provision of 120 000 face masks and 5 000 face shields to old-age homes;

* The provision of 50 litres of sanitisers to each home;

* Specialised training for carers;

* The facilitation of volunteers to deep-clean old-age homes, particularly in poorer areas and hotspots; and

* As far as feasible, the provision of a small number of relief staff to funded facilities.

During the Covid-19 lockdown, the department of Social Development provided funding to over 1 000 social workers in the NPO sector in the Western Cape. We would also like to remind the public that If anyone requires a social worker or any form of psycho-social support, please contact us on our hotline number on 0800 220 250 to be connected to your nearest local office.

To respond appropriately to bereavement, we have consulted widely with religious and cultural organisations to develop a guide for managing deaths and burials in the province.

Behaviour change and communication

We have met with community groups, religious leaders and behavioural change experts in order to spread the message of safety.

We have rolled out 10 000 street pole posters as part of our communications campaign.

We have created 8 different radio campaigns in all three official languages to be run on radio stations across the province. The latest campaign uses healthcare workers to share messages around staying safe and keeping your loved ones safe.

We are doing loud hailing in communities in conjunction with local governments in our hotspot areas.

We have partnered with mobile networks to deliver text messages via SMS and Please Call Me, to millions of cellphones across the province.

We have branded taxis that travel within hotspots in Cape Town to boost awareness.

We are running Facebook ads in all 3 languages, showcasing the importance of behaviour change.

We have participated in dedicated radio shows to engage with the public on key topics such as quarantine and isolation and stigma.

We have hosted a weekly digital press conference, broadcast to the public – where we have shared insights and research from medical and other experts.

Transport

We have developed systems to monitor compliance at all our major Public Transport Interchanges (PTIs).

We have donated thousands of litres of sanitisers and masks to the taxi industry.

We have distributed megaphones to PTIs for use by trained security staff in order to share safety messaging.

Our Red Dot Taxi service started providing transport to and from quarantine and isolation facilities, and has transported over 2 300 people in both metro and non-metro areas.

The Red Dot service also transports healthcare workers to and from work at night- transporting over 15 000 passengers so far, over a distance of 200 000km since being launched in May.

Education

The Western Cape was the only province that continued to feed learners during lockdown when meals were most needed. We have served over 2 million meals to learners since 8 April.

The School Nutrition Programme has been up and running since learners returned to school on 1 June and feeding for all learners, even those not yet back in class, has been provided.

The Department of Education has spent R450 million so far on cleaning materials, soaps, sanitizers and masks to prepare schools for the phased return of learners to schools.

Developed a comprehensive set of guidelines including on how to manage positive cases at schools.

Created a teacher training course for eLearning and using the various platforms for teaching.

Developed a virtual library for foundation phase learners, allowing them to access reading materials.

Provided psychosocial support to teachers and school staff through our employee health and wellness programme which provides mental health and trauma counseling, bereavement counselling, alcohol abuse and drug dependency support, HIV and Aids management, and practical advice on financial and basic legal issues to staff members and their immediate family members.

The Department of Cultural Affairs and Sport’s MOD coaches and Yeboneers have assisted in school feeding, and are assisting schools manage learners, screening and social distancing.

Economy and business

We have advocated for the safe reopening of the ecommerce, construction and tourism sectors, and George Airport.

We have run workplace safety communications sessions with the economic clusters in the Overberg, West Coast and Garden Route municipalities.

We have created workplace safety checklist, contacts sheets, FAQs and communications materials being rolled out in hotspots.

The Department of Economic Development and Tourism is currently in the process of distributing 11 000 safety kits to small businesses, comprising masks, sanitisers, posters and pamphlets.

We developed a page where complaints about non-compliance by business can be submitted. By last week, over 800 complaints had been received and 623 had been closed off.

We’ve received over 80 000 visitors to the business support website.

Over 6 657 users have accessed the business support finder tool.

We have responded to over 2 300 direct queries from businesses.

The Red Tape Reduction Unit has dealt with 1000 queries.

The Department of Cultural Affairs and Sport has developed relief options for the Cultural, Creative and Sport industries. The sports fund has already awarded its funding, while the arts fund is in the final adjudication process.

Our Tech Volunteer programme matched small businesses in distress with an industry expert to offer them one on one sessions of advisory, tech and digital related support, during Covid-19. 

Safety and law enforcement

We have worked closely with SAPS, traffic and law enforcement to ensure that alert level restrictions have been implemented. We are also working with Neighbourhood Watches and Chrysalis to encourage behavior change in public spaces.

LEAP officers were deployed to assist with roadblocks, respond to COVID-19 complaints, issue notices or fines, make arrests and encourage social distancing within the hotspots where they are deployed.

Between 25 and 31 May, we began deploying our LEAP officers, appointed through the Western Cape Safety Plan, in the province’s targeted Covid-19 hotspot areas including Tygerberg, Western, Khayelitsha and Klipfontein hotspots.

60 Chrysalis graduates have been deployed as part of our hotspot plan in Khayelitsha to assist with social distancing at malls and shopping centres and sharing of information.

We advocated for Neighbourhood Watches to be allowed to operate under alert level 3.

We will soon be activating an additional 15 neighbourhood watch structures to assist in COVID-19 related tasks in Khayelitsha. Training has been provided to both Chrysalis and NHW members by doctors without borders (MSF).

Between 21 March and 26 June, the Western Cape Liquor Authority (WCLA) conducted 82 liquor-related investigations which resulted in the suspension of 34 licenses. Illegal liquor sales and alcohol abuse contribute significantly to trauma admissions in our hospitals and ensuring that alcohol sales are regulated, helps to ease this burden on our healthcare systems.

* Alan Winde is Premier of the Western Cape

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