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Experts concerned about sleeper Covid-19 infections which could be devastating

"We have been testing the affluent population, and we might have an outbreak that we don’t know about, ” says says Professor Alex van den Heever. Picture: Phando Jikelo/African News Agency(ANA)

"We have been testing the affluent population, and we might have an outbreak that we don’t know about, ” says says Professor Alex van den Heever. Picture: Phando Jikelo/African News Agency(ANA)

Published Apr 11, 2020

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Johannesburg - As South Africans prepare for another three weeks under lockdown, the reality is that restrictions to fight the coronavirus could be in place for longer as the country waits for the arrival of a vaccine.

The lockdown has so far been hailed a success, with infection rates falling from 42% to 4%.

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On Friday as South Africans prepared for an Easter behind closed doors, the country learnt that the number of infections had increased to just over 2000 cases, with 24 deaths.

These are figures that are still minuscule when compared to the hundreds of thousands of infections that countries like the US, Italy and Spain have experienced. But the end of the lockdown won’t be a return to the normal that we knew, believes Professor Alex Welte, of the DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis at Stellenbosch University.

“As long as there are one or two infections cases out there and if you don’t have herd immunity, you’ve just started again, back to the beginning, then you’ve wasted your time with the lockdown. So there is no way we can go back to normal. Not for a long, long time,” he explains.

Herd immunity would only happen if a large enough portion of the population contracts the virus, which would result in high numbers of fatalities, or people get vaccinated.

Scientists around the world are racing to develop a vaccine but this may only be available within the next 12 to 18 months. Welte believes that the lockdown should be lifted with restrictions in place to prevent the spread of the disease. This would allow the economy to restart and save jobs.

Another academic says no one is sure of just how effective the lockdown has been. The problem, says Professor Alex van den Heever, who holds the Chair of Social Security Systems Administration and Management Studies at Wits University, is that “we are blind in the one eye as we look at the epidemic”.

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The reason is that no one knows if the virus has unknowingly taken hold in communities that have not been tested.

“It is quite a complex picture,” explains Van den Heever. “One of the issues is that the testing regime has been incredibly narrow. And it was effectively only designed to detect people who were tied to the imported infection.

“So the numbers that we’re seeing at the moment are essentially still tied to the old testing regime. We have been testing the affluent population, and we might have an outbreak that we don’t know about.”

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The government is trying to ramp up and expand its testing regime. But the extension to the lockdown is clearly an indication that they are not ready for an expanded testing and contact tracing programme, Van der Heever adds. “Yet that leaves us exposed to the risk of the areas that are not socially distancing under the lockdown.”

Health Minister Dr Zweli Mkhize warned that the storm is not over yet as there might be another increase especially if South Africans are not co-operating with the lockdown conditions.

A spike in infections might occur in the winter season.

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He said the department would soon launch an investigation into an alarming large number of infections at Netcare St Augustine’s, a private hospital, in Durban. The hospital had reported 66 of which 48 were staff members. There had been three deaths in the same institution. Mkhize said since this was a large number of cases to have occurred in one institution, he had asked the provincial health department to investigate “why, how” so many people, especially healthcare workers whose training should have equipped them to deal “on a day-to-day” basis with infections without themselves being infected.

“So we want that investigation to find out what exactly happened, and the leadership of Netcare has been advised that this is going to be happening,” he said.

He said there would now be a close working relationship between the public and private healthcare to share beds.

“The large number of people who are in treatment in hospitals, that number is largely in the private sector,” he said.

Mkhize, too, recommend the widespread use of cloth masks. “Individuals can make their own masks. There shouldn’t be a need for everyone to be wearing surgical/N95 masks. Let us reserve those for the front-line workers treating patients,” he pleaded.

KwaZulu-Natal Health MEC Nomagugu Simelane-Zulu said the provincial department would also investigate two infections, of a nurse and patient, that were recently reported at the Inkosi Albert Luthuli Hospital, which was one of the biggest referral institutions in the province.

The department was working on establishing whether the infected nurse ever worked for a private hospital at the same time.

She said there were a number of public healthcare workers who were also working for private hospitals, which was risking the spread of the virus into the government institutions.

“At this point we are establishing whether that healthcare worker had actually worked for another hospital.

“There are indications that the healthcare worker had actually worked for St Augustine’s, but we are investigating at this point,” said Simelane-Zulu.

The Public Servants' Association of South Africa (PSA) had written to Simelane-Zulu demanding that the institution should be temporarily shut down and fumigated.

On Friday also happened to be the deadline for all provincial health departments, metros and district morgues to report on their availability and capacity.

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