The world is changing fast and to keep up you need local knowledge with global context.
Panic has swept across the globe as news channels have documented the zombie apocalypse style shut down of cities in China and Italy, and reported regular updates on quarantines on passenger ships and deaths in hospitals. Travel plans have been cancelled, big events have been closed to spectators and, in the UK, supermarkets have run out of soap and hand gels as well as other staples like toilet paper, as people fear a major, debilitating crisis is unfolding. But, in South Africa, the authorities have been several steps ahead of global experts and bodies in preparing to cope with a coronavirus outbreak. Although The Lancet medical journal reported that South Africa could be among the hardest hit nations in Africa, the evidence from Pretoria suggests otherwise. As Helmo Preuss reports, a detailed action plan has been in place to protect against any nasty disease. When China signalled the alarm from Wuhan, South African health authorities moved quickly to update strategies – several days before the World Health Organisation sent out its directives. Since Preuss put pen to paper, the first case has been reported, and the SA authorities have started rolling out their plans to contain the disease. – Jackie Cameron
South Africa is prepared for coronavirus outbreak
By Helmo Preuss*
Conducted over 60 tests to date, none tested positive for virus (The report was issued before the first case was discovered in Kwa-Zulu Natal)
South Africa is prepared for a coronavirus outbreak and has so far conducted 60 tests, none of which detected the virus. Dr Kerrigan McCarthy of the Division of Public Health, Surveillance and Response from the National Institute for Communicable Diseases said South Africa has been lucky in that no cases have yet been diagnosed in South Africa, which has allowed the government to pro-actively prepare for a possible outbreak. She was addressing the first conference on the coronavirus in South Africa, which was a two-day event held in Pretoria.
She said a national response team had been convened on 24 January, the day after Chinese health authorities placed the city of Wuhan, which is where the virus originated, under quarantine. This was six days before the World Health Organisation (WHO) declared the virus outbreak a Public Health Emergency of International Concern (PHEIC). On that day, Health Minister Dr Zweli Mkhize declared a Public Health Emergency in South Africa and activated the Emergency Operations Centre. The Incident Management Team was then constituted the following day and has met daily since then.
The team has since then developed case definitions, issued guidelines to provincial health authorities as well as the private sector health facilities. A 24/7 hotline to support suspect investigation has been set up for health care workers, while a public hotline at 0800 029 999 is in operation. It has also issued data collection tools for persons under investigation, contact tracing and reporting. It has also issued a travel health questionnaire for travellers returning from China.
In response to a question from The BRICS Post, McCarthy said at this stage the travel questionnaire was for people arriving from mainland China, not Hong Kong, Macau or Taiwan.
As part of the preparedness training, simulation activities with isolation pods have been conducted. The team is also planning for the possible evacuation of South African citizens from Wuhan and has activated the social services clusters. A total of 11 hospitals have been designated as special hospitals to treat the virus.
Dr Michael Boswell from the Division of Infectious Diseases at the Steve Biko Academic Hospital in Pretoria said South Africa has in the past had to deal with several epidemics. These included the smallpox epidemics which decimated the indigenous San populations in the 1700s, as they had not developed immunity to smallpox. There had been a pneumonic plague in Johannesburg in 1904, but it was the 1918 Spanish influenza epidemic that had a major impact on South Africa, when an estimated half a million people died, making South Africa’s death toll the fifth highest in the world during that epidemic.
As people living with HIV (PLWH) have a compromised immune system, the mortality rate in South Africa, as well as in many other African countries, from the H1N1 virus in 2009, was amongst the highest in the world. This was a major concern if the coronavirus made its way to South Africa, as PLWH have a 20 times higher risks of dying from flu than those whose immune systems are not compromised. In addition, PLWH with a CD4 count below 200 tend to have prolonged viral shedding, in other words they remain contagious for longer than the currently accepted norm of 14 days.
He suggested that there needs to be clear communication on the risks to the public. As hospitals are the epi-centres, they need to know how to reduce the risk of spreading the virus. This applied to health care workers as well as support staff such as receptionists, cleaners and cooks. To minimise the risk, patients, who now have to come monthly for prescriptions, should be given longer prescriptions. There should also be clear guidance to staff on the protocols for dealing with suspected cases, and they should practice infection control training so that it becomes automatic. Hospitals should have plans in place for isolating suspected cases early, so that they do not sit in a waiting room and infect other patients while sitting there.
- Helmo Preuss in Pretoria, South Africa for The BRICS Post.
Cyril Ramaphosa: The Audio Biography
Listen to the story of Cyril Ramaphosa's rise to presidential power, narrated by our very own Alec Hogg.