Alan Winde after Covid-19 deaths: Patients’ sudden deterioration a shock, W Cape braces for worse

Western Cape Premier Alan Winde says the province is bracing for a surge in Covid-19 infections and has taken a cue from elsewhere by planning temporary hospitals to deal with the pandemic. Infections in the province are rising exponentially, but even so the first two deaths today came as a shock as they were 28 and 48 year old women*, people supposedly not within the highest risk demographic. On Friday there were seven hospitalised cases of Covid-19 in Cape Town and based on projections, many more are expected. In this podcast, Winde shares how the Western Cape Government has prepared for the expected onslaught, emphasising how critical it is to strictly adhere to the 21 day lockdown. For more information on Covid-19 click here. – Alec Hogg.Be sure to listen to the daily Inside Covid-19 podcast hosted by Biznews founder Alec Hogg..___STEADY_PAYWALL___.Well, we're joined now by the Premier of the Western Cape, Alan Winde. Premier, it's been a tough day for you with the first deaths of Covid-19 in South Africa in your province..Yes, it's been a very tough day. I remember vividly on the 11th of March when we actually had this showcase. We wanted to show the media that we were ready for corona. We went down to Tygerberg Hospital, and we were going to show them the lockdown facilities, the quarantine facilities, and how ready we were and, on the way, there, I got the message that we'd had our first positive case. And so, when I walked into the hospital, this sort of readiness changed to the first case. I still remember after that saying, "Are we ready for the first death" and we were so consumed by lockdown. We had three patients in ICU. We'd already had patients going into ICU and out. We knew there were round about 200 cases and you didn't even think it was going to happen. Lockdown was what we were focusing on and this morning, I was waiting to hear about how the roadblocks had worked and how lockdown was happening and I got the message of two deaths, not just one. So yes, a sombre day, a day that really lands what we're doing and why we're doing it. We're doing it to actually mitigate deaths. We want to mitigate thousands of deaths, but it really hit home today..There were a couple of myths that were shattered by this. It's supposed to be only old men who die of Covid-19 and there was a 28-year old who'd only been admitted yesterday. Was this a surprise to you, too?.Yes, absolutely. That was the biggest surprise, I think. You assumed – and this is one of the problems, I think, when we assume too much – that it was either going to be someone who was elderly or someone who was immune-compromised. We have a lot of people in our province who are HIV positive, who have TB, and have diabetes, so you assumed that it was either going to be someone from the vulnerable groups and definitely not female because male is definitely also more vulnerable and less able to deal with this, so female and right in the middle of this, a 28-year old and a 48-year old (both women), that just actually added to the power of the punch that we took this morning..Were either of them at Tygerberg?.Yes. One of them was at Tygerberg and one was in a private facility and as you say, she came in last night and in actual fact; it was one of those things where the doctors have clinically signed it off as Covid-19 but we actually didn't even have a positive test on the 28-yr old so we've got a confirmed Covid-19 of a 48 year old and I'm 98% certain, a 28-year old woman but that test's still to come in but everybody in the medical field are certain that both of these are Covid-19 cases..Do you have others who have been hospitalised in the province?.Yes, we had three yesterday and we've got seven today and hospitalised doesn't always mean that you stay there but obviously 3-7 and yesterday I wasn't even worried about whether anybody was going to be getting closer to death's door. This shows you how quickly things move and yesterday, we were sitting under 200 and now we're on 260 cases by 2pm today. You can also see that the contagion of this virus is so strong and so virulent. It takes your breath away every single day when you see these numbers and that's why I'm so in support of this lockdown. We've got to take it seriously and we've got to measure the 21 days. It could even go longer than the 21 days, especially if you're looking at what's happening in other parts of the world..The lockdown is not working particularly well in parts of Gauteng. How's it going in Western Cape?.No, we've also got our problems here, definitely in a number of towns and in a number of parts of the city. People are just carrying on as if there's no change. At the 10 'o clock meeting I had today, we'd already had 52 roadblocks, 51 arrests, but definitely insufficient and this afternoon again, we've got between the military, SAPS, our Metro Police and our Traffic Police roping them in as well, that we've got to get out there to put a lot more pressure on citizens who don't realise the enormity of what we're facing as a society. I really want more arrests if people are not going to adhere and the second thing is obviously, people can go out to get groceries, to go and get from pharmacies and get medical care. That's the only reason you need to be out of your home and we found long queues at some of our shopping centres so we need to have a look at actually mitigating measures there because people also aren't adhering to the 1½ metre spacing so yes, we've still got some work to do. Day One of the lockdown: I'm not too unhappy although I would have liked to have seen it across the board – everybody staying at home – but I think generally, fairly good in the region but obviously, those hotspot areas: we've got to make sure we up our game and there'll be more military coming into the region over the next two days, making sure that we deal with this. My plea, always, is to all of society. It's all of our responsibility to mitigate the risk. We've got our first two deaths. The risk is that we move to thousands of deaths and that's why we're doing what we're doing and we need everyone to take co-responsibility in dealing with this..Social media is amazing at times like this. You can pick up all kinds of information, including a video that's doing the rounds, which I have confirmed is legitimate. In Alexandra, where there's a KFC store with a lengthy queue. Is that also allowed in the Western Cape, where fast foods outlets can remain open?.As far as I'm concerned, the answer is 'no'. They cannot remain open. You can only go to buy groceries although I know that there has been an appeal to relook at the regulations around food outlets, but not to be open to the public. In other words, a restaurant or a fast-food outlet like a KFC could still prepare food and then there would be a delivery system but that is still illegal at the moment. There is an application to say 'surely, this makes sense' if you're trying to keep people behind closed doors – especially vulnerable people – try and keep them behind closed doors from going shopping so surely, if we could deliver a meal to them, it would be better so we have got that application in with the regulators at the moment. But definitely, at the moment, it is illegal..When the President announced, he said that homeless people would be looked after. Have you got particular/special plans in that regard?.Okay, so we have a number, specifically, and the biggest problem sits in the city of Cape Town. We have a number of shelters and I think as of yesterday, all of the shelters bar 192 beds, I think it was but we've got a couple of thousand homeless people and so the teams are out today, creating temporary shelters and looking at how… Of course, you can't create congregations of temporary shelters. You've got to create spaces that people can also have social distancing. We also still have 300 foreign nationals in a church in the middle of the city and we've been, in the last two days, in negotiation with national government and the city for a piece of land so that we can repatriate these people to a space where they can stay for these 21 days before they either integrate into society or get repatriated to their country of origin..Well, as if you haven't got enough problems, we know that there is a very serious Tik problem in the Western Cape, with drug-related issues. These people, presumably, are even more vulnerable than most..Correct. Drugs, gangs, and crimes. I must say that it's still very early days but speaking to Minister Albert Frits, the MP of Community Safety; since we've had the lockdown where liquor outlets have been closing early and much more evidence of police on the streets, we actually have started to see a little bit of a reduction but I don't want to get too excited too early and of course, drug addiction and alcohol addiction is a big problem and social development has a big role to play. But also, not only with our gangs and our drugs but also with the people who are needing food from feeding schemes. Once you close your schools and your ECD's, there are many children who don't get a meal anymore. So, social development is still busy setting up feeding schemes and mechanisms so at least, we can find a meal a day for some of our youngsters and of course, these become very difficult during lockdown conditions..We know that in the UK, they've called for volunteers and they've had an overwhelming response to support the NHS there – 600,000 people have already signed up there. Have you anything similar in the Western Cape?.Okay, so we haven't move to real big, open calls although we have had a number of medical people who have retired whom we've asked to come back, people who have got medical backgrounds and the department has been working in a number of areas – not that we need them today. We have sufficient medical care and medical space but it's in the preparatory environment, but I suppose exactly the same thing's happening in the UK. I saw the big conference centre is turning into a 4,000-bed hospital plus 2 morgues so that's quite phenomenal. What we're doing is we're trying to create a similar kind of operation – military-style tents close to our hospitals with 100 beds with oxygen, so it's almost a pre-ICU care space because we need to make sure we've got sufficient beds. We've done the modelling, which shows us that it will build up April/May/June and our modelling says June will be our peak but hopefully, we arrest some of that growth now with the lockdown and then our modelling should readjust and then it will tell us. We've got trigger points that tell us when we should be converting. Already, some of the hotel space in our region is converted into lockdown/quarantine/isolation quarters and of course, the next stage would be to build these style/field hospitals around the province to cater for the numbers as it grows further..Is your modelling based on the 30% per day rate that we've been seeing in South Africa?.We've got a 10%, 20%, 30% – not a day growth, but a total infection rate. I must say that yesterday/last night, I was on a Silicon Cape Zoom discussion panel for an hour and I shared a platform with a CEO of one of our private hospitals and I was listening to their modelling and our modelling. There's a little bit here and there where we differ but generally, our modelling is fairly similar. I agreed with him today that we would again get our teams together to just have a look and share that information because you need to be working on some kind of model and then we were measuring ourselves against that model whether we're doing better or not and then also, taking into account what has happened in other countries and what they've done to mitigate risk. If we overlay all of those, it should help us to make those decisions and also, really exciting for me is the agreement between private and public healthcare, something we put together during the World Cup for real emergencies. We would move to what we call Gold Standard Management of healthcare and that means that there's no difference between a private bed and a public bed when it comes to this crisis. A bed is a bed and an ICU bed is an ICU bed, and it would go to the next patient and we've already got that put in place, which would really make it a lot easier in that modelling to have sufficient beds. Still, even that means we have to build tents and we still have to create extra spaces..But it sounds to me like you've been doing this planning for a little while now..I started this now, 3 weeks ago, we started with our preparedness. Two weeks ago, we went into 24-hr joint operation command status. We had 5 work streams to start. We then moved to 7 and we're now 10 work streams. A workstream would be health, economy, social development, or education and each of those work streams have now been working for nearly 3 weeks but two weeks intensively, but working against the modelling that we've put in place so that we e.g. in education, should schools not be able to open, we're already working on the e-learning. But from the economy; at what stage do we trigger what kind of relief and what are the alternatives? How do we create new economic environments to fill some of the gaps? Repurposing: I think that goes to the point earlier about businesses. One of the economic ideas was repurpose our restaurants, so our restaurants have to be closed, but can we not repurpose them to still produce food, package it, and then get it delivered in some way? The economics team are doing that kind of thing. Our transport team out in the taxi ranks and, in the buses, making sure the cleansing systems are working and right down to delaying initially 3 months and could even go for 6 months. Any license expiry of a vehicle license and all licensing processes for taxis and buses etc. so yes, lots of work..How are you keeping yourself safe?.Well, I've actually been operating remotely now… I've lost count of days but I think I've been operating remotely since Wednesday, so I'm sitting at 9 days now – operating remotely. I have broken that once or twice. I have chaired one cabinet meeting – not remotely, but today's cabinet meeting was chaired remotely. We've been doing our cabinet meetings remotely for a week already. We, the cabinet, meet every single day at 12:30. All the teams come together almost military-style, run by Minister Maynier. They come together and report back every day at 10:00 so we've got quite a strong structure going and we've put those processes in place right down to the last ask, which is that every single lead coordinator – work stream lead and the top management of this government – have to have not just one person to take over from them if they become sick too. So yes, lots of work..Are you communicating with the other provincial Premiers?.I haven't for a while. I've been a bit snowed in here but we've definitely had lots of national provincial and local government communication. If I think about the refugees, I think Minister Motsoaledi and I; the number of calls we had yesterday between each other was quite scary and so definitely, lots of work there. Our officials specifically, especially around the regulations and changes in the regulations; our officials have been doing lots of work together. There is one thing and personally phoning the President, and him calling me so definitely, lots of real work saying 'opposition parties and politics – there's no time for that'. We've got a country to save and we've got people's lives to save. I'm really happy with the relationship that we've got at the moment and there's lots of work still to do and lots of risk but I'm pretty happy..* The 28 year old woman was later diagnosed as not having died to due Covid-19. This was confirmed post the interview with Western Cape Premier Alan Winde.

Alan Winde after Covid-19 deaths: Patients’ sudden deterioration a shock, W Cape braces for worse

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