Fellow South Africans, it has been almost a month since we presented a situational update on COVID-19 as the Department of Health. There has been a number of developments and we want to take this opportunity to give an update to the public and also respond to questions that the members of the media may have.
Epidemiological Update
As we present today, we have now gone beyond the half a million mark of confirmed COVID-19 cases. Last night we announced a total of 521 318.
We are happy that even with the targeted testing approach which we adopted as a department based on the Ministerial Advisory Committee advice, our testing numbers continue to grow. To date, we have tested 3 078 202. This translate to a testing rate of 51 514 per million population which compares well to global figures.
The question that has been raised is whether the plateau that is observed in some provinces is due to reduced testing numbers or if indeed less people are becoming infected with Coronavirus. To assess this, we have looked at other key indicators which are that:
- We have seen reduced hospital admissions and PUI’s presenting in health facilities;
- We have not breached hospital capacity;
- Despite the surge, we have not seen a significant increase in deaths.
Whilst we are cautiously optimistic, it is still too early for us to make definite conclusions regarding the observed decline. We need to continue to track all these indicators and ensure that our testing capacity reflects a realist picture of our epidemiological status. We will therefore only know for sure when there is a consistent decline over a period.
It is worth mentioning that, as part of improving the records of COVID-19 related deaths in response to reports on excess deaths, we now require that all the sudden deaths and those that occur at home must have specimens taken for COVID-19 before a death certificate is issued.
graph: 7 Day Moving Average of New Cases
Health Care Worker Safety and PPE’s
As the government, we have constantly given our commitment to the public that the protection of health workers, including doctors and nurses, is of utmost importance. This workforce remains at the frontline of our battle against COVID-19 and it is in our interest as the government to ensure that they are protected.
The Department of Health, therefore, notes, with concern, increasing allegations of health care workers contracting the Coronavirus on the line of duty due to lack or poor quality of personal protective equipment. We have even received reports that some may be dying after being infected due to the lack of sufficient PPE or due to sufficient PPE not be provided and/ or failure or neglect by management to adhere to prescribed workplace safety protocols.
We want to outrightly state that this cannot be tolerated.
To give an example, a few days ago my office brought to my attention that there were public reports that a doctor had passed away at George Mukhari Academic Hospital due to COVID-19 related illness. There were also allegations that this was due to lack of sufficient supply of PPE and doctors being made to work in unsafe environments at the facility. I viewed these allegations in a serious light and have decided to urgently appoint a team led by Professor Taole Mokoena together with other medical, nursing and legal professionals, to conduct an urgent investigation and provide me with a report in 14 days from the commencement date.
This report will provide me with independent findings and recommendations. These will also be communicated publicly. I want to assure members of the public that if individuals entrusted with positions of power in health facilities or even at the district level are found to be in dereliction of duty by not ensuring adherence with health protocols, appropriate action will be taken against them.
We encourage health care workers at this facility to avail themselves for this probe. I believe that this approach of zooming into specific incidents will assist us to establish the real challenges and deficiencies occurring in the health facilities. It will also ensure accountability and promote a culture of heightened awareness of workplace safety.
The latest number of infected Health Workers that we have received from provinces is a total of 24,104 as at 2 August 2020 with 181 fatalities recorded. This means that the national infection rate of health care workers stands at 5% of all confirmed cases. We have also kept track of the level of infection on Health Workers globally: on 17 July 2020 the WHO reported that health workers account for 10% of global infections.
As part of continuous monitoring, we have requested provinces to further verify and break down this data so that we know exactly how many health workers have demised, recovered, the full breakdown of categories of health care workers.
Whilst we appreciate that employees can acquire the virus both in their line of duty as well as in the community, we encourage employers in different sectors across the country to continue taking measures to minimise the chances of acquiring Coronavirus in the workplace.
Unions have been raising their concerns about workplace safety, the availability and quality of PPE and the mental and physical wellbeing of their members. We also recognize the critical role-plays by Unions in representing their members’ views and concerns at the workplace during this period.
We have noted reports from Unions collected through their fact-finding missions and also the ones indicating a shortage of PPE in some hospitals. I have since instructed the provinces to ensure that PPE is immediately made available at those facilities highlighted and for a report to be made available.
The provinces have also been instructed to ensure that the Occupational Health and Safety Committees are established in every province, district and health facility. This is to facilitate constant communication and co-operation between unions and management. I have now obliged all provinces to ensure that these committees are fully formed and functional within the week and must meet at least once a week. In these OHS meetings, staff and unions must ventilate all issues and if the resolution is not satisfactory, the complaints must be escalated to the relevant MEC’s.
The mental well-being of our health care workers is equally as important, more so during high-pressure periods like the one we are going through now with the COVID19 surge. I have requested that in all provinces work must be done at provincial, district and facility level to promote psychosocial counselling to deal with the trauma experienced by health care workers, ensuring that they get support and manage the problems of fatigue and irritability and any indications of burnout. Once again this requires a multi-sectoral approach, in particular, collaboration with unions, lay councillors and religious leaders.
To my dear and esteemed colleagues: doctors, nurses, physiotherapists, psychologists, medical technicians, pharmacists, porters and all general workers, lab technicians, environmental health practitioners, dentists and dental technicians, optometrists – ALL frontline health care workers, for your commitment and resilience, we, as South Africans, are indebted to you.
Thank You, Siyabonga, Re a leboga, Enkosi, Dankie, Ndo Livhuwa.
Bed and Oxygen Capacity
We continuously assess the availability of beds, oxygen and staff compliment. While there have been constraints, work has been done to ensure vacancies are filled but we can also confirm that we have not breached our bed capacity and many of our field hospitals are not filled to capacity and we continue to monitor this as we manage the surge.
We have no doubt experienced challenges and glitches. This is in no way unique to our country. I, therefore, want to submit, with all humility, that up to now our government has displayed its readiness and has thus far coped with the surge.
We remain committed to taking all the measures necessary to protect our people
It appears we may have benefitted from treatment developments as we were experiencing our surge. Our indications are that there has already been an improvement in the survival rate from ICU where the mortality has been reduced demonstrably: one study shows ICU mortality has been reduced by about 25% since the introduction of dexamethasone on June 16. In another study undertaken by MRC, ICU survival rates showed dramatic improvement at 30-40% whereas the ICU mortality rate at the beginning of the pandemic was around 80%.
Notwithstanding these encouraging scenarios, we have directed all provinces to enter into service level agreements with private health facilities to ensure that when bed shortages are experienced that alternative can be explored.
Update on Vaccines
Whilst it’s still early days we have undertaken to get involved and invest in the development of a vaccine against the novel Coronavirus.
Currently, we are participating in the ChAdOx-1 study and in the COVAX project to be part of the global research initiatives as well as the access to vaccines programme. We also wish to pursue the possibility of manufacturing vaccines locally
WHO Surge Team Arriving in South Africa
I am very pleased to announce that the WHO has agreed to our request for their re-enforcement as we continue to implement our national COVID-19 response. As we know, South Africa is now in the top five globally in terms of the number of infections. I want to pause and acknowledge the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, for his continuous support and counsel. We know that he and his team have had to carry the global burden in the battle against COVID-19.
Today we announce that the WHO will be sending 43 senior experts from across the globe including renowned specialists such as Dr David Heymann, who is a seasoned infectious disease epidemiologist and public health expert.
I’m also pleased that Dr Mike Ryan will be leading the team from Geneva and will now be focusing on South Africa and providing us with constant advice whilst analyzing our strategies, including the decisions we have taken as the Department of Health in our COVID-19 response.
We see this as a great opportunity, not only to improve our health strategies during this pandemic but also to accelerate our path towards health care reform.
The first 17 experts will touch down on South African soil today and will complete a period of quarantine and initiation before being deployed within the department and across various provinces.
Conclusion
We can never over-emphasise the importance of good human behaviour and the impact it can have on flattening the curve. The containment measures being implemented are assisting however, we must not be complacent. The real risk of experiencing the “second wave” of the pandemic remains, so containment measures must never be abandoned. Until we are completely safe, we will keep reviewing restrictions and, if necessary certain restrictions will still remain in place.
Source – SAcoronavirus
