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Infectious Diseases

Updated 13 October 2020

Coronavirus morning recap: SA treatment innovation, and strict rules for companies

Cape Town hospitals prove oxygen therapy can improve Covid-19 patients' survival rate; and government has introduced more stringent regulations for workplaces.

LATEST SCIENCE AND RESEARCH

READ | Cape Town hospitals prove oxygen therapy can improve Covid-19 patients' survival rate

One of the leading effects of Covid-19 is the drop in oxygen levels in the blood, which can severely worsen a patient's condition and lead to the need for a ventilator.

Unfortunately, since resources in the healthcare sector have been constrained during the pandemic, having ample ventilators on hand for Covid-19 patients can be difficult. Requiring a ventilator lowers one's survival rate considerably, and patients coming off the machines have a long recovery process ahead of them.

But a lesser-known treatment used at Tygerberg Hospital in Cape Town and other South African hospitals, has shown great promise in helping to better manage resources and increase Covid-19 patients' mortality rates.

Heated and humidified oxygen is pumped directly into the lungs through the nose at 60 litres per minute, called high-flow nasal oxygen (HFNO) therapy.

While it can't replace mechanical ventilation, it increases the recovery chances of Covid-19 patients with severe hypoxaemic respiratory failure (HRF).

It also provides an additional treatment in resource-constrained situations, doesn't require the ICU to be administered - it can easily be set up in a general ward - and you don't need specially trained doctors and nurses to administer it.

READ | Just like the flu? No, hospitalised Covid-19 patients tend to be younger, and healthier

A new global network study, which included data of more than 34 000 Covid-19 patients from across three continents, has provided a better understanding of the profiles of hospitalised Covid-19 (the disease caused by SARS-CoV-2) patients.

The study was published this month by the Observational Health Data Sciences and Informatics (OHDSI) community (housed at the Department of Biomedical Informatics at Columbia University) and in the journal Nature Communications.

"Despite recent discourse around the supposed poor health and limited life expectancy of Covid-19 patients, we see Covid-19 patients to be in no worse health than those typically hospitalised with influenza,” said co-author Edward Burn, a postdoctoral researcher at the Centre for Statistics in Medicine (CSM), University of Oxford, UK, in a press statement by Columbia University.

"This further highlights the high rate of mortality among Covid-19 patients," he added.

The results show that patients hospitalised with Covid-19 were more typically male in the US and Spain – but more often female in South Korea.

The ages of patients varied, with the most common age groups in Spain and the US reported to be between 60 to 75.

CORONAVIRUS CASES LATEST

SA cases update: 

The latest number of confirmed cases is 693 359.

According to the latest update, 17 863 deaths have been recorded in the country.

There have been 624 659 recoveries.

So far, more than 4.4 million tests have been conducted, with 10 977 new tests reported.

Global cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Monday night, positive cases worldwide exceed 37.6 million, while deaths were over 1 million.

The United States had the most cases in the world - more than 7.7 million, as well as the most deaths - more than 214 000.

WHAT'S HAPPENING IN SA

Latest news:

READ | All the strict new Covid rules for SA companies

Lockdown regulations may have eased, but government has introduced more stringent regulations for workplaces.

New rules have been gazetted to prevent and combat the spread of Covid-19 in South African workplaces.

While one might have expected the measures to be less strict than before, the opposite is true, says Jan Truter, director of the labour advisory service Labourwise.

According to the new regulations, workers diagnosed with Covid-19 are only allowed to return to work (without requiring viral testing) if they have completed ten days of isolation from the onset of symptoms – but only if the employee had a mild case of infection, which didn’t require hospitalisation.

If the employee had a severe case, and required supplemental oxygen or hospitalisation, they may only return 10 days from the date of achieving “clinical stability”. They may only return earlier if medical evaluation confirmed their fitness to work.

The employers must closely monitor the worker for symptoms on return to work, and the workers must wear a surgical mask for 21 days from the date of diagnosis, the new rules state.

READ | Working from home? You can still be fired for drinking on the job

It may be tempting to reward yourself with an afternoon drink between Zoom sessions while working from home, but think twice before reaching for that glass while you are still on the clock, a legal expert warns.

While "WFH" has become the new normal for many as a result of the coronavirus pandemic, just because your employer may not physically be able to see you, labour laws and company policies still apply - and that includes the consumption of alcohol and drugs while on the clock, according to Aadil Patel, national head of the employment law practice at Cliffe Dekker Hofmeyr.

Being drunk at work constitutes misconduct and an employee can be dismissed, however, employers must have an alcohol (and drug abuse) policy which is communicated to all its employees.

“Management is responsible for putting policies in place, not just for consumption on the premises – policies can extend to behaviour off company premises, during working hours in the event that it impacts the employee’s ability to do their job. Policies should not be limited to the consumption of alcohol, and should include any substance that prevents one from doing their duties, such as cannabis for example,” says Patel.

According to Patel, the Occupational Health and Safety Act states that “no person at a workplace shall be under the influence of or have in his or her possession or partake of or offer any other person intoxicating liquor or drugs”.

WHAT'S HAPPENING IN THE REST OF THE WORLD 

Latest news:

READ | UK hospital admissions exceed level seen at start of first lockdown – new stricter rules expected

UK Prime Minister Boris Johnson will on Monday reveal plans for a series of new local lockdown restrictions as the number of people being hospitalised with the coronavirus in the UK exceeds the level seen at the start of first national lockdown.

Johnson will unveil the plan to Members of Parliament this afternoon before explaining them to the nation in a televised press conference alongside his scientific advisers at 18:00 (BST.)

The UK government is under growing pressure to escalate lockdown measures after a surge in new infections across the country — particularly in the north of England and cities Liverpool, Manchester, Nottingham, and Newcastle.

Senior scientific and medical advisers to the government on Monday morning unveiled the scale of the crisis facing the UK, with 3,451 hospitalizations on October 11 compared to just 3,079 on the day the country locked down in the final week of March.

Johnson is not expected to announce the full list of areas of England which will be affected. Instead, he is set the explain how the new system will work in broad terms, before the government announces later this week how it will be applied to different areas of the country.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

Image credit: Getty Images