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Infectious Diseases

16 April 2020

Coronavirus morning update: A harsh truth, Trump vs the WHO, and an annual Covid-19 season?

Your latest coronavirus news: A top SA expert says after lockdown, our lives won't be the same; anger and concern after US president freezes World Health Organization funding; and researchers predict that the virus is likely to be around for years to come.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 2 506.

There have now been 34 deaths recorded in the country.

The most deaths have been in KwaZulu-Natal - 18, where there have also been the third most cases in the country - 519.

Latest news:

The day South Africa recorded its first positive Covid-19 case on 5 March was a day that altered our way of life drastically, and South Africans will not be able to return to their normal way of doing things, says the chief epidemiologist at the centre of the country's Covid-19 fight. 

Professor Salim Abdool Karim, an epidemiologist and infectious disease specialist working with the government in the fight against the coronavirus, has some sobering news: There will be no return to normal.

Covid-19 has drastically altered the way we live now, and it will continue to do so in the future as people become more aware of the everyday preventative measures they need to take.

"I am sorry to say that life is not going to be what it was like before. Our lives have changed since 5 March when we saw that first case. [Before] then, it was somebody else's problem.

"Our lives, when we go back after this lockdown, are simply not going to be the same," he said. 

READ MORE | Covid-19 in SA: Life is not going to be what it once was, says Prof Karim

Karim also said this coming week will provide some answers on whether the nationwide lockdown has been effective in curbing the virus.

In an interview with News24's Frontline on Wednesday, Karim explained that the state of disaster declared by President Cyril Ramaphosa before the lockdown had helped bring down the number of Covid-19 infections through initiatives like hand washing, social distancing, closing schools and limiting travel.

The next week will be critical to determine whether the lockdown has been effective.

Karim explained that, because of the nature of Covid-19, people may not display symptoms for almost two weeks and could be "none the wiser" about their infections.

This, coupled with the amount of time it takes to screen and test people, means that results reflect infections that had occurred two weeks earlier.

As South Africa enters its third week under lockdown, Karim said this coming week would show a true reflection of cases recorded from the start of the lockdown.

This will give a representation of whether these measures have had any impact on the rate of Covid-19 infections, Karim said.

READ MORE | Critical week ahead to measure impact of lockdown - Prof Karim

Seven people have died of the coronavirus in less than a week, Health Minister Zweli Mkhize said on Wednesday, bringing the number of fatalities across the country to 34.

This as 91 new infections were confirmed, taking the number of infections to 2 506 nationwide.

Mkhize said six of the seven fatalities were recorded in KwaZulu-Natal.

Two women, aged 73 and 79, died on Monday. The first suffered from diabetes and hypertension, while the other woman’s comorbidities were unknown.

On Sunday, a 91-year-old man died. He had suffered from diabetes.

Last Friday, a 71-year-old woman with diabetes, hypertension and renal failure died as well as a 79-year-old man with unknown conditions.

Last Thursday, an 86-year-old woman diagnosed with hypertension died.

One fatality was recorded in Gauteng on Monday when a 50-year-old asthmatic man died.

READ MORE | Covid-19 in SA: 7 people die in less than a week

WHAT'S HAPPENING IN THE REST OF THE WORLD 

Cases update:

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

Late on Wednesday night, positive cases worldwide were close to 2 045 000, while deaths are more than 133 000.

The United States had by far the most cases, with nearly 633 000, as well as the most deaths - nearly 28 000.

READ MORE | All the confirmed cases worldwide

Latest news:

The US decision to freeze funding to the World Health Organization over what President Donald Trump said was its "mismanaging" of the global coronavirus pandemic triggered anger and concern on Wednesday.

Trump announced on Tuesday that the United States would halt payments to the UN body that amounted to $400 million last year.

He said it would be frozen pending a review into the WHO's role in "severely mismanaging and covering up the spread of the coronavirus," said Trump, who accused the Geneva-based body of putting "political correctness above life-saving measures".

Trump charged that the outbreak could have been contained "with very little death" if the WHO had accurately assessed the situation in China, where the disease broke out in December 2019.

READ MORE | 'The last thing we need now is to attack the WHO' - World leaders express need for funding

Iceland has provided a textbook example of how to get out ahead of a looming pandemic: per capita, it has tested more people for coronavirus than any other country on earth and it got started a month before the first case was even confirmed in the tiny Nordic island nation.

In a study published on Tuesday in the New England Journal of Medicine, researchers from Icelandic universities and deCODE Genetics, a subsidiary of the US biotech giant Amgen, released the results of an all-out screening program launched on 31 January - before the disease caused by the virus had even been baptised Covid-19 and more than a month before the global pandemic was declared.

The study involved two testing drives. The first, starting 31 January, targeted people with symptoms of coronavirus infection and people who had travelled to high-risk areas - initially China and the Alps regions of Austria, Italy and Switzerland - or people who had come into contact with others who were in fact infected with the virus.

It found that as of late March, 13.3 percent of more than 9000 people who were screened tested positive. The first case of infection was confirmed on 28 February.

READ MORE | Study shows Iceland got it right with early, widespread virus testing

LATEST RESEARCH

Since South Africa’s current state of lockdown was extended by a further two weeks, as announced on Thursday, 9 April 2020, people have been wondering how far we are from getting a vaccine.

While there are daily reports of “promising” developments and discoveries, the hard truth is that before a vaccination can be made available it needs to be subjected to rigorous tests and trials, which can take months or even years.

For those who don't have the time or inclination to browse through numerous studies and reports, here's what is happening regarding a Covid-19 vaccine

So far, the World Health Organization (WHO) has announced that at least 70 possible candidates for vaccines – of which three are in clinical evaluation and 67 in preclinical evaluation,

READ MORE | Coronavirus: WHO lists at least 70 vaccines in development – but most are in early stages

Covid-19 is likely to be around for years to come, haunting humans as either a yearly flu-like illness or as a virus that occasionally resurfaces following years of dormancy, a new Harvard modelling study argues.

It's unlikely that Covid-19 will go the way of its closest cousin, SARS (severe acute respiratory syndrome), which was eradicated by an intense public health effort following a brief pandemic, the researchers said.

Instead, Covid-19 is expected to be an ongoing fact of life, with the duration of human immunity determining exactly how often the virus returns.

If immunity to the Covid-19 coronavirus is not permanent, the virus will likely enter into regular circulation – just like the influenza virus or the beta coronaviruses responsible for the common cold, the model showed.

READ MORE | Annual 'Covid-19 season' may be here to stay, scientists predict

President Cyril Ramaphosa’s decision to lock down the country was largely based on epidemiological projections. It was projected that if the SARS-CoV-2-19 virus was allowed to spread unchecked to the extent that 40% of people in the country became infected, more than 350 000 people could die.

The National Institute of Communicable Diseases (NICD) has confirmed that these numbers are already outdated and new models are coming up with new numbers, that are yet to be announced. 

The results of Imperial College London modelling published in mid- March, indicated that more than 500 000 people may die from Covid-19 in the United Kingdom, and more than 2.2 million in the United States if no action was taken. This modelling prompted UK Prime Minister Boris Johnson's announcement of new restrictions on people’s movements. Social distancing measures were also introduced in many parts of the United States.

Referring to the South African model, Alex Welte a research Professor at the Centre of Excellence for Epidemiological Modelling and Analysis at Stellenbosch University pointed out “nobody is expecting an infection rate of 40% at this point”. “If you put your hands in your lap and do nothing that may plausibly be the case,” he said. “If we look at Wuhan in China, by the time the epidemic has withered away to nothing, the attack rate (infection rate) has been less than 1%.”

READ MORE | Covid-19: What we think we know about the epidemiological numbers

In the midst of the current global pandemic, feelings of uncertainty continue to rise. There is not yet any proven treatment against the new coronavirus, officially named SARS-CoV-2, but trials are ongoing.

South African Epidemiologist and Infectious Diseases Specialist, Professor Salim Abdool Karim, told News24 that we are still in the early stages of understanding treatments for viruses.

“Unlike with [drug development for] bacteria… we don’t have the same historical track record of developing drugs against viruses. Against viruses, we’ve been successful only in the last three to four decades.

“Our ability to make drugs against viruses was not really well developed until HIV. But the problem is that these viruses are too different,” Karim explained.

READ MORE | SA expert cautions on coronavirus treatment

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.

READ MORE: Coronavirus 101 

Image credit: Getty Images