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Infectious Diseases

Updated 22 May 2020

Coronavirus morning update: Cape Town's 'hotspots', grim projections, and how the virus exploits smokers

Your latest coronavirus news: Five areas within the Cape Town metro have been identified as "hotspots"; projections show that 12 to 13 million infections could have cumulatively occurred in SA by November - of which only roughly 3.7 million will be detected; and research suggests smoking encourages the lungs to produce more of a protein that makes it easy for the virus to infect the body.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 19 137.

According to the latest update, 369 deaths have been recorded in the country.

So far, more than 525 000 tests have been conducted, with more than 18 550 new tests

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

Five areas within the Cape Town metro have been identified as "hotspots" by the Western Cape government.

Lit up with red dots on maps of suburbs, the province has revealed where clusters of Covid-19 cases are being detected in the metro.

In a digital press conference on Wednesday, the province said it believed that having 62.6% of the national number of cases simply means that community transmission "seeded" earlier in the Western Cape, and that other provinces could soon follow suit.

They had identified clusters of outbreaks as "hotspots" and have focused testing, screening, tracing, support, and prioritising treatment of the most vulnerable from these hotspots.

READ MORE | PICS | This is where Cape Town's Covid-19 'hotspots' are

Projections by a consortium of experts advising the government have been clarified to show that 12 million to 13 million Covid-19 infections could have cumulatively occurred in the country by November, of which only roughly 3.7 million will be detected.

News24 reported on Wednesday that the South African Covid-19 Modelling Consortium projected a figure of between 1 and 1.2 million infections and that the model was not a crystal ball prediction, but subject to change as more data became available.

During a further media briefing by the consortium and other modelling groups on Thursday, in conjunction with Health Minister Zweli Mkhize, it has now been clarified that the one million infections are the expected number of active cases at the peak of the country's infection curve at that specific moment in time.

Peak infection is expected to occur between early-July (pessimistic, 1.2 million cases) and mid-August (optimistic, 1 million cases), according to the consortium's model.

The total number of detected cases would be around 3.7 million to 3.9 million cases by November, a report by the consortium published on the National Institute for Communicable Diseases (NICD's) website shows.

RED MORE | Covid-19 projections show 12 to 13 million infections by November

The cause of death of the baby born prematurely, and said to have died of Covid-19 after a two-day struggle for survival, will be investigated, the Western Cape government said on Thursday.

"We are saddened by this tragic loss of such a young life and send our deepest sympathies to the family at this time," said Western Cape Premier Alan Winde.

"Western Cape doctors are currently investigating the case, to better understand all the details."

Health Minister Zweli Mkhize announced the death of the baby on Wednesday evening.

READ MORE | Premature baby's Covid-19 death to be investigated

Parliament is expediting the passing of the budget, which would allow Finance Minister Tito Mboweni to table an adjustment budget earlier than what normally would be the case.

The budget will outline the government's response to the Covid-19 pandemic.

The National Assembly Programming Committee agreed on Thursday to scrap the mini-plenaries in which each department's budget is debated. This annual process usually takes a few weeks of the Parliamentary calendar.

Instead, there will be a 90-minute debate on the budget and an opportunity for parties to make declarations on their vote for each department.

READ MORE | National Assembly to expedite budgetary process for Covid-19 response

The Gauteng Department of Education says it expects 300 000 Grade 7 and 12 pupils back when schools reopen on 1 June.

But, before the reopening can take place, health protocols will have to be met by all schools, Education MEC Panyaza Lesufi said.

Lesufi was speaking at the province's weekly Coronavirus Command Council briefing on Thursday.

The MEC said, in order for schools to be ready, it will need to have all the necessary personal protective equipment (PPEs) for pupils, while classrooms need to meet the necessary standards for physical distancing.

READ MORE | No visitors, 3 screenings a day - all you need to know about Gauteng's plan for school reopening

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.

Early on Friday morning, positive cases worldwide were more than 5.07 million, while deaths were more than 331 000.

The United States had the most cases in the world - more than 1.57 million, as well as the most deaths - more than 94 500.

READ MORE | All the confirmed cases worldwide

Latest news:

Wuhan, China, has banned the eating of wild animals and farmers in neighbouring regions are being offered cash incentives to stop breeding exotic livestock.

Both steps are part of China's ongoing efforts to stem the transmission of viruses from animals to humans.

On Wednesday, authorities in Wuhan, a city of 11 million in Hubei and the epicenter of the coronavirus pandemic, announced eating wild animals would be banned, according to CBS News.

Wuhan would become a "wildlife sanctuary," officials said, with a citywide prohibition on hunting except for "scientific research, population regulation, monitoring of epidemic diseases and other special circumstances," according to the Independent.

Before it was shuttered in January, merchants at Wuhan's Huanan Seafood Wholesale Market sold and slaughtered beavers, porcupines, and baby crocodiles, National Geographic reported.

READ MORE | Wuhan bans eating of wild animals – farmers offered cash to stop breeding exotic livestock

LATEST RESEARCH

New research from Cold Spring Harbor Laboratory (CSHL) suggests that cigarette smokers may be more susceptible to Covid-19.

The research suggests that smoking encourages the lungs to produce more ACE2 (angiotensin-converting enzyme 2), the protein that makes it so easy for the SARS-Cov-2 to adhere to and infect the cells in the body.

This research was discussed in a news release and published in the journal Developmental Cell on 16 May 2020.

One thing that the researchers from CSHL noticed is the dramatic differences in how patients with Covid-19 experience their symptoms. In most cases, people experience mild illness that can be treated, but some cases require hospitalisation and may even lead to death. They also noted three vulnerable groups who seem to be more prone to severe Covid-19: men, older adults and smokers.

READ MORE | Why smokers appear to be particularly vulnerable to severe Covid-19 infections - what science says

The new coronavirus has mostly spared children, making them represent only a tiny fraction of confirmed Covid-19 cases, while largely affecting the elderly and those with pre-existing chronic conditions and weakened immune systems.

According to research, less than 2% of reported infections in China, Italy and the US have been in people under the age of 18. In South Africa, out of a total 312 deaths (recorded on 19 May), none occurred in anyone under the age of 20. Yet, researchers are still on the fence on whether children are less likely than adults to get infected and spread the virus, notes an article in the research journal Nature.

The World Health Organization (WHO) previously reported that although children seem to be mildly affected with no fatalities, experts still warn that children can contract the virus, and that this warrants serious consideration. The reason behind mild cases in children is not exactly clear, but experts agree that adults may be more susceptible to infection because of their age, since, with age, our immune systems become less effective.

A study, published in Science last month, examined data from Hunan and found that for every infected child under 15 years, there were close to three people infected between the ages of 20 and 64. Still, the existing data is less conclusive when it comes to teenagers aged 15 and older, says Munro, further indicating that their risk of infection is similar to that of adults.

READ MORE | Can children spread the new coronavirus? The science still isn’t clear

A new modelling study by the Stop TB Partnership suggests that the longer countries spend under lockdown, the more tuberculosis (TB) cases and deaths the world could see.

While that report is a modelling study, with all the uncertainties that entails, there is now compelling evidence that South Africa’s TB response is already severely impacted. Spotlight studied the various new reports and asked a range of experts how the country’s TB response is holding up under lockdown.

A recent report from the National Institute of Communicable Diseases (NICD) details a significant decline in TB testing since the beginning of the lockdown. In the weeks prior to the lockdown, the NICD conducted an average of 47 520 TB tests per week. This dropped to an average of 24 574 tests per week during the lockdown – a 48% reduction.

The report concludes that the decrease is largely due to restrictions on movement and public transport, rather than the availability of healthcare services.

READ MORE | Covid-19: Lockdown takes heavy toll on SA’s TB response

Obesity makes Covid-19 worse and may lead to deadly blood clots in the lungs, a new study finds.

The researchers said that obese patients with Covid-19 may have nearly three times the risk of developing what is known as a pulmonary embolism.

"Clinicians can utilise our findings to aid in determining which patients should have evaluation for pulmonary embolism with pulmonary CT angiography, as the symptoms for Covid-19 and pulmonary embolism overlap," said lead researcher Dr Neo Poyiadi, from the department of diagnostic radiology at Henry Ford Hospital in Detroit.

"Early detection of pulmonary embolism can allow prompt treatment with anticoagulation and minimise clinical problems," he said.

READ MORE | Obesity and Covid-19: Researchers find major risk for deadly blood clots in the lungs

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