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Infectious Diseases

04 June 2020

Coronavirus morning update: Concern over Eastern Cape, and latest on court bids over cigarettes

The Eastern Cape is showing the "same pattern that drove up the outbreak" in the Western Cape; and the government asks for more time to defend the cigarette ban in court.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 37 525.

According to the latest update, 792 deaths have been recorded in the country.

There have been 19 682 recoveries.

So far, 785 979 tests have been conducted, with 24 445 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

The Western and Eastern Cape accounts for 78% of the country's confirmed coronavirus cases, with the Eastern Cape showing the "same pattern that drove up the outbreak" in the Western Cape, Health Minister Zweli Mkhize said on Wednesday.

More than 1 700 new cases have seen the number of coronavirus infections increase to 37 525, according to the statistics.

The Western Cape has 65.7% of the total cases and Eastern Cape 12.1%.

"The two provinces now consist of 78% of all positive cases. Additional attention is being directed to the Eastern Cape to ensure the province can adequately respond to limit escalation of infection," Mkhize said in a statement.

READ MORE | Mkhize: Covid-19 in the Eastern Cape showing same pattern that drove up Western Cape outbreak

The government is feeling the pressure of having to defend two separate cases relating to its ban on the sale of cigarettes and tobacco products during lockdown, and has requested a postponement in the first case which was set to be heard next week.

State attorney Arista Wasserman has written to Judge President Dunstan Mlambo of Gauteng to request that the initial hearing in the challenge against the ban being brought by the Fair Trade Tobacco Association be postponed, in light of the pressures facing Minister of Cooperative Governance and Traditional Affairs, Nkosazana Dlamini-Zuma, including the national state of disaster.

FITA, whose members include Carnilinx and Gold Leaf Tobacco, launched their court bid in May to have the sale of cigarette and tobacco products reauthorised.

The state banned the sale of tobacco at the start of the nationwide lockdown in late March, citing health reasons. The ban was extended under Level 4 and again under Level 3 of the lockdown. In defending the ban, the government has argued that emerging research shows smoking leads to more severe cases of Covid-19, and the ban is necessary to reduce strain on SA's health system.

READ MORE | State requests more time to defend cigarette ban in court

The Western Cape government has explained its decision to not test people aged 55 or younger in the Cape Town metro if they have no underlying conditions, as a nationwide backlog is holding up priority tests for those most at risk.

This is a formal new policy that has already been implemented by the provincial health department and City of Cape Town, in the Cape Town metro for now.

Speaking at the Red Cross War Memorial Children's Hospital, Premier Alan Winde said: "When you have a backlog of tests - and we have 27 000 tests in the backlog [from the Western Cape], some of them taking longer than a week to get a test result - you have to make some management decisions."

He added it was not an option to wait seven to 12 days to get a test result back for high-risk individuals.

READ MORE | Covid-19 tests: This is why those under 55 without comorbidities will not be tested in Cape Town

Pensioners, who were ready to receive their grant money, had to be sent back home after an armed gang pretending to be Covid-19 healthcare workers allegedly robbed a pay point in a suburb in Pietermartizburg.

According to the police, the four men were dressed in white overcoats and entered the business premises in Scottsville through the main entrance at 08:15.

The men went straight to the cash office and asked to speak to the manager.

Two members of the gang entered the manager's office, together with the employee, while the other two stood outside.

READ MORE | Armed gang pretending to be healthcare workers hit pension pay point

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 Thursday morning, positive cases worldwide were more than 6.39 million, while deaths were more than 383 000.

The United States had the most cases in the world - just short of 1.85 million, as well as the most deaths - more than 107 000.

READ MORE | All the confirmed cases worldwide

Latest news:

The World Health Organization (WHO) lavished China with praise early in the coronavirus outbreak in an attempt to flatter it into handing over data, a new Associated Press (AP) investigation has found.

China informed the WHO about the virus on December 31, 2019, and in early January 2020, as the virus spread in Hubei province, the WHO asked China to hand over the genetic map of the virus and detailed patient data.

But it took until January 12 for China to hand over the genetic sequence, and two more weeks to hand over patient data. China has been widely accused of covering up the virus in its early days.

So the WHO turned to flattery to try and speed up the process, according to AP, which had obtained internal WHO documents and meeting audio.

READ MORE | WHO reportedly heaped praise on China early in Covid-19 outbreak to get data

LATEST RESEARCH

As debate rages about whether it’s safe enough to send children back to school amidst the Covid-19 pandemic, research continues to suggest that children contract milder Covid-19 than adults.

The latest study, a case investigation published in the American Journal of Roentgenology (AJR) showed that most young patients who contract Covid-19 have negative chest CT findings.

But what does this mean? When a chest CT scan or X-ray is referred to as “negative”, this means that the lungs present as normal and that no damage is found.

The research was conducted by a team at the Icahn School of Medicine at Mount Sinai. The researchers reviewed the CT scan imaging and clinical cases of 30 children, all between the ages of 10 months and 18 years who tested positive for Covid-19 through the RT-PCR testing method.

These children were all treated at six centres in China between 23 January and 8 February 2020. The majority of the children (77%) revealed negative lung CT scans – 23 out of the 30 children, according to Sharon Steinberger, first study author.

And even though the sample size may seem small, it’s the largest case series to date to describe the imaging findings of paediatric patients with Covid-19, according to Steinberger.

READ MORE | Children and Covid-19: What the latest study says

According to a recent study by University of Cincinnati researchers and four Italian institutions, altered mental status and stroke are the most common neurological symptoms in Covid-19 patients. The research team, whose work was published in the journal Radiology, examined 725 hospitalised patients who presented with Covid-19, of whom 108 (15%) presented with serious neurological symptoms that required neuroimaging.

Neuroimaging, also known as brain imaging, uses various methods to allow neuroscientists to see inside the living brain. Analysing neuroimaging, as well as neurological symptoms in patients with Covid-19 may provide insight on how SARS-CoV-2 (the virus that causes Covid-19) can impact the central nervous system.

The majority of the 108 patients (99%) with confirmed Covid-19 underwent CT scans, while 16% received head and neck CT imaging, and 18% had a brain MRI. The most common neurological symptoms the team of 15 researchers found was 59% of patients reporting an “altered mental state”, and 31% experiencing stroke. Headache (12%), seizure (9%) and dizziness (4%) were also reported.

"Of these 108 patients, 31, or 29%, had no known past medical history. Of these, aged 16 to 62 years, 10 experienced stroke and two had brain bleeds," lead author Abdelkader Mahammedi, MD, assistant professor of radiology at UC and a UC Health neuroradiologist wrote, further explaining: "Seventy-one, or 66%, of these patients revealed nothing on a brain CT, while in seven of them (35%) brain MRI showed abnormalities."

READ MORE | The most common neurological symptoms of Covid-19 – and how 'red flags' can be identified earlier

Armadillo-like animals called pangolins may have played a role in the emergence in humans of the new SARS-CoV-2 coronavirus, but they weren't the only links in animal-to-human transmission, scientists say.

Pangolins are sold for food in live-animal "wet markets" in China – facilities that have long been suspected of being ground zero for the spread of viruses originating in animals to people.

Since the pandemic, experts worldwide have called for the closure of such markets in China and elsewhere.

Researchers at Duke University School of Medicine, Los Alamos National Laboratory in New Mexico, the University of Texas at El Paso and New York University are studying the virus that causes Covid-19, and their research sheds new light on how it was able to make the leap from animals to people.

By exchanging an essential fragment of a gene in the virus in pangolins, SARS-CoV-2 became able to make its move, the researchers concluded.

This species-to-species jump was made possible because the virus' mutation allowed it to attach itself to human cells, like a key fitting into a lock, explains study co-author Dr Feng Gao, a professor of medicine at Duke.

READ MORE | Pangolins, bats or what? New coronavirus' path to humans still unclear

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