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Infectious Diseases

11 June 2020

Coronavirus morning update: Court bids - latest on cigarette ban challenge, and lockdown regulations

The cigarette ban is both legal and supported by science, the State has argued, while Minister Nkosazana Dlamini-Zuma asks for leave to appeal a lockdown regulations ruling.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 55 421.

According to the latest update, 1 210 deaths have been recorded in the country.

There have been 31 505 recoveries.

So far, 998 400 tests have been conducted, with 30 330 new tests..

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

The government has maintained in court that Minister of Cooperative Governance and Traditional Affairs, Dr Nkosazana Dlamini-Zuma, acted legally and rationally in banning the sale of cigarettes and tobacco products under the nationwide lockdown, saying the Disaster Management Act affords the minister broad powers to safeguard the health of SA citizens.

The case, brought by the Fair Trade Independent Tobacco Association, was argued before three judges in the Pretoria High Court on Wednesday morning.

FITA, whose members include cigarette makers Carnilinx and Gold Leaf Tobacco, is challenging the cigarette ban for a number of reasons, saying the minister overstepped her authority in declaring the ban, and that it in any case been unsuccessful in significantly reducing the sales of cigarettes or in getting smokers to quit.

The tobacco's group lawyer, Advocate Arnold Subel SC, put it to the court that current medical evidence does not support the state's assertion that smoking likely leads to more severe cases of Covid-19, saying peer reviewed medical studies on this were still lacking.

READ MORE | Cigarette ban is both legal and supported by science, State argues in court

Cooperative Governance and Traditional Affairs Minister Nkosazana Dlamini-Zuma has filed an application for leave to appeal against a High Court judgment that declared various regulations governing levels 3 and 4 as unconstitutional and invalid.

In the application, her lawyers argued Judge Norman Davis had erred in striking down the disaster regulations on the basis that a number of Level 3 regulations were irrational and unconstitutional.

"The appeal will have a reasonable prospect of success," it says in court papers.

The judgment was handed down last Tuesday following an urgent application brought by the Liberty Fighters Network (LFN) and Hola Bon Renaissance Foundation.

READ MORE | Dlamini-Zuma asks for leave to appeal lockdown regulations ruling

The Ministerial Advisory Committee (MAC) is recommending making a distinction between patients who have died as having Covid-19 present, Covid-19-related, or Covid-19 caused, as debate over why no other cause of death is registered on death certificates of people who die with other serious conditions besides the virus.

"So, now we can relook at how many of the deaths are associated with, but not directly caused by Covid-19," said Dr Keith Cloete, the head of the Department of Health in the Western Cape.

He added Covid-19 had been declared a "natural cause of death", as opposed to unnatural deaths like a trauma.

Cloete said with a natural death an autopsy was not indicated, so they do not have to find other reasons for the death.

READ MORE | Why 'Covid-19' is written on death certificates in spite of other ailments

The National Health Laboratory Services (NHLS) is working hard to make inroads into the backlog of Covid-19 tests, and according to the statistics provided to both houses of Parliament's health committees, they are making progress.

On 25 May, the "exact figure of specimens that have not been processed" was 96 480, the Department of Health confirmed after much confusion.

On Wednesday, the NHLS informed the committees the backlog is 63 244.

"As of 8 June 2020, the NHLS has conducted 492 704 tests," NHLS CEO Kamy Chetty told the MPs.

READ MORE | Covid-19 testing backlog: NHLS gradually reducing unprocessed tests, Parliament hears

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 Thursday morning, positive cases worldwide were more than 7.31 million, while deaths were close to 414 000.

The United States had the most cases in the world - more than 1.99 million, as well as the most deaths - almost 113 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Cabin crew in protective suits, health certifications for passengers, mandatory face masks, and longer check-in times.

This is the new reality of mass air travel.

As people dream of taking to the skies once more, they face the prospect that changes to curb the spread of coronavirus will be even more challenging than those brought in after the 2001 terror attacks in the United States.

In addition to the strict security measures commonplace around the world since then, passengers will now encounter a barrage of checks for Covid-19.

READ MORE | Face masks, health checks and long check-ins: the future of flying

LATEST RESEARCH

At the beginning of the Covid-19 outbreak, the use of a mask in public spaces was still frowned upon in countries where this has never been done before. Masks were mostly recommended for those who were already coughing and sneezing, and it was recommended that surgical masks be reserved for healthcare workers who regularly come into contact with infected people.

As the pandemic swept across the world, many nations adopted regulations that made the use of a fabric mask mandatory when outdoors. In South Africa, a mask should be worn at all times when venturing outdoors for work, shopping or exercise.

When Covid-19 first made headlines, scientists and healthcare professionals identified it as a mostly respiratory disease, which spreads through respiratory droplets when an infected person sneezes or coughs. It, therefore, seemed logical to suggest that a mask only be worn if you yourself were ill and sneezing or coughing – and as long as you stayed away from someone who was ill, a mask was unnecessary.

But as scientists unpacked more about Covid-19 over the last couple of months, there were more grey areas. It was suggested that infected people could spread viral particles long before they even showed symptoms, as the incubation period could be up to 14 days. Research even investigated the possibility of the virus being airborne, especially in healthcare settings and indoor spaces with little ventilation, which made health authorities, including the WHO question their stance on masks.

READ MORE | Masks and Covid-19: How, when and why – the latest guidelines

How fast does a virus really spread in a hospital? One simulation recently showed that it can take only 10 hours for a virus to contaminate 41% of all surfaces in a single hospital ward.

Published as a letter in the Journal of Hospital Infection by University College London and Great Ormond Street Hospital, researchers smeared a harmless DNA oligonucleotide surrogate on a bed rail in a paediatric ward’s isolation room. The "fake virus" could also be easily destroyed by proper handwashing regiments and alcohol wipes, thus simulating the prevention of the Covid-19 virus.

The surrogate was put in place on a Monday morning, and 44 samples were taken from surfaces in the evening, then every evening for the next four days. The surfaces included the immediate vicinity of the infection area, clinical areas outside of the isolation room and the general ward.

In the first 10 hours, 41% of all surfaces sampled were ‘infected’ with the surrogate, reaching its peak at 52% on day three. According to the letter, this meant that cleaning procedures were not adequate, and that patient and healthcare worker movements need to be better monitored.

READ MORE | How far does a virus spread in 10 hours in a hospital ward?

When someone infected with the new coronavirus talks, coughs or sneezes, tiny droplets containing virus land on surfaces nearby.

If touched by someone else, those contaminated surfaces are a means of Covid-19 transmission. But new research shows that surface-based infections are far more likely in some cities than others.

Climate is the key, according to researchers from the Indian Institute of Technology Bombay, in Mumbai, India. They discovered that in cities with cooler but more humid weather, viral-laden droplets on surfaces linger longer before drying out, greatly upping the odds that the virus within them stays alive and contagious.

"The likelihood of the survival of the virus increases roughly by five times in a humid ambient as compared to a dry ambient" environment, researchers Rajneesh Bhardwaj and Amit Agrawal concluded. High temperatures tend also to dry up droplets lingering on surfaces quicker, they explained.

READ MORE | Worried about catching coronavirus from surfaces? The city you live in may matter

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