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Infectious Diseases

23 May 2020

Coronavirus morning update: No final decision on cigarette, alcohol sales, and latest on lockdown arrests

Your latest coronavirus news: Cooperative Governance Minister Nkosazana Dlamini-Zuma has told the NCCC that the sale of tobacco and alcohol should continue to be banned until Level 1 of the lockdown, but "the discussion goes on and on and there is no finality"; and almost 230 000 people have been charged for contravening lockdown regulations since they were enforced.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 20 125.

According to the latest update, 397 deaths have been recorded in the country.

There have been 10 104 recoveries.

So far, more than 543 000 tests have been conducted, with just short of 17 600 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

Cooperative Governance Minister Nkosazana Dlamini-Zuma has told the National Coronavirus Command Council (NCCC) that the sale of tobacco and alcohol should continue to be banned until the country reaches Level 1 of the lockdown.

News24 was reliably told that Dlamini-Zuma was supported by Home Affairs Minister Aaron Motsoaledi when she told the NCCC this week that she believed it would be too much of a health risk to allow the sale of cigarettes and alcohol on 1 June when the country is expected to go to Level 3 of the nationwide lockdown.

This prompted a debate in the meeting, chaired by President Cyril Ramaphosa, with no resolution on the matter.

A high-ranking insider with intimate knowledge of the meeting said Dlamini-Zuma had come prepared with academic papers that argued against the sale of tobacco and alcohol during the Covid-19 pandemic, citing health risks.

READ MORE | Lockdown: Dlamini-Zuma pushes for tobacco, alcohol ban to continue until Level 1

Internationally recognised epidemiologist and infectious diseases specialist Professor Salim Abdool Karim has weighed in on the debate about schools reopening in the midst of the Covid-19 pandemic.

He said the country should expect small outbreaks in schools - although they would be handled and dealt with accordingly.

Karim stated this during an interview with broadcast channel eNCA, where he said there was no good reason for children not to return to school if there were health protocols - such as hand sanitisation and social distancing - in place to curb the spread of the virus.

He added scientific evidence showed children seemed to be infected at a much lower rate than adults and were less susceptible to the virus.

READ MORE | Small Covid-19 outbreaks must be expected in schools, says Karim

Almost 230 000 people have been charged for contravening lockdown regulations since they were enforced on 26 March, Police Minister Bheki Cele has revealed.

Cele, who briefed the media on Friday, said the number of people charged for breaking the regulations had almost doubled as the country started moving into Level 4 of the lockdown.

"At one point towards the end of April when we were still on Level 5, we had about 107 000 cases opened with 118 000 people charged for contravention of the lockdown regulations. In just over a month, this number has more than doubled and is almost at 230 000 for contraventions," he added.

Cele said the provinces with the highest number of arrests almost mirrored the provincial infection statistics, with the Western Cape recording the most arrests and highest number of confirmed cases of Covid-19, followed by the Eastern Cape, KwaZulu-Natal and Gauteng.

READ MORE | Almost 230 000 people charged for contravening lockdown regulations

The Western Cape is starting to see increased pressure on its hospital systems ahead of the coronavirus peak, but it has not yet reached peak capacity, the Premier's office said on Friday.

It warned however that, while it was ready to meet current critical care needs, at the peak, "even in the best-case scenario, we will still fall short of ICU beds".

"The public sector has an existing capacity of 2 162 acute beds, and an 1 428 additional care beds will be provided by temporary 'field hospitals' in the Western Cape, including the 850 additional beds at the Cape Town International Convention Centre, 330 beds at a temporary hospital facility in Brackengate, 68 at the Khayelitsha Thusong Centre, 150 at the Cape Winelands Sonstraal Hospital, and 30 additional beds at Tygerberg Hospital," said Premier Alan Winde's spokesperson Bianca Capazorio.

She said the 850-beds planned for the CTICC remained on schedule to be completed by the first week of June, and that work was "progressing well".

The temporary hospital at the convention centre will cater for patients presenting with milder clinical signs, and who are in need of hospitalisation and treatment, including administration of oxygen, but not to those with severe clinical signs requiring intensive care treatment.

The CTICC agreed to waive the hiring costs of the venue, welcoming the opportunity "to be part of the solution".

READ MORE | Winde confirms pressure on hospital system increased, despite not yet hitting peak capacity

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 Saturday morning, positive cases worldwide were 5.18 million, while deaths were more than 336 000.

The United States had the most cases in the world - closing in on 1.6 million, as well as the most deaths - almost 96 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Brazil has emerged as a coronavirus hotspot, and President Jair Bolsonaro seems to be taking a page out of US President's Donald Trump's playbook to tackle the growing number of cases.

Over the past several days the country's daily spikes of cases have grown. On Tuesday, the country recorded 1 179 fatalities. On Wednesday, Brazil has the largest spike of cases in 24 hours with close to 20 000 cases, about a fifth of the overall record 106 000 new global cases the World Health Organisation recorded.

The country holds the third-highest number of cases behind the US and Russia, with over 310 000 infections and more than 20 000 deaths.

Vox reported that Bolsonaro mishandled the outbreak from the start by "continuously downplaying the seriousness of the virus, vocally opposed state governors' decisions to impose lockdown measures, personally attended anti-lockdown protests, and pushed for businesses to reopen despite the growing outbreak."

READ MORE | Brazil's death toll is over 20 000 - and its president's response mirrors Trump's playbook

LATEST RESEARCH

Hydroxychloroquine, a drug used to treat lupus and rheumatological disorder, has received a massive amount of publicity this year. The reason? Its role in the Covid-19 pandemic.

The drug made headlines after being proposed as a preventative measure (prophylaxis) against Covid-19, as reported in the New York Times.

While hydroxychloroquine has generally fewer side-effects than its cousin chloroquine, which was also researched as a possible Covid-19 treatment, it was generally declared as ineffective against the novel coronavirus, based on several studies.

But, besides the fact that the hydroxychloroquine hype may cause those who really need the medicine for lupus not being able to find it, the drug can also have irreversible side effects, as discussed in the journal Nature.

READ MORE | Covid-19: Amid caution over use of hydroxychloroquine, experts warn of possible irreversible blindness

As schools in South Africa are set to reopen for Grades 7 and 12, there is a debate whether children are less at risk from Covid-19 than adults and those with underlying conditions.

While the general consensus has been that children are not as severely affected by Covid-19 as the elderly, more severe cases in children have been recorded throughout the world.

A new report from paediatric anaesthesiologists, infectious disease specialists and paediatricians at the Children’s Hospital at Montefiore and Albert Einstein College of Medicine describes some of the most significant clinical characteristics of children hospitalised with severe Covid-19.

This report was published in the Journal of Pediatrics and compared the cases of 46 Covid-19 patients aged between one month and 21 years. These patients were either admitted to the general unit or the Pediatric Critical Care Unit (PCCU) at Montefiore.

READ MORE | Why do some children get sicker from Covid-19 than others?

The Covid-19 crisis is sweeping across the planet, becoming “the greatest disruptor the world has seen in generations”, according to a statement by the International Union Against Tuberculosis and Lung Disease (Union). But as the infection rate continues to surge, it should not result in other serious diseases, such as tuberculosis (TB), being neglected, a Union panel discussion on TB and Covid-19 on Wednesday concluded.

As of 21 May, South Africa has 369 confirmed Covid-19 deaths. Projections indicate that this figure could rise to more than 40 000 by November this year. However, according to the latest statistics by the World Health Organization (WHO), TB caused around 63 000 deaths in South Africa in 2018 (figures for 2019 are not yet available).

Following the recent release of modelling on the impacts of the initial Covid-19 response on TB – commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University – key leaders in the Union panel discussed what the results of this modelling study mean, and how governments can all work together to prevent the potential 1.4 million TB deaths worldwide, caused by the Covid-19 pandemic.

A major factor indicated in the study was an estimation that, globally, a three-month lockdown and a protracted 10-month restoration could lead to an additional 6.3 million people falling ill with TB and an additional 1.4 million TB deaths over the next five years. As a result, the world would face a setback of around five to eight years in the fight against TB.

READ MORE | Fighting TB in the time of Covid-19: how 1.4 million deaths can be prevented

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