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Infectious Diseases

Updated 15 May 2020

Coronavirus morning update: 'Not stuck on level 4', says president, and what you can now buy online

Your latest coronavirus news: We are not stuck on Level 4, we are going to migrate to Level 3 so that we can loosen up a number of restrictions, says the president; and you can now buy anything online under Level 4 restrictions – except cigarettes and alcohol – and actually have it delivered.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 12 739.

According to the latest update, 238 deaths have been recorded in the country.

The health minister reported 5 676 recoveries, to date.

So far, 403 018 tests have been conducted, with more than 16 650 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

President Cyril Ramaphosa has fired back at critics, who believe the lockdown restrictions should be immediately lifted, by saying "of course not everyone" will agree with the government.

Ramaphosa boldly added the lockdown levels were a strategic approach to save lives in what seemed to be an answer to the DA's open criticism of the regulations. He was speaking to the media in Port Elizabeth during an oversight visit to inspect the state of the Eastern Cape's health systems in the battle against Covid-19.

"Of course, not all of us will agree on the strategic approach we have taken, but we believe this is an appropriate strategic approach that is appropriate to save the lives of our people. The consultation processes [with the National Coronavirus Command Council] are starting as early as tomorrow," said Ramaphosa.

"We are not stuck on Level 4 - I need to make that very clear. We are going to migrate to Level 3 so that we can loosen up a number of restrictions so that the economy can start operating once again.

We have said from the onset that our purpose is to save lives and the same time to save livelihoods."

READ MORE | Ramaphosa hits back at critics: 'We are not stuck on Level 4'

Gauteng Premier David Makhura is of the view that if the province can achieve compliance at Level 4 of the lockdown, then it will move to Level 3 "much quicker".

"If we can't have compliance at Level 4, and we go to Level 3, we are going to be overwhelmed," Makhura said at a virtual briefing on Thursday.

"I would like the people of our province to know that greater levels of compliance with all the measures at Level 4, then we will move to Level 3 much quicker."

Makhura's comments came after President Cyril Ramaphosa announced on Wednesday that parts of the country would be moving to Level 3 of the risk-adjusted strategy at the end of the month. The parts of the country moving to Level 3 have not been announced yet.

READ MORE | Makhura warns Gauteng: If we can not comply, we will be overwhelmed at Level 3 lockdown

The Western Cape government has asked that municipalities which are not Covid-19 hot spots and only have one or two cases be allowed to go into Level 3 lockdown. 

Speaking during a virtual meeting of the provincial legislature, Premier Alan Winde said the provincial "death rate" related to the virus was 1.8% of cases, which was down from an earlier 2%.

He added the province was constantly working with experts as well as the national and provincial government, and also questioning its modelling and planning.

But Winde said one thing was certain: There were only two Covid-19 hot spots in the province - Witzenberg and the Cape metro. He added the other municipalities only had a few cases, and so the humanitarian and economic implications for people in those other areas, who were also under extremely strict lockdown, would be disastrous.

READ MORE | Winde calls for Level 3 lockdown for municipalities with few Covid-19 cases

Health Minister Zweli Mkhize has explained how provincial districts will be assigned a lockdown level, saying the government has adapted its approach to combating Covid-19 and shifted its focus to be narrower. "The time has now come to look forward to the horizon and take bold steps to beat the virus.

The government has thus prepared a district-based approach to its Covid-19 response, moving away from a one-size-fits-all method," Mkhize said in a statement released on Thursday.

As the government prepares to ease the nationwide lockdown to Level 3, Mkhize said it would closely follow World Health Organisation guidelines on how to do this. On Wednesday, President Cyril Ramaphosa addressed the nation and announced most parts of the country would drop to Level 3 on the lockdown scale, while those areas with higher infection rates would remain on Level 4.

READ MORE | Covid-19: This is how lockdown levels will be assigned to districts

With immediate effect, South Africans can buy anything online under Alert Level 4 restrictions – except cigarettes and alcohol – and actually have it delivered. New regulations were gazetted on Thursday, which now give consumers access to a range of products that are not currently allowed for sale.

While online retailers previously could, and did, accept money for non-essential items, they weren't allowed to deliver. Now such orders are good to go.

According to the new regulations, retailers have to give "prominence" to products manufactured in South Africa, to bolster local industries which have been suffering due to Covid-19. Retailers are also required to provide "as many payment options as possible", and help poorer consumers to access delivery services.

READ MORE | What you can now buy online but not in stores – including jewellery, furniture, and t-shirts

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 night, positive cases worldwide were more than 4.41 million, while deaths were close to 301 000.

The United States had the most cases in the world - more than 1.4 million, as well as the most deaths - more than 85 000.

READ MORE | All the confirmed cases worldwide

Latest news:

An ousted US health official warned Congress on Thursday that President Donald Trump's administration has no "master plan" to fight the coronavirus pandemic and is unprepared to distribute enough vaccines to immunize millions of Americans.

Rick Bright told a House panel that without clear planning and an improved co-ordinated response, "2020 could be the darkest winter" in decades for Americans.

Bright was removed last month from his post as head of the Biomedical Advanced Research and Development Authority (BARDA), the agency charged with developing a vaccine against coronavirus.

In his first congressional appearance since his demotion, he presented a grim picture to lawmakers.

READ MORE | Ousted official warns US has no 'master plan' to fight virus

LATEST RESEARCH

As Covid-19 sweeps across the globe, and the number of cases in South Africa grows on a daily basis, we are eagerly awaiting the arrival of an effective vaccine. Health24 recently published an article explaining why clinical trials are key to ensure the safety of any medication, and why it may still be a while before we have a Covid-19 vaccine.

Researchers at Baylor College of Medicine and Texas Children’s Hospitals are experiencing first hand the challenges surrounding the development of a new vaccine.

The National School of Tropical Medicine at Baylor and the Center for Vaccine Development at Texas Children’s Hospital are currently in the process of developing a coronavirus vaccine.

The key goal of a vaccine is to trigger an immune response that will fight off a virus, but still be safe enough not to make the person sick.

This is true for all vaccines, but the end product is different for each pathogen. According to Dr Maria Elena Bottazzi, vaccine development is a balancing act between design and the immune response.

READ MORE | What does it really take to develop a safe, effective vaccine?

It’s generally agreed that avoiding exposure to the deadly Covid-19 virus, officially named SARS-CoV-2, is achieved through physical distancing and also basic hygiene, which entails frequent, thorough handwashing, and avoiding contact with surfaces that are touched by a lot of people, such as doorknobs and elevator buttons.

However, with the constant emergence of new studies, we are learning of other ways in which the virus can be transmitted, particularly via aerosol (small respirable particles that can remain airborne, and travel short and long distances) transmission.

A recent study, undertaken by four researchers and published in Risk Analysis, provides evidence for aerosol transmission of the virus.

This was done by studying how the normal breathing and talking of asymptomatic individuals produce small droplets that can travel through the air. Physical distancing measures across the world, including the implementation of lockdowns as well as the mandatory wearing of face masks, has been prompted by the fact that SARS-CoV-2 spreads through two main avenues: coughing and sneezing from infected individuals, and through hand-to-face transport from surfaces.

Although not everything is known about airborne aerosol transmission of the new coronavirus, the researchers explain that the difference between small and large droplets in infectious disease transmission (originally observed in the 1930s) is reflected in current World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) guidance, as well as additional publications.

A news release by EurekAlert also notes that a letter in April by the National Academy of Sciences Committee on Emerging Infectious Diseases and 21st Century Health Threats concluded that, despite limited research on SARS-CoV-2 specifically, "the results of available studies are consistent with aerosolisation of virus from normal breathing".

READ MORE | Breathing and talking contribute to coronavirus spread, study finds

People in South Africa who have recovered from Covid-19 are donating their blood to help others who are trying to fight off the disease that has so far claimed over 200 lives and infected over 10 000 people in the country.

At least 30 Covid-19 survivors so far have registered to donate their blood to South Africa’s National Blood Service (SANBS) to be used in a large clinical trial to see if their plasma, once separated from their blood, can help treat patients who have a moderate or severe form of Covid-19.

The first unit of convalescent plasma, as it is called, will be donated this week and stored at minus 18 degrees Celsius for a clinical trial scheduled to begin next month.

The independent Human Research Ethics Committee at SANBS has approved plasma collection from donors. Approval from the South African Health Products Regulatory Authority (SAHPRA) for the clinical trial is expected soon. Marion Vermeulen, a SANBS biomedical scientist who is also co-principal investigator for the trial, says there are hundreds of registered scientific studies globally but as yet there is no proven treatment for Covid-19.

“These donors, our unsung heroes, will add to the information and science we need now to save lives. People are scared, and fake news is adding to the fear. These survivors want to help,” says Vermeulen.

Blood from Covid-19 survivors can be a rich source of antibodies or proteins that the immune system makes to attack the SARS-CoV-2 virus, the virus causing Covid-19. Plasma is the part of the blood that contains these valuable antibodies. 

READ MORE | Covid-19: Survivors in SA donating blood for treatment study

A team of researchers at the University of Pittsburgh are re-imagining a way to test Americans (and hopefully the rest of the world) through something most of us own – the smartphone.

According to a news release, their project aims to use the existing hardware and computing power of smartphones to promote non-invasive at-home testing for Covid-19.  

The goal is ultimately to be able to test on a mass scale without special equipment and clinicians.

"In this project, we will develop new mobile sensing and artificial intelligence techniques for in-home evaluation of Covid-19 in an effort to quickly and effectively identify viral disease carriers," said Wei Gao, lead researcher and associate professor of electrical and computer engineering at Pitt's Swanson School of Engineering in a press release.

"We hope this work will also help identify negative cases caused by other diseases with similar symptoms, and therefore, help eliminate unnecessary hospital visits during this pandemic," he stated.

Gao and his research team will look towards the microphones and speakers of smartphones to develop acoustic sensing to measure changes in the human airway linked to Covid-19.

READ MORE | Could we soon diagnose Covid-19 at home with a smartphone?

While a vaccine against the novel coronavirus is still a pipe dream, researchers are looking towards existing drugs to buy time and help fight the most severe cases of Covid-19.

One of the drugs being researched is senicapoc, a treatment for sickle cell anaemia, a blood abnormality where red blood cells are unable to produce a sufficient amount of oxygen. Although the drug was found safe for use in clinical trials, it did little to actually reduce sickle cell anaemia and was not used.

Now, a team consisting of John Olichney, the clinical core director for the UC Davis Alzheimer's Disease Center; Heike Wulff, a professor of pharmacology; and other UC Davis researchers have been looking at senicapoc and its effect on stroke and Alzheimer’s disease according to a news release.

"In the Alzheimer's research field, it is becoming more evident that the immune system often results in excess inflammation and certain cytokines that can interfere with the synapse and its memory functions," Olichney stated.

As we now know from previous reports, a cytokine storm is a possible effect from Covid-19 that can cause severe symptoms and even death in patients.

Now, further research showed that senicapoc can prevent the lung damage that stems from severe acute respiratory syndrome as the drug has a combination of effects – blocking a severe immune response and blocking lung secretions.

READ MORE | Could a sickle cell anaemia drug help prevent lung damage in Covid-19 patients?

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