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Infectious Diseases

Updated 20 June 2020

Coronavirus morning update: Personal care services back, latest on dexamethasone, and WHO warning

The official rules for legal hair cuts, manicures, or tattoos; what local experts say on dexamethasone; and the WHO warns the world is in a "dangerous phase" of the pandemic.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 87 715.

According to the latest update, 1 831 deaths have been recorded in the country.

There have been 47 825 recoveries.

So far, more than 1.26 million tests have been conducted, with 32 336 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

Personal care services – including hair salons – may legally open again from Friday night, after the publication of rules they must follow in the Government Gazette.

The rules are immediately in force, which means more than 80 days of prohibition on such services has also ended immediately.

All must follow the same strict hygiene protocols required of other businesses, albeit with some unique twists – and a handful of strange provisions.

Social distancing is required “wherever possible”, with a requirement, above normal face masks, for “more protective masks for close facial contact”.

READ MORE | Here are the official rules for legal hair cuts, manicures, or tattoos

With applications for R3.2 billion in coronavirus payouts to more than 725,000 workers still left unpaid, employers and the Unemployment Insurance Fund (UIF) are at loggerheads about who’s to blame.

Workers who are put on leave, have been laid off temporarily, or whose employers can’t afford to pay their full salaries due to the coronavirus crisis are entitled to Covid-19 Temporary Employer/Employee Relief Scheme (TERS) payouts.

The UIF is blaming employees for not submitting the right information as part of their applications, while businesses say workers are not being paid due to UIF ineptitude.

“We are perturbed at the suggestion that employers should carry the blame for employees not receiving their TERS benefits timeously, when the administrative system has proven so grossly unreliable,” says Rob Legh, chairperson of the law firm Bowmans, on behalf of Business for South Africa (B4SA), an organisation convened amid the crisis.

READ MORE | UIF coronavirus payouts: Companies in revolt with 725,000 workers left unpaid

Pharmaceutical giant Aspen Pharmacare has said that it is ready to scale up production of a generic anti-inflammatory drug that could help save the lives of critically ill coronavirus patients.

A mass treatment trial led by Oxford University this week found that a low-dose steroid named dexamethasone could reduce mortality among ventilated patients by a third.

Durban-based Aspen, the largest drug producer in Africa, will now "ramp up production" of the drug, Aspen senior executive Stavros Nicolaou said.

Dexamethasone has been on the market for over 60 years and usually serves to reduce inflammation.

"We are still getting to terms with what the global demands will be," Nicolaou said.

"Obviously, if this surges through the roof, you are going to have some constraints."

READ MORE | Dexamethasone: SA pharma giant Aspen to 'ramp up' production of 'breakthrough' drug

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 nearly 8.64 million, while deaths were more than 459 000.

The United States had the most cases in the world - nearly 2.22 million, as well as the most deaths - more than 119 000.

READ MORE | All the confirmed cases worldwide

Latest news:

The new coronavirus pandemic is now in a "new and dangerous phase", the World Health Organisation said on Friday, with the disease accelerating at the same time as people tire of lockdowns.

WHO chief Tedros Adhanom Ghebreyesus urged nations and citizens to remain extremely vigilant, as the number of cases reported to the UN health agency hit a new peak.

"The pandemic is accelerating. More than 150 000 new cases of Covid-19 were reported to WHO yesterday - the most in a single day so far," Tedros told a virtual press conference.

He said almost half of those cases were reported from the Americas, with large numbers also being reported from South Asia and the Middle East.

READ MORE | World slips into 'dangerous phase' of Covid-19 pandemic, warns WHO

LATEST RESEARCH

Dexamethasone made headlines this week after it emerged that it was the only drug to have made a significant difference to patient mortality from Covid-19. The drug was part of the Randomised Evaluation of Covid-19 Therapy (RECOVERY) trial, a range of potential treatments tested for Covid-19 patients, Health24 reported.

But can we fully trust this drug hailed as a groundbreaking treatment? We spoke to Associate Professor Sean Wasserman, infectious diseases specialist at Groote Schuur Hospital, University of Cape Town; Dr Jantjie Taljaard, infectious diseases specialist at Tygerberg Hospital, Stellenbosch University; and Professor Francois Venter, director of Ezintsha, deputy executive director of Wits RHI, and member of the ministerial advisory committee (MAC).

Taljaard explains that the theoretical basis for this drug is the fact that it is a potent anti-inflammatory. The main problem in Covid-19 patients who deteriorate after a week or more of infection, is the severe inflammatory reaction that develops in response to the respiratory tract infection – also known as a "cytokine storm". This complication is also well described in other viral respiratory tract infections like SARS and influenza, Taljaard adds.

“The cytokine storm, among other things, results in a condition called ARDS (acute respiratory distress syndrome), and other systemic complications including an increased tendency for clotting. So it makes sense that if one can avoid or suppress the cytokine storm with a potent anti-inflammatory, one may be able to attenuate the severe complications of Covid-19 and prevent mortality.”

READ MORE | What local experts say about dexamethasone - labelled as a 'breakthrough' in Covid-19 treatment

On 16 June 2020, an ongoing clinical trial for a potential Covid-19 treatment finally brought good news. Dexamethasone, a common corticosteroid, could result in saving many lives among the most severely affected Covid-19 patients.

But the search for other treatment options is still ongoing, and one unlikely drug is being investigated – Prozac.

The name “Prozac” is not unfamiliar. This antidepressant medication, also known by its generic name fluoxetine, is a selective serotonin uptake inhibitor (SSRI) which first appeared on the market in the late 1980s.

It is often used as a treatment for depression, anxiety and obsessive-compulsive disorder. Now, researchers from the Julius-Maximilians-Universität Würzburg are investigating this medication as an effective treatment for the early stages of Covid-19.

READ MORE | Scientists also looking at Prozac as Covid-19 treatment, but study still in early stages

One of the groups most affected by the current Covid-19 pandemic is diabetics - they have some of the highest risks of severe complications when contracting Covid-19.

A French study found that 10% of older Covid-19 patients who have diabetes, die within a week of entering the hospital, and 20% need a ventilator to breathe by that point. In the Western Cape alone, 52 out of 100 deaths due to the coronavirus were attributed to diabetics, according to the province's health department.

However, researchers from around the world are noticing another worrying trend - that Covid-19 could trigger diabetes in people who have no diagnosed pre-existing conditions.

In a letter published in The New England Journal of Medicine, a group of international researchers highlight a dangerous two-way relationship between Covid-19 and diabetes.

READ MORE | Covid-19: Experts worry that the virus is triggering diabetes in otherwise healthy people

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