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Infectious Diseases

06 May 2020

Coronavirus morning update: President says no agenda over cigarettes, and warning from SARS boss

Your latest coronavirus news: The president has rubbished claims there is an agenda from the government in banning of tobacco products during the Level 4 lockdown; and the SARS commissioner says impending joblessness and business closures would hammer revenues even harder.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 7 572.

According to the latest update, 148 deaths have been recorded in the country.

So far, 268 064 tests have been conducted - with more than 10 500 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

President Cyril Ramaphosa has rubbished claims there is an agenda from the government in banning of tobacco products during the Level 4 lockdown.

"No one is trying to pursue any interests. The only interests we are pursuing is the health of our people, finish and klaar," the president said on Tuesday.

Ramaphosa was addressing journalists at the Royal Show Grounds in KwaZulu-Natal, where he inspected a quarantine facility. He was in the province to examine the state of its response to the pandemic. 

He said in taking the decision for the tobacco ban, the government was consultative.

On Monday, News24 reported the Fair Trade Independent Tobacco Association (FITA) had launched a legal challenge to South Africa's ban on the manufacture, export and sale of cigarettes.

The association launched the legal action after Cogta Minister Nkosazana Dlamini-Zuma's announcement the National Coronavirus Command Council (NCCC) had decided not to lift the cigarette ban after Ramaphosa earlier stated it would end on 30 April.

Commenting on the court challenge, Ramaphosa said: "We live in a free country. The content of our democracy is such that if you feel aggrieved you are entitled to take your grievance to the court of the country and that's what they've elected to do."

He added he had faith in the judicial system.

READ MORE | Tobacco ban: Our only interest is our people's health, says Ramaphosa

More clarity on when schools will be reopened, as the country deals with the Covid-19 pandemic, may be available in two weeks.

Minister of Basic Education Angie Motshekga said she can only say for sure when schools will reopen when the plan has been approved by the National Coronavirus Command Council (NCCC) and the Cabinet.

She told a joint meeting of the Portfolio Committee on Basic Education and the Select Committee on Education and Technology, Sports, Arts and Culture on Tuesday that her department will present the detailed plan for the reopening of schools on 18 May.

Last Wednesday, the department made a presentation to the committees and, according to their presentation, the initial plan was for schools to reopen in phases from 6 May, with Grade 12s and Grade 7s returning to schools.

However, later in the briefing, after MPs questioned the feasibility of 6 May for schools to reopen, the department's deputy minister, Reginah Mhaule, said the plan was presented to the social cluster of ministers on Tuesday, who said 6 May was not achievable.

READ MORE | Dept of Basic Education to present reopening plan to NCCC on 18 May

While the South African Revenue Service has already been counting its losses as a result of the coronavirus' economic impact, impending joblessness and business closures would hammer revenues even harder, commissioner Edward Kieswetter said on Tuesday.

Kieswetter was speaking during a media briefing which took place on the same day he told a joint sitting in Parliament that the combined impact of SA's struggling economy and the lockdown could mean a loss of up to R285 billion in tax revenues this year.

Kieswetter told Parliament the combined impact of Covid-19 and sovereign credit rating downgrades was expected to lead to a potential reduction in revenue collections of between 5% and 15%.

The commissioner added that while April is not a significant month for corporate tax collections, indications were that there would be a significant slowdown in collections and that the downward spiral in various sectors was set to continue.

Many jobs, businesses won't come back

"The early indication is that this downward spiral will continue and will be reflected throughout the economy, except in places like electricity, gas and water, and areas that have continued to be active during this period. We expect the number of companies who will apply for business rescue will continue to grow in this country," said Kieswetter.

Kieswetter said the full impact of the novel coronavirus and the subsequent lockdown would bear out over the next few months, but that this would also depend on how South Africa manages the lockdown and phases in economic activities.

READ MORE | Business closures, job losses will hammer revenue in the months ahead, Kieswetter warns

There is fear, anxiety and panic from South Africans stuck in the United States as they scramble to get on the first SAA repatriation flight they can be confirmed on. 

News24 has spoken to at least three citizens among a group of over 20, waiting to board a flight to bring them home. 

The group had been unsuccessful in getting on previous flights, which departed Washington DC on Saturday and Sunday night.  

Catherine Berlein, 23, from Nelspruit, who had travelled to the United States in January for business purposes, told News24 she had booked and paid R15 150 for the repatriation flight which left the country on Saturday.

This after she had received emails from the South African Embassy asking her to confirm her details, she said.

After receiving her flight confirmation, she then went to Dulles International Airport on Saturday, 2 May, with the hope of being on the flight. On arrival, though, she was informed her booking was cancelled and her ticket not issued, without any clear explanation as to why.   

Berlein's efforts to get on the flight were unsuccessful and she had to return to her accommodation.

"The women behind the counter were only commissioned by SAA; they were not SAA staff, so unfortunately they couldn't do much. If we weren't on the system, they couldn't issue tickets. The most they could do was check if you were on the system," she said.

READ MORE | Repatriation chaos: SA citizens in Washington DC frustrated as they struggle to get SAA tickets

South Africa's tourism industry must not be allowed to regress during the coronavirus pandemic to the point that it looks like "pre-1994", Tourism Minister Mmamoloko Kubayi-Ngubane told Parliament's portfolio committee on tourism on Monday.

She also remained steadfast in her conviction that empowerment criteria for small businesses seeking relief were a matter of law.

The committee is concerned that tourism is one of the industries hit hardest by the coronavirus pandemic, resultant travel bans and lockdown restrictions.

While Level 4 of lockdown has allowed a partial return to economic activity, several sectors related to tourism remain impacted. Restaurants may only open for takeaways and deliveries, during certain hours, while accommodation establishments will remain closed.

Some industry experts, including the minister herself, have predicted that the sector may only start up again by December this year, starting with domestic tourism.

READ MORE | Coronavirus: Stop SA tourism industry regressing to 'pre-1994' disaster, minister warns

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 Tueday night, positive cases worldwide were more than 3.64 million, while deaths were more than 255 000.

The United States had the most cases in the world - more than 1.19 million, as well as the most deaths - more than 70 000.

READ MORE | All the confirmed cases worldwide

Latest news:

A new report has warned that loosening lockdown travel restrictions in Italy could lead to a huge second wave of as many as 18,000 new coronavirus deaths.

The report from Imperial College London, published Monday, came on the same day Italy entered its "Phase 2" lockdown plan, which eases restrictions that had been in place since March 10.

The country is one of the world's worst-hit by the virus, and has reported more than 29,000 deaths.

In the report, researchers said that even a partial increase in mobility in Italy could cause a second wave of deaths within eight weeks. It's worth noting, however, that this does not factor in measures like social distancing or isolating of infected people.

The researchers modeled scenarios where mobility was increased by 20%, 40%, or not at all. They quantified these percentages by increasing the rate of visits to places like public transport stations, shops, workplaces, and recreation facilities.

Using mobility as "a proxy for changes in behavior," the researchers compared an estimated number of new deaths prevented by Italy's lockdown with the potential impact of relaxing it.

READ MORE | Easing Italy lockdown could cause new wave of deaths, research shows

Canada's attempts to combat the coronavirus are far from perfect - it trails behind the low death rates of South Korea and Germany - but it's doing a lot better than the US.

According to Vox, the US has nearly twice as many confirmed cases of the coronavirus as Canada, and it has 30% more deaths per capita.

As of May 5, according to data from Johns Hopkins University, Canada has 61,954 confirmed cases with 4,003 deaths, out of a population of about 37 million. The US has 1,178, 906 cases with 68,689 deaths, out of a population 328 million.

Both nations watched coronavirus spike at about the same time in mid-March. But Canada's caseload trajectory took a far gentler curve than that in the US.

These divergent trajectories are down to a number of factors. Canada's response was mostly quick and coordinated - it closed down schools and promptly told people to stay home, according to The Guardian. Its borders were shut off to every country but the US on March 16. (The US-Canada land border was also closed on March 20.)

READ MORE | Canada is dealing with the coronavirus far better than the US - here's why.

LATEST RESEARCH

As we know by now, those with underlying conditions and chronic health issues are more likely to suffer serious consequences should they become infected with the new coronavirus.

According to a study reported in the journal Cell Metabolism, there is evidence that those with type 2 diabetes are more likely to suffer serious complications, should they be infected with the new coronavirus.

Luckily, if blood sugar is well-controlled, this might not be the case, according to experts. 

"We were surprised to see such favourable outcomes in well-controlled blood glucose groups among patients with Covid-19 and pre-existing type 2 diabetes," says senior author Hongliang Li of Renmin Hospital of Wuhan University in a news report. 

"Considering that people with diabetes had a much higher risk for death and various complications, and there are no specific drugs for Covid-19, our findings indicate that controlling blood glucose well may act as an effective auxiliary approach to improve the prognosis of patients with Covid-19 and pre-existing diabetes."

READ MORE | Blood sugar control for diabetics more vital than ever during coronavirus pandemic

As the new coronavirus continues to spread around the world, staying at home as much as possible in order to limit exposure cannot be stressed enough, especially for those with immunocompromised conditions, such as cancer, as they have a unique vulnerability to infectious diseases such as Covid-19.

According to a new study by physician-researchers at Montefiore Health System and Albert Einstein College of Medicine, cancer patients who develop Covid-19 are much more likely to die from the disease than those without cancer.

The study involved 218 cancer patients who tested positive for Covid-19, the disease caused by the new coronavirus and is, therefore, the largest of its kind, to date. It was published in the online edition of Cancer Discovery.

The study involved 218 cancer patients who tested positive for Covid-19 from 18 March to 8 April at Montefiore Medical Center in the Bronx, New York City. The results reveal that 61 of these cancer patients died from Covid-19.

Covid-19 patients with haematologic (blood) cancers, such as leukaemia and lymphoma, were also found to have the highest mortality rate, while those with breast cancer and prostate cancer had the lowest mortality rates.

READ MORE | Cancer patients may face higher risk of death from Covid-19

The World Health Organization (WHO) on Wednesday said it would back traditional or alternative medicines as potential treatments for Covid-19, as long as the efficacy and safety of these treatments were established through rigorous clinical trials.

In a statement, it said it welcomes innovations around the world including repurposing drugs, traditional medicines and developing new therapies in the search for potential treatments for Covid-19. 

"WHO recognises that traditional, complementary and alternative medicine has many benefits and Africa has a long history of traditional medicine and practitioners that play an important role in providing care to populations."

But, it said, medicinal plants such as Artemisia annua, which are being considered as possible treatments for Covid-19, should be tested for efficacy and adverse side effects.

The statement, while not specifically making reference to it, appears to be in response to the situation in Madagascar as the country continues to ship what it claims to be a remedy for Covid-19.

The drink is derived from Artemisia – and other indigenous herbs, and has been baptised Covid-Organics, according to an AFP report.

READ MORE | WHO backs traditional medicines as potential Covid-19 treatments - but must be scientifically proven

One need not be an expert in public health or an epidemiologist to quickly conclude that prisons present particular challenges regarding Covid-19. Some basic but noteworthy issues about South Africa’s prisons are set out below and a few conclusions are drawn. 

South Africa has a prison population of some 163 000 – of which roughly 48 000 are awaiting trial and the rest (approximately 115 000) are sentenced prisoners. The overwhelming majority of prisoners are sentenced adult males (112 000). There are almost 3 000 adult sentenced females.

Children comprise fewer than 100 individuals. For the past 12 years, our prison population has been remarkably stable due to two major competing drivers. The first driver is that we are sending fewer and fewer people to prison due to a poorly performing criminal justice system. The second driver is that we are imposing longer sentences. 

The introduction of minimum sentences in the late 1990s saw a rapid increase in sentence tariffs, but most importantly in the use of life imprisonment. In 1994/5 there were some 400 people serving life sentences, and it is estimated that this has now increased to 20 000, or roughly one in every six sentenced prisoners. Nowhere else in the world has the use of life imprisonment increased at such a rate. 

READ MORE | Prisons, overcrowding and preventing transmission

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