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Infectious Diseases

20 May 2020

Coronavirus morning update: Shocking projections on cases, deaths in SA, and the plan for schools

Your latest coronavirus news: According to projections by a group of scientists advising the government, more than 40 000 coronavirus-related deaths are expected in SA by November - with one million infections; and the National Coronavirus Command Council and Cabinet have approved the reopening of schools, the basic education minister has announced.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 17 200.

According to the latest update, 312 deaths have been recorded in the country.

The Northern Cape reported its first death - Mpumalanga is the the only province not to have reported a death.

So far, more than 488 000 tests have been conducted, with more than 13 500 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

More than 40 000 people are expected to die from the coronavirus in South Africa by November, one million people will be infected and the country is unlikely to have enough ICU beds at the peak of the pandemic. 

This according to a presentation by a group of scientists advising the government on projections and modelling to inform policy and regulations. 

Dr Sheetal Silal, who led the presentation in a virtual meeting co-ordinated by Health Minister Zweli Mkhize, said projections showed there would be 40 000 deaths by November with 475 expected deaths by the end of May

Based on a pessimistic projection, there might be between 45 000 and 48 000 deaths by November, she added. "Even these projections may change as interventions come into play and transitioning to different levels [of lockdown] in the future," Silal said, painting a grim picture of how the coronavirus will peak in South Africa this coming winter.

READ MORE | Grim Covid-19 projections for SA: 40 000 deaths, 1 million infections and a dire shortage of ICU beds

The minister said independent or private schools would also be opening in the metropolitan areas, adding the revised school calendar would be gazetted soon.

She added schools should adhere to and observe health and safety protocols that would be in place when schools reopen.

READ MORE | Schools to reopen from 1 June, starting with grades 7 and 12 - Motshekga

Gauteng Premier David Makhura says the entire province will move to Level 3 of the lockdown at the beginning of June.

Makhura, who was answering questions during a virtual session of the Gauteng provincial legislature said the province and its districts were highly integrated.

"We can't go to Level 3 in a disjoined way, we can't have one metro in Level 4, another in Level 3 and another at Level 2," he said on Tuesday.

The country is slowly making its way out of a hard lockdown that was imposed by President Cyril Ramaphosa in March after the deadly novel coronavirus hit South African shores.

READ MORE | Lockdown: Whole of Gauteng to move to Level 3 in June - Premier Makhura

Western Cape Premier Alan Winde says the province is prepared for the imminent peak in Covid-19 infections and must move down to Level 3 lockdown before interventions become unsustainable.

The Western Cape currently has the highest number of cases in the country, recording 10 558 confirmed cases as of Tuesday, according to its live dashboard.

In a statement, Winde said the harsh impacts of the lockdown were being felt, posing a threat to public health. He presented this to the President's Coordinating Council over the weekend, which is discussing the proposed alert levels for various parts of the country.

A determining factor in deciding lockdown levels should be based on a preparedness to care for all those who needed it, Winde said.

READ MORE | Winde calls for Western Cape to move to Level 3 lockdown, says province is prepared for peak

The Department of Correctional Services recorded 654 positive Covid-19 cases on Tuesday evening, an increase of 49 since Monday morning.

This included 199 officials and 455 inmates, with recoveries standing at 123, the department said in a statement on Tuesday.

"Results of inmates who were tested at SADA [prison] in the Eastern Cape recorded an increase of 34 positive cases.

"This is one of the areas receiving attention from the provincial Department of Health as Chris Hani District has been classified as one of the epicentres in the Eastern Cape," spokesperson Singabakho Nxumalo said.

READ MORE | Coronavirus: SA prison cases reach 654, as Eastern Cape remains a worry

While it is clearing the backlog in birth registrations created by Level 5, the Department of Home Affairs is considering allowing the registration of marriages when the country moves to Level 3.

This after the department addressed a portfolio committee on Tuesday.

"Of the aforementioned backlog, the department registered 46 541 births which represent 57% of the above, estimated backlog."

MacKay said this meant the department was left with 35 109 births to be registered from the backlog, but during that period, 8 989 births for newly born babies were registered at health facilities.

READ MORE | Home Affairs considers marriage registrations during Level 3

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 Tuesday night, positive cases worldwide were more than 4.88 million, while deaths were more than 322 000.

The United States had the most cases in the world - more than 1.52 million, as well as the most deaths - closing in on 92 000.

READ MORE | All the confirmed cases worldwide

Latest news:

A study in 15 Australian schools found that children are unlikely to transmit the coronavirus to each other or to adults in the classroom.

The report has been cited by Australia's Chief Medical Officer Brendan Murphy as part of his advice to Prime Minister Scott Morrison, who is keen to reopen schools, according to The Queensland Times.

Between March 5 and April 21, researchers at the National Centre for Immunisation Research and Surveillance (NCIRS) tracked cases of Covid-19 among pupils and teachers at 10 high schools and five elementary schools in New South Wales.

The researchers found that out of 863 pupils and teachers who had had close contact with an infected person, just two coronavirus cases were likely to have been transmitted in school - or 0.23%.

Early on in the study, 18 people across the 15 schools tested positive for the coronavirus, all of whom were immediately told to self-isolate. By the end, just two more tested positive, despite over 800 having close contact with those 18 people.

READ MORE | An Australian coronavirus schools study found children are unlikely to infect others

LATEST RESEARCH

As scientists worldwide are racing towards a vaccine against Covid-19 infection, experts are warning us that this may take a long time – and that a vaccine may still not be effective enough, as there is no certainty that the vaccine will elicit a lasting response from the immune system.

But now, some of that uncertainty has been alleviated slightly by Dr Alessandro Sette and Shane Crotty at the La Jolla Institute for Immunology.

Their new study was published on 14 May 2020 in the journal Cell and documents a robust antiviral immune response to SARS-Cov-2 according to a news release. The research found that the body’s immune response is able to recognise the SARS-Cov-2 pathogen in a number of ways – which means that we don’t have to be scared that a vaccine will cause an unwanted response from our immune system.

"If we had seen only marginal immune responses, we would have been concerned, but what we see is a very robust T-cell response against the spike protein, which is the target of most ongoing Covid-19 efforts, as well as other viral proteins.

These findings are really good news for vaccine development," said Dr Sette in a news statement.

"All efforts to predict the best vaccine candidates and fine-tune pandemic control measures hinge on understanding the immune response to the virus.

"People were really worried that Covid-19 doesn't induce immunity, and reports about people getting re-infected reinforced these concerns, but knowing now that the average person makes a solid immune response should largely put those concerns to rest,” stated Crotty.

READ MORE | Analysis of how immune system responds to coronavirus is good news for vaccine developments

World leaders have taken various approaches to contain the Covid-19 virus. While catastrophic levels of infection ravaged European countries such as Italy and Spain, Germany took early preventative measures, resulting in fewer mortalities.

And now a new modelling study reveals how the increase in Covid-19 cases dropped off, thanks to a series of three physical distancing interventions. There was a two-week delay after each intervention, but the scientists conducting the study note that it was only after the third intervention, i.e. the contact ban, that numbers dropped significantly.

In trying to control the outbreak, testing began on 19 January, soon after the Covid-19 outbreak hit Germany. The country has one of the world’s strongest healthcare systems, with a high number of intensive care beds. At one point, the country was even able to take in a number of critically ill Italian patients. To estimate the impact of the different levels of physical distancing on the spread of the virus, a modelling study was carried out by Jonas Dehning and colleagues.

The team, whose results were published in the journal Science, combined a Susceptible-Infected-Recovered (SIR) transmission model with Bayesian parameter inference (a technique used in mathematical statistics). According to the Institute for Disease Modeling (IDM), the SIR model is a generic epidemiological model that provides a simplified way of looking at the transmission of an infectious disease, such as Covid-19, through individuals.

The model specifically looks at individuals passing through the following states: susceptible, infectious, and recovered.

READ MORE | What we learned from Germany's physical distancing discipline

Could blood plasma drawn from people who've recovered from Covid-19 help prevent new coronavirus infections or ease symptoms in those already infected? Two groups of researchers aim to find out.

One clinical trial, from doctors at NYU Grossman School of Medicine, Montefiore Health System and Albert Einstein College of Medicine in New York City, will try to determine whether "convalescent plasma" injected into hospitalised Covid-19 patients can protect them from developing severe disease or requiring a ventilator.

Meanwhile, researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore are poised to launch a pair of new studies looking at the use of plasma in health care workers and those who are sick at home with Covid-19.

Dr Corita Grudzen, vice chair for research in NYU Langone Health's department of emergency medicine, wrote the study protocol for the New York City study.

"What we hope to see is that convalescent plasma, used at this stage of disease, so early on, prevents patients from dying, from going on a mechanical ventilator, or any sort of bad outcome," Grudzen said in a HealthDay Live interview.

The tactic is "sort of a stopgap measure in the sense that, when you don't have a vaccine, it's something that can be used in a new infection where we don't have known drugs or other therapeutics or biologics that we know can work against the disease," Grudzen explained.

READ MORE | Could survivors' blood help patients battling Covid-19? Trials may tell

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