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Infectious Diseases

15 June 2020

Coronavirus morning update: Testing strategy questioned, latest on obesity and Covid-19

Scientists "cannot fathom" why health authorities are sticking to a testing strategy which isn't producing the necessary results; and what experts say on Covid-19 and obesity.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 70 038.

According to the latest update, 1 480 deaths have been recorded in the country.

There have been 38 531 recoveries.

So far, more than 1.12 million tests have been conducted, with 34 071 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

A senior member of the Covid-19 Ministerial Advisory Committee (MAC) has accused the country's health leadership of refusing to change its mass testing strategy in the face of serious resource constraints and a large testing backlog, even though scientists have repeatedly advised that an urgent rethink is needed.

Professor Francois Venter, head of the Ezintsha health unit at the University of the Witwatersrand and a member of the MAC, says he and other scientists cannot fathom why health authorities are sticking to a testing strategy which is not producing the necessary results.

Until now, the Covid-19 strategy – defended by Health Minister Zweli Mkhize in an interview on Friday - involves testing patients referred from a mass screening programme, which has seen more than 180 000 people referred for Covid-19 tests so far. According to Mkhize, this has enabled the department to identify hotspots which would now be targeted with more resources, including priority testing.

But Venter and others have for weeks argued that, due to severe resource constraints, leading to low turnaround times from sample collection to results, tests should be reserved for hospitalised patients and healthcare workers.

READ MORE | Stop mass Covid-19 testing now - irate scientists to Health Minister Zweli Mkhize

South Africa's Covid-19 capital, the Western Cape, showed President Cyril Ramaphosa this month that obesity was one of the most prevalent comorbidities in its hundreds of deaths. Only diabetes, hypertension and HIV were more regularly cited as co-killers.

But obesity may be as dangerous as a pre-condition, because it is not only a risk in and of itself, but also a potential cause of diabetes and hypertension.

The Western Cape's Department of Health told Ramaphosa that available data thus far showed that 65% of deaths were a result of two or more comorbidities. And a study of global reports suggests obesity is regularly among them.

An insider at one major hospital said the vast majority of Covid-19 patients they have admitted to their intensive care unit, were obese – "and this often goes hand in hand with diabetes".

READ MORE | Covid-19: How at risk are people with obesity? Q&A with the Medical Research Council

The Royal Agricultural showground in Pietermaritzburg has undergone a transformation and has now been launched as a Covid-19 field hospital.

KwaZulu-Natal Premier Sihle Zikalala officially handed over the field hospital to the province's health department on Sunday.

"This field hospital is giving us 254 isolation beds, which will service uMgungundlovu, Harry Gwala and uThukela districts. Another field hospital, the Durban Exhibition Centre, is being constructed on our behalf by the national Department of Health," the premier said.

The premier said, over the past few months, KwaZulu-Natal had created 7 111 beds in the province through extensive renovation and repurposing of hospitals as well as the establishment of field hospitals.

READ MORE | Covid-19: Field hospital launched in KZN

The Ministry of Health says the motorbikes provided for health workers in the Eastern Cape are not meant to replace ambulances but are designed to bring healthcare closer to the people.

According to the health ministry, after it received backlash from the public and media queries, it had to clarify why the motorbikes were needed.

"One of the complaints that the Eastern Cape Department of Health has received from rural communities is that because of a lack of road infrastructure, especially in rural areas, ambulances do not reach people who are sick, especially the elderly," said health ministry spokesperson Dr Lwazi Manzi.

"The members of the community end up having to put an individual in a wheelbarrow or walking a long distance whilst carrying a patient until they reach a road where the ambulance can go."

READ MORE | Eastern Cape motorbikes designed to bring healthcare closer to people, says Ministry of Health

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 Sunday night, positive cases worldwide were almost 7.85 million, while deaths were more than 431 000.

The United States had the most cases in the world - more than 2.09 million as well as the most deaths - more than 115 000.

READ MORE | All the confirmed cases worldwide

Latest news:

A 70-year-old American man who nearly died of Covid-19 has been billed a heart-stopping $1.1 million (about R18 730 877 in today's exchange rate) for his hospital expenses, media in the US has reported.

Michael Flor was admitted to a hospital in the northwestern city on 4 March, and stayed for 62 days - at one point coming so close to death that nurses held up the phone so his wife and children could say goodbye.

But he recovered and was discharged on 5 May to the cheers of nursing staff - only to receive a 181-page bill totalling $1 122 501.04, he told the newspaper.

That includes: $9 736 per day for the intensive care room, nearly $409 000 for its transformation into a sterile room for 42 days, $82 000 for the use of a ventilator for 29 days, and nearly $100 000 for two days when his prognosis was life-threatening.

Flor is covered by Medicare, a government insurance program for the elderly, and should not have to take out his wallet, according to the Times.

READ MORE | US Covid-19 survivor hit with $1.1m hospital bill

A district in Beijing said it was in "wartime emergency mode" after a cluster of novel coronavirus cases emerged at a major wholesale market.

The discovery came after a man who had visited the Xinfadi market in the southwest district of Fengtai on June 3, tested positive for the coronavirus on Thursday, according to Beijing's Center for Disease Control and Prevention.

Chu Junwei, a Fengtai district official, said the area was in "wartime emergency mode" at a press briefing on Saturday. The district locked down 11 neighborhoods close to the market, which is the biggest meat and vegetable market in the capital city.

It prompted Beijing authorities to test and swab 1,940 workers in major supermarkets and other food markets in the Chinese capital.

READ MORE | Beijing goes into 'wartime mode' and locks down after a spike in coronavirus cases

LATEST RESEARCH

Being overweight, and obesity, are major risk factors for several chronic diseases, such as type 2 diabetes, cancer, stroke and heart diseases, and, more recently, severe Covid-19. In a paper published in the BMJ journal this week, researchers at the Queen Mary University of London (QMUL) argued that the food industry shares the blame, not just for the obesity pandemic, but also for the severity of Covid-19 disease and its devastating consequences.

According to the World Health Organization (WHO), worldwide obesity has nearly tripled since 1975, and 2016 statistics show that more than 1.9 billion adults, aged 18 and older, were overweight, and 650 million of this total were obese. Locally, 2016 statistics show that obesity rates in South Africa are also increasing rapidly, with almost 70% of women and 40% of men either overweight or obese, according to the Department of Health’s website.

The problem is also not limited to high-income countries anymore. Low- and middle-income countries are also seeing a dramatic rise in overweight and obesity cases, especially in urban areas. The causes of obesity are complex, but one of the key drivers is in the way we eat, something that has changed dramatically over the last 50 years.

As a result of changes in our environment, unhealthy, processed food has become more readily available (and affordable), and opportunities for physical activity are lacking. In their paper, the three researchers argue that the high number of obesity cases worldwide is the result of living in food environments that make it difficult not to overconsume calories, and mention the global food industry’s role in this.

READ MORE | Obesity and Covid-19: Junk food industry ‘shares the blame’, some experts say

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