Coronavirus morning update: What could happen after lockdown, stayaway threat, and medical masks worries

23 Apr 2020

Cases update:

The latest number of confirmed cases is 3 635.

According to the latest update, 65 have been recorded in the country.

So far, 133 774 tests have been conducted

Latest news:

As the government seeks to relax some of the rules governing the nationwide lockdown, access to sit-in restaurants, bars and sporting events would likely remain restricted, according to a leaked, draft discussion document prepared by the Presidency.

Confirming the validity of the draft document, Presidency spokesperson Khusela Diko said it was prepared as an early input into the development of a "risk-adjusted approach" to resuming economic activity.

She added it had changed substantially and would therefore caution anyone on relying on it for accurate information.

The risk-adjusted approach is being finalised and will be elaborated on by President Cyril Ramaphosa on Thursday evening.

READ MORE | What the new reality for South Africans post-lockdown could look like, according to draft input

A trade union representing about 15 000 nurses at public and private health facilities, is threatening a mass stayaway from 1 May if the government doesn't meet their long-standing demands.

The Young Nurses Indaba Trade Union (YNITU), an affiliate of the South African Federation of Trade Unions (Saftu), says it feels neglected by the government, having raised issues of a lack of personal protective equipment (PPE), expensive transport and "poverty-level" salaries.

However, Department of Health spokesperson Popo Maja says if the union calls for a stayaway, it will be "a criminal offence in line with the Disaster Management Act" which the police can look into.

The union became particularly disgruntled following President Cyril Ramaphosa's address to the nation on Tuesday night.

READ MORE | Nursing union threatens mass stayaway, health dept warns it would be a criminal offence

A race against the clock is under way to source vitally needed masks and other personal protection equipment (PPE) for health workers at the front line of the Covid-19 pandemic.

With South Africa able to only produce 10% of the medical-grade masks it needs, a dual strategy of sourcing stock abroad and ramping up local production is under way, according to Stavros Nicolau, who heads up Business Unity SA's (BUSA) healthcare workgroup, GroundUp reports.

The healthcare workgroup is one of several that have been set up, with big business working alongside the government to prepare for Covid-19.

"This has been a big wake-up call and our response has been to engage with suppliers, both manufacturers and importers," Nicolau told GroundUp in a telephone interview. The intention is to cut through red tape and help facilitate and speed up imports, while also ramping up local production.

"We have costed an eight-week supply at between R1.6 billion and R1.7 billion and after that, normal stocking can kick in," says Nicolau. "But if there is a massive spike we are in the dwang."

READ MORE | Covid-19: South Africa racing to produce medical-grade masks

Handling procurement on a decentralised basis – as the South African government does – is a terrible idea during the Covid-19 pandemic, National Treasury says.

Usually, individual government institutions place their own orders for supplies such as personal protective equipment (PPE), which means even small municipalities are going to market looking to buy gloves and masks individually.

But the global crisis has crippled supply chains, complicated logistics, and caused countries to bid against one another for scarce protective supplies, Treasury says in an instruction to all public entities, so small orders are not getting priority in manufacturing and importation.

"More seriously, the small size of orders has crippled the process to place orders and procure products on the scale required to support mass testing and treatment initiatives, as recently pronounced by the President," Treasury director-general Dondo Mogajane writes in the instruction.

READ MORE | Mass Covid-19 testing has been ‘crippled’ by how SA buys supplies, says National Treasury

Labour and Employment Minister Thulas Nxesi told MPs on Wednesday that the Unemployment Insurance Fund had found instances where employers attempted to over-claim from its Covid-19 special cover, but that employees should not be made to suffer as a result during tough economic times.

Nxesi was addressing a joint meeting of the Portfolio Committee on Employment and Labour in the National Assembly and Select Committee on Trade and Industry, Economic Development, Small Business Development, Tourism, Employment and Labour in the National Council of Provinces.

The UIF buffers the impact of unemployment through contributions members make while they are gainfully employed. It introduced a special coronavirus fund which allows employers to pay out salaries during the April lockdown without loss.

The non-compliance underscores the tight balance the government must strike between enforcing compliance and ensuring penalties to not shut vulnerable businesses down and leave their employees without work.

READ MORE | Some employers over-claiming coronavirus UIF, says labour minister

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 Wednesday night, positive cases worldwide were more than 2.6 million, while deaths were more than 182 000.

The United States had the most cases in the world - close to 840 000, as well as the most deaths - more than 46 000,

Latest news:

US President Donald Trump vowed to sign on Wednesday an order partially blocking immigration to the United States, as health experts warned a second coronavirus wave could be even more destructive.

Trump said his action was being taken "to protect American workers" after 22 million people lost their jobs in the United States alone in the devastating economic backlash sparked by unprecedented measures taken to halt the spread of the virus.

And the United Nations warned that the world is facing a "a humanitarian catastrophe" with millions on the brink of starvation.

Nations around the world have been scrambling to fight the pandemic – which has killed almost 178 000 people and infected more than 2.5 million worldwide – while desperately seeking ways to limit the colossal damage inflicted on the global economy.

READ MORE | Trump to curb immigration as health experts warn of second coronavirus wave

The UN General Assembly has demanded equal access for any future Covid-19 vaccine, but its seeming unanimity was a fluke. The United States in fact opposed the resolution but acted too late to stop it, diplomats say.

The 193 members of the General Assembly adopted by consensus on Monday a resolution led by Mexico that calls for "equitable, efficient and timely" access to any vaccine developed to fight the pandemic.

But the non-binding resolution irked the United States for another reason. It highlighted the "crucial leading role" of the World Health Organisation, which President Donald Trump has strongly criticised for not doing more to halt the virus after it was detected in China.

The adoption of the text was announced three hours after the vote, an unusually long gap.

READ MORE | US failed to block UN resolution on equal access to any future coronavirus vaccine

LATEST RESEARCH

Earlier in April, Health24 reported on the immune system phenomenon, known as a cytokine storm, that Covid-19 seems to trigger in some people.

This overreactive response by the immune system damages the lungs and can cause death.

Even though cytokine storms have been investigated, many clinicians worldwide were not exactly sure how to treat it, especially because it was unknown earlier in the coronavirus outbreak.

But now, a team of researchers at MIT has developed specialised proteins, similar in structure to antibodies, that could potentially “soak up” excess cytokines, according to a news release.

"The idea is that they can be injected into the body and bind to the excessive cytokines as generated by the cytokine storm, removing the excessive cytokines and alleviating the symptoms from the infection," says Rui Qing, an MIT research scientist and one of the study authors.

READ MORE | There may be a solution to the immune system 'storm' caused by Covid-19 in some patients

Regular exercise is crucial for optimum mental and physical health, but research has also shown that regular exercise could reduce the risk of acute respiratory distress syndrome (ARDS), which is a major Covid-19 complication.

A review from the University of Virginia School of Medicine “strongly supports” the possibility that exercise can prevent or reduce the severity of ARDS, which affects between 3% and 17% of all patients with Covid-19.

Based on his findings, published in the journal Redox Biology, he strongly suggests that people exercise regularly.

Right now, ARDS is proving to be one of the most serious complications of Covid-19. It is estimated that between 20% and 42% of people hospitalised with Covid-19 will develop ARDS, which is fatal for up to 45% of patients.

READ MORE | Could exercise lower your risk of potentially fatal Covid-19 complication?

The role of good hand hygiene to reduce the burden of the number of infected people with the new coronavirus continues to be stressed by the World Health Organization (WHO) and other health sectors, and a new study provides further insight into doing this right.

The study, published on 17 April and carried out by three researchers from the University of Leeds and Leeds Teaching Hospitals NHS Trust, had four volunteers’ hands contaminated using a bacteriophage – a virus that infects bacteria and is commonly used in genetic research – and is harmless to humans.

The volunteers did not wash their hands after contamination, but proceeded to dry their hands using either paper towels or a jet/air dryer.

"Paper towels should be the preferred way to dry hands after washing and so reduce the risk of virus contamination and spread," the authors wrote.

READ MORE | Paper towels more effective at removing virus than air dryers

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.