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Infectious Diseases

24 April 2020

Coronavirus morning update: What's next for lockdown, the 5 levels, and Western Cape now has most cases

Your latest coronavirus news: President Cyril Ramaphosa announced the lockdown would be eased from 1 May; the government is following a 5-level phased approach - with level 4 up next; and the Western Cape now has the most cases, as well as the most deaths in the country.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 3 953.

According to the latest update, 75 deaths have been recorded in the country.

So far, 143 570 tests have been conducted - nearly 10 000 new tests were conducted.

READ MORE |All the confirmed cases of coronavirus in SA

Latest news:

On the same day the country recorded its biggest spike in the number of positive Covid-19 cases, President Cyril Ramaphosa announced the lockdown would be eased from 1 May.

Addressing the nation on Thursday night, Ramaphosa announced the government would follow a five-level phased approach towards easing lockdown restrictions.

He said it would implement a risk-adjustment strategy that would be deliberate and cautious. 

"There is still much that is unknown about the rate and spread of the virus. Action we take must be measured and incremental."

READ MORE | Covid-19: Ramaphosa warns of ending lockdown abruptly, announces phased easing of restrictions from 1 May

President Cyril Ramaphosa has shed light on what the country's new reality will look like when the lockdown continues beyond the end of April, albeit in another format. 

South Africans entered the lockdown at midnight on 26 March to prevent the spread of the Covid-19 pandemic. It was expected to end on 16 April, however, Ramaphosa announced a few days before its end it would be extended for a further two weeks. 

The lockdown in its current form is expected to end on 30 April.

During his address to the nation on Thursday evening, Ramaphosa announced that beyond the end of April, a risk-adjusted strategy would be implemented to ease the current lockdown restrictions.

READ MORE | List: Here's what you can and can't do during level 4 of the lockdown

While the SA National Defence Force (SANDF) will continue to support the police in enforcing Disaster Management Act regulations, as the country enters a new phase of the lockdown, soldiers will be providing assistance in other essential areas, including health care.

After 27 days of a hard lockdown, President Cyril Ramaphosa announced a new level on Thursday evening, allowing for the gradual easing of restrictions from 1 May.

Ramaphosa also clarified the mobilisation of more than 70 000 soldiers, one of South Africa's biggest deployments in history.

"As we slowly ease the lockdown restrictions, we are substantially and rapidly increasing our public health response

READ MORE | Deployment of SANDF to assist in essential areas, including health care - Ramaphosa

"Some activity will be allowed, subject to extreme precautions," the president said.

Businesses that are allowed to resume activity will be allowed to do so under specific conditions. Every business will have to adhere to detailed health and safety protocols to protect their employees, and plans will have to be put in place for disease surveillance and to prevent infection.

Ramaphosa did not announce which businesses would be allowed to reopen – though he did say cigarettes, and some other additional goods, would be on sale. Food retail stores that are already open are expected to be allowed to sell the full line of products within their existing stock. 

In weighing up whether a sector would be allowed to operate, its economic contribution, the effect on livelihoods, and the risk of transmission in each sector would be considered, he said.

READ MORE | Some businesses will reopen in May - but it won't be business as usual

From 1 May, smokers will be happy to know that they can light up once again, and some businesses will be allowed to operate, under specific conditions, as government gradually begins to lift the coronavirus lockdown. 

In an address to the nation on Thursday, the president said that while there has been progress in limiting the spread of the Covid-19, the lockdown cannot continue indefinitely.

It was instituted on 26 March. Several businesses, not deemed essential services, have had to close temporarily, leading to a loss of income for many South Africans.

The Reserve Bank has projected that the impact of the Covid-19 crisis would see SA's economy contract by 6.1%. Ratings agency Moody's projects a 2.5% contraction and the International monetary fund (IMF) a 5.8% contraction.

READ MORE | 'Our people need to eat. They need to earn a living' - Ramaphosa

Another viral WhatsApp message is doing the rounds making claims about the coronavirus crisis in South Africa, supposedly authored by a top Cape Town doctor.

Health24 can confirm, however, that the message was not authored by him.

The message claims to be the 13-point "outcomes" of a discussion on the pandemic, with "some doc friends of mine in the school group", and claims to be "written by The Head of Trauma at Groote Schuur Hospital, Prof Andrew Nicol".

In an e-mail, Professor Nicol – the Director of the Groote Schuur Hospital Trauma Centre and a professor of surgery at the University of Cape Town – denied that he was involved.

"Fake news. I am not the author," Prof Nicol said, and added that his expertise was trauma, not Covid-19.

READ MORE | 'I am not the author' - top doc denies he wrote viral WhatsApp message being attributed to him

The traditional Muslim greeting of Ramadan Mubarak, or Happy Ramadan, will wait one more day after the moon was not sighted on Thursday evening.

This means the holy month will begin on Saturday in South Africa.

Three members of the Crescent Observers Society were authorised to visit the promenade at Three Anchor Bay on Cape Town's Atlantic Seaboard to search the skies for the moon.

A traditional period of several minutes is taken to scour the darkness for a precious glimpse of the slender-lit moon, which heralds the official start of Ramadan.

READ MORE | Moon not sighted, Ramadan to start on Saturday in South Africa

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 Thursday night, positive cases worldwide were almost 2.7 million, while deaths were more than 187 000.

The United States had the most cases in the world - nearly 865 000, as well as the most deaths - nearly 48 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Iran called on Thursday for the US to be held accountable for "cruel" sanctions that have hampered its efforts to fight a coronavirus outbreak that it said claimed another 90 lives.

The Islamic republic has been struggling to contain the virus that causes the Covid-19 disease since revealing its first cases more than two months ago.

It accuses its arch enemy the United States of making the crisis worse through sanctions imposed unilaterally since Washington pulled out of the Iran nuclear deal in 2018.

The latest fatalities given by the health ministry for the past 24 hours took the overall death toll in Iran from the coronavirus to 5 481.

READ MORE | Virus-hit Iran demands US be held to account for 'cruel' sanctions

The European Medicines Agency on Thursday added its voice to growing concern about an anti-malarial drug widely touted as a potential cure for the Covid-19 disease, warning about fatal side effects.

Beneficial effects of chloroquine and hydroxychloroquine, which count US President Donald Trump as a major backer, have "not yet been demonstrated," the Amsterdam-based EMA said.

"Recent studies have reported serious, in some cases fatal, heart rhythm problems with chloroquine or hydroxychloroquine, particularly when taken at high doses or in combination with the antibiotic azithromycin," the EMA said in a statement.

They could also cause liver and kidney problems, nerve cell damage that can lead to seizures, and low blood sugar, it said.

READ MORE | 'Serious side effects' from Trump-backed virus drugs: EU agency

Saudi Arabia, home to Islam's holiest shrines, has announced that the holy fasting month of Ramadan will start Friday, as Muslims worldwide face unprecedented restrictions to counter coronavirus.

"Based on the sighting of the new month's moon ... it has been decided that Friday is the start of the month of Ramadan," the royal court said on Thursday in a statement cited by the SPA news agency.

King Salman said he is saddened that Muslims cannot pray at mosques because of coronavirus restrictions.

"I am pained that the holy month arrives amid circumstances that make us unable to perform group prayers and Taraweeh - special Ramadan night prayers - at mosques due to precautionary measures to protect the peoples' lives and health in combating the coronavirus pandemic," the king said in a statement cited by SPA.

READ MORE | Saudi Arabia announces Ramadan starts Friday amid virus fears

LATEST RESEARCH

The continued ban on cigarette sales during lockdown appears to be a bone of considerable contention. From a general health perspective, the message is pretty clear – smoking is bad for you, and at Health24, we agree – the studies are clear, and we have a section dedicated to stopping smoking – here. 

This stance won’t change, but, in relation to this unprecedented period in our history, we are still not clear on the relevance of this ban to the lockdown.

The word draconian crops up regularly, to describe the ban – frankly, warnings regarding smoking have been around for years, it’s front and centre on packaging, yet people still choose to smoke.

So, why has this choice been taken away? We reached out to a few medical experts to find out more.

READ MORE | Five medical experts weigh in on the lockdown cigarette ban

Even as scientists are slowly learning more about the new coronavirus, the virus which causes Covid-19, there are still many grey areas.

One of these is whether someone who became infected with the new coronavirus and contracted Covid-19 will be immune against the virus.

Experts can’t provide a clear answer at this stage, even though it’s assumed that once you get ill from a virus, you acquire immunity, even if it's just for a short while.

"Being immunised means that you have developed an immune response against a virus such that you can repulse it," stated Eric Vivier, a professor of immunology in the public hospital system in Marseilles in a news report.

READ MORE | Scientists unsure about immunity after recovery from Covid-19

Preliminary data from two clinical trials using the antiviral drug remdesivir to treat Covid-19 patients is encouraging, researchers report.

One trial is providing the drug to patients with moderate illness and the other focuses on patients with severe illness.

A number of the patients are now recovering and have been released from the hospital. While it's too early to tell, the researchers said there are also indications that remdesivir can possibly stave off being put on a ventilator.

"Early results are promising, and that is important right now. Much of what we are learning about Covid-19 management is centred around preventing quick deterioration. Timing is everything. I can't say for certain they [patients] would have been intubated otherwise, but it's encouraging," said Katherine Perez, an infectious diseases pharmacist who is co-leading the trials.

READ MORE | More good news on remdesivir's power to treat Covid-19

As researchers hunt for ways to treat severe Covid-19 infections, a new trial will ask whether an old arthritis drug can prevent serious complications in the first place.

The medication, called colchicine, is an oral anti-inflammatory that has long been prescribed for gout, a form of arthritis. Its history goes back thousands of years, and the drug was first sourced from the autumn crocus flower.

Doctors also sometimes use colchicine to treat pericarditis, where the sac around the heart becomes inflamed.

Now researchers in the United States and Canada are testing it for a different purpose: Keeping high-risk Covid-19 patients from getting sick enough to land in the hospital.

READ MORE | Could an ancient drug help fight severe Covid-19?

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