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Infectious Diseases

09 September 2020

Coronavirus morning update: WHO backs SA's Covid fight, but Mkhize warns 'not over the worst yet'

SA is doing its best, we know it's very complicated but it is doing its best, WHO says; and the health minister says we are over the surge - but we are not over the worst yet.

WHAT'S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 640 441.

According to the latest update, 15 086 deaths have been recorded in the country.

There have been 567 729 recoveries.

So far, a total of 3.82 million tests have been conducted, with 12 213 new tests reported.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

World Health Organisation (WHO) director-general Dr Tedros Ghebreyesus has commended South Africa for the significant reduction in the number of Covid-19 cases and deaths in the country.

In a briefing on Monday, Ghebreyesus said: "South Africa is doing its best. We know it is very complicated but it is doing its best and we are very glad to partner and send our colleagues there to work with [the country] and it's an honour for us to support any country.

"With the current trend, we hope to further push it to a decline and further control the pandemic."

"I would like to thank the leadership of the president, [Cyril] Ramaphosa, not only in South Africa but in the whole continent, by helping to develop the continental strategy; one continental strategy and helping the continent to move as one," he added.

The organisation said South Africa reached out to it through strength - not weakness.

"In many ways, South Africa reached out to the WHO, not through weakness, but through strength in recognising that it had a complex outbreak in its hands and not that it needed the help of [the] WHO [but] what they wanted to do was to be able to work with the WHO to identify areas in which things could be done better," executive director, Dr Michael Ryan said.

READ MORE | South Africa reached out to us, not through weakness, but strength - WHO commends SA

Health Minister Zweli Mkhize says South Africa is over its Covid-19 surge and the sooner lockdown can be reduced to Level 1, the better, according to media reports.

According to TimesLive and BusinessTech on Monday, Mkhize, in interviews with media, was optimistic about South Africa's Covid-19 trajectory, saying the number of people testing positive everyday had declined from 11 000 to about 2 000.

He added that South Africa was over its Covid-19 surge, but warned against an early celebration.

"We never actually knew what to expect and the reality is that we can now safely say we are over the surge. We are not over the worst yet. We are worried about what may happen in terms of a resurgence in the country," Mkhize said.

He added that while an increase in numbers was expected with a relaxation of restrictions under lockdown Levels 3 and 2, this did not happen.

"It would have been logical that from Level 3 to Level 2, there would have been an increase in numbers, it didn't happen. We don't want to make conclusions, because we have seen what happened in other countries where there was a lull for a few weeks before a resurgence."

READ MORE | Mkhize says SA is over its Covid-19 surge, but warns against early celebrations - reports

Defy, with help from Denel, is building a suitcase-sized ventilator at its Durban factory.

According to the manufacturer, the ventilator is the first “intensive-care quality” ventilator to be manufactured on the African continent.

he ventilator was designed in partnership with the University of Cambridge Open Ventilator System Initiative team, as well as Defy’s Turkish owner Arçelik. Denel and local engineers were also involved in the design process. Prototype versions of Impilo were developed under the specifications of the UK Medicines and Healthcare Products Regulatory Agency (MHRA) and the World Health Organisation’s requirements for ventilators.

Defy worked with Denel, as well as 17 local suppliers – which are each responsible for various device components – to manufacture the Impilo ventilators.

“Impilo means ‘life’ in Zulu and Xhosa, which we think is a fitting name for a device that so many people depend on right now for their survival,” says Evren Albas, CEO of Defy Appliances. Defy previously said that it would include components used in the everyday production of core appliances.

Impilo is a full-function ventilator, which can be used in “invasive mode” - via tubes on sedated patients – as well as for “assisted” ventilation, to help patients who are awake with their breathing.

READ MORE | TAKE A LOOK: Defy's new SA-built ventilators are the size of a suitcase

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.

Early on Wednesday morning, positive cases worldwide were more than 27.43 million, while deaths were more than 894 000.

The United States had the most cases in the world - more than 6.32 million, as well as the most deaths - more than 189 000.

READ MORE | All the confirmed cases worldwide

Latest news:

A second wave of coronavirus infections "is coming" to the UK, a top World Health Organisation official has warned, as UK Health Secretary Matt Hancock urged young people not to "kill your gran" by spreading the virus.

Dr David Nabarro, the WHO's special envoy for the global coronavirus response, was asked if a "second wave" of coronavirus infections was imminent in the UK and replied: "It's coming."

"I don't like it calling it a second wave, I just say there are going to be more spikes and indeed some surges of cases because the virus hasn't changed.

"It's the same virus that came and caused so much trouble earlier this year.

"It's just been lurking, we've been very good at holding it back through restricting movement and lockdowns."

"Now as life gets going again, younger people are going to university, also there's some movement around with holidays and of course work - then I'm afraid it does mean the virus is going to come back."

READ MORE | Covid-19: UK government urges young people not to 'kill your gran' as the WHO warns of second wave

Shops and restaurants should cut the calories in their pizzas, fries, and garlic bread, the UK government has said, following research that suggests being overweight increases your risk of dying from Covid-19.

New government guidelines issued Monday say cafes, restaurants, and takeaways should cut the calories in most of their meals by 20%. Grocery stores should reduce calories in ready meals, fries, and garlic bread by 10% – but for pizzas this should be 20%.

PHE issued the guidelines after its research showed that being overweight increases your risk of dying from Covid-19. Morbidly obese people make up only 2.9% of the UK population, but almost 8% of all critical Covid-19 cases in intensive care units, data from the Intensive Care National Audit & Research Centre showed.

PHE gave stricter targets to restaurants, cafes, and takeaways because research shows that people consume on average 200 more calories a day when they eat there, as opposed to eating food from grocery stores. Pizzas from restaurants and takeaways can have up to 1,000 calories more than ones in shops and supermarkets, PHE said.

The measures are only voluntary — companies will not be penalized if they don't follow them. Health groups argue that fines or taxes would make the guidelines more effective.

READ MORE | Restaurants should cut calories in pizzas, fries to tackle obesity during Covid-19 - UK government

LATEST RESEARCH

The Covid-19 pandemic has shone a bright spotlight on the many previously ignored cracks in our society.

Just before the virus upended our fragile systems, climate change was one of the main topics dominating headlines, and big moves were being made to change global behaviour regarding single-use plastic and air-travel pollution.

As the pandemic hit and borders closed, bringing travel to a near standstill, many saw it as a chance for Mother Nature to take a breath. And indeed she did. A study published in Science of The Total Environment confirmed that greenhouse gas emissions had dropped to pre-World War II levels.

No one was flying or driving due to strict lockdown regulations, and factories had to close. According to Nasa and the European Space Agency, airborne nitrogen dioxide levels dropped drastically in China in January and February this year, and similar reductions were observed in Rome, Madrid and Paris.

Not only the air got a chance to recover, but there was also a sharp decline in beach pollution as Northern Hemisphere coasts were spared the customary invasion of summer crowds. Fewer tourists meant cleaner beaches all over the world.

But, unfortunately, this breather is only temporary. As more restrictions are lifted and people start travelling again, previous levels of pollution will return. A few months of environmental reprieve won't fix decades of damage.

READ MORE | Lower emissions, more plastic: Double-edged sword of Covid-19 on the environment

Scientists might have found a new link between chronic disease and Covid-19 that could explain why patients with comorbidities are so susceptible to the virus.

They think the answer may lie with plasmin, a type of enzyme in the blood that degrades plasma proteins. Its levels are normally elevated in those with underlying medical conditions like hypertension, diabetes, cardiovascular disease, cerebrovascular disease, and kidney disease.

One of these plasma proteins is fibrin, which appears when the blood is clotting and impedes the flow of blood. When the fibrin is broken down through fibrinolysis, protein fragments remain behind called D-dimer.

According to the study published in Physiological Reviews, the plasmin makes the virus more deadly and infectious by cleaving the spike proteins it uses to invade cells through the ACE2 receptors.

"Extracellular cleavage of virus envelope fusion glycoproteins by host cellular proteases is a prerequisite for the infectivity of respiratory viruses. The presence of a polybasic cleavage site that can be cleaved by furin-like proteases is a signature of several highly pathogenic avian influenza viruses."

Covid-19 patients show high levels of D-dimer, indicating higher levels of plasmin, which is an independent risk factor of disease severity and death alongside age and comorbidities.

"The existence of significantly increased fibrin degradation products and reduced platelets in severe Covid-19 patients is consistent with the presence of hyperfibrinolysis."

READ MORE | A blood enzyme might be the link between Covid-19 severity and comorbidities

Scientists are learning more about how Covid-19, the disease caused by SARS-CoV-2, affects pregnant women and their unborn babies during and after pregnancy. And based on a new, live systematic review by a team of international researchers, pregnant women with the disease may likely need intensive care and experience preterm birth.

The team, who compared the clinical features, risk factors, and outcomes of Covid-19 in pregnant and recently pregnant women with non-pregnant women of similar age, also found that being older, overweight, and having other medical conditions increase a pregnant woman’s risk of having more serious Covid-19.

The findings were published in BMJ.

Living systematic review (LSR) is an emerging approach that provides real-time, trustworthy evidence.

In their recent analysis, the team looked at 77 studies that reported on the rates, clinical features (symptoms, laboratory and X-ray findings), risk factors, and outcomes of 11 432 pregnant and recently pregnant women admitted to hospital and diagnosed as having suspected or confirmed Covid-19.

READ MORE | Pregnancy and Covid-19: What the latest science says

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