Minister of Health Zweli Mkhize said we are going to see a rapid rise in the cumulative number of positive COVID-19 cases indicating that, as we had expected, we are approaching a surge during the latter winter months of July and August.
It is anticipated that while every province will unfortunately witness an increase in their numbers, areas where there is high economic activity will experience an exponential rise – beginning with Gauteng and Western Cape and followed by Eastern Cape and KwaZulu-Natal.
Mkhize said that in the next coming days, Gauteng will emerge with the highest COVID-19 numbers. Factors contributing to this trend are inward migration; the large population (especially in metros like Johannesburg, Ekurhuleni and Tshwane); increased congregating which spurs cluster outbreaks; and the level to which people are able to adapt to new behaviours such as social distancing and the wearing of masks.
When the national lockdown was eased to level three, there was a large inward movement of people as economic activities resumed. The surge that has been witnessed in the past two weeks has developed due to seeding of infections carried in by members of the community as they moved back into the workplace. It was therefore inevitable that there would be cluster outbreaks as infections spilled over from communities into places of congregation such as mines, factories, taxis and busses. (We have indeed witnessed this in the mining sector in the North West where cluster outbreaks in the the mines have driven a sudden increase in the numbers in this province.)
It therefore remains critical to have well-established screening programmes in place at all junctures where people transition into high-density areas like in the mining sector, where we have observed quite a number of cluster outbreaks as miners return to work.
He said they have been engaging the Gauteng MEC for Health as well as the Provincial Department to ramp up their capacity expeditiously.
In the next few days, the testing backlog will be cleared and the numbers we see will be based on a much shorter turnaround time. They have identified the need to increase COVID-19 hospital beds in this province and they will be supporting the province to ensure that they are capacitated to meet the rising demands.
In addition to regular hand washing, social distancing and the correct wearing of masks at all times, early case detection, contact tracing, quarantine and isolation are the key armaments we have in our toolbox to break the cycle of infection. The province is being engaged to strengthen their contact tracing and quarantine/isolation uptake.
The graph below clearly shows Gauteng’s steep upward curve denoting the largest surge in the country at present.
Meanwhile in the Western Cape, they have recognized that there were some key issues that led the province to having high number of cases. One of the main observations was that the the provincial strategy was mainly hospicentric- focusing on case management. Intensive contact tracing, quarantine and isolation programmes were suboptimal.
Since the intervention, the province has been working hard to address these gaps but we are receiving reports that most community members remain reluctant to subject themselves to quarantine and isolation, despite government having secured these sites in various parts of the province. Their concern is that this continues to exacerbate the risk of spread of infections in communities especially in households where it is practically impossible to self isolate given the limited space.
Although there may be provisions for authorities to enforce law, it is important for members of the public to partner with government in its efforts. They remain committed to work together with civil society in an empowerment exercise that enables each individual to make the right decisions – decisions that allow people to protect themselves, protect the elderly, protect those with co-morbidities and protect the poor and vulnerable.
Mkhize said they are working on a programme with social scientists and a new multi-sectoral Ministerial Advisory Committee on Social Behavioural Change to attain fundamental reform at grassroots levels for the sake of saving lives. It will be important to engage community, religious and traditional leaders who can motivate individuals to adhere to non-pharmaceutical interventions.
Having compared the real numbers with those depicted in predictive models, they have noticed that Western Cape hasn’t quite reached the surge as expected by modellers. The consortium has accordingly reviewed their models, taking into account what has been observed in actual terms.
Mkhize added that they are now reinforcing this support by deploying experienced senior managers to deal with the overall health systems management in the province and assist with the ground response. Once again, it will be important to carry out strong tracking and tracing systems and optimize quarantine and isolation uptakes.