CAPE TOWN- South Africa's healthcare system's responsiveness to the Covid-19 pandemic has been world-class, and with evidence showing the decline in transmissions, the government decided to move the country to alert level 1 of the national lockdown from Sunday at midnight.
Medical Director at LeGulo Africa, Dr Tshidi Gule, addresses the current medical state of the nation and whether we still have cause for concern in the short- and long-term.
A Move to Level 1
With a recovery rate of 89.6 percent which was achieved in six months, a fatality rate of less than the world average for the virus at 2.3 percent, and new cases receding to just below 1,500 cases per day, one could not be more relieved at the scientific data presented by the Department of Health during September 2020.
It has demonstrated the desired health outcomes every medical professional who has complied with the country's leadership call to contain this virus, as well as the majority of citizens' responsible contribution to reducing transmission. So, the question worth answering now is - What does the country's long-term health destiny look like with Covid-19 as a companion for the next 12 to 24 months?
One should not be too naïve as to ignore the reality that the virus has resurfaced in countries that had previously eradicated its transmission. In his address to the nation on 16
th of September, President Cyril Ramaphosa emphasised this risk. Factors affecting this resurgence have largely been placed at the increased mobility, both internally and by opening the borders.
This increased mobility, which on the economic side will be necessary, deems it wise to project that as soon as South Africa joins the call to re-open its borders, preparation must be made to expect more infections and reduce the impact of new cases, by continuing to employ the best screening methods to assess incoming travellers and lobbying local citizens to not renege of existing hygiene practices.
The reality of the economy's needs must now be balanced with active health vigilance and monitoring the risk of resurgence. This is going to decisively determine whether South Africa falls victim to a resurgence or whether it truly earns a badge of resilience against the pandemic as a developing country that understood and appreciated its obligations to protecting all humanity, especially with its historic divisions when it comes to the poorer social groups. The escalating unemployment rate that has overshadowed the success of the first wave of the pandemic is a lurking and disturbing shadow that threatens to unravel the progress made should it not be met with urgency and swift socio-economic remedial actions.
Health Vigilance - The Future
To contain the ongoing risk of Covid-19 amongst citizens, the Department of Health is expanding criteria for Covid-19 testing to include the following groups:
All patients admitted to hospitals,
Outpatients who present with symptoms of Covid-19, and
- Symptomatic and asymptomatic close contacts of individuals confirmed to have Covid-19 infection.
Increased contact tracing support is provided through commendable health technology developed by the department, mainly:
- The Covid-19 alert South Africa app (a very comprehensive tracking app available to all citizens with smartphones on Google Play and Apple store). This app is zero-rated by cell phone networks and alerts all citizens who have been exposed to a positive Covid-19 case over a 14-day period, and
- The Covid-19 Connect WhatsApp network which has been active in educating citizens on Covid-19 support channels since the beginning of lockdown.
The Department of Health plans to launch a nationwide seroprevalence study to assess the actual infection rate in the country through antibody testing. Research groups will be identified as this forms part of any scientific model where severe pandemic and epidemic exposure has occurred.
Citizens should appreciate that studies like this are necessary for medical surveillance and provide necessary information to the scientific community for health intelligence to be developed to protect them from further disease exposure and complications. Knowing how many citizens who have contracted Covid-19 unbeknownst to them is one example of how these studies impact healthcare planning positively through accurate transmission assessment and assessing immunity patterns between provinces.
The seroprevalence study is crucial for the long road ahead, as more than 58 million lives need answers on whether Covid-19 will continue to claim lives for many years to come. Also, our way of living in the new world will be determined by the results of such mass surveys. To get back to normal, we must understand what that new baseline is. And the study outcomes will paint a more practical picture that all stakeholders can move forward from.
The Road Ahead - What Citizens Need to Know Now
This year has been one long defining moment for citizen advocacy as each member of society has now experienced the full anxiety-driven rollercoaster of the impact of a pandemic, a phenomenon that last hit the world back in 1918. We have experienced the breadth, heroism and, limitations of science and technology (there is no truth to the notion that vaccines are developed overnight, no matter how sophisticated the system). We have also observed the best and worst of human nature as economic survival and social resilience were tested to the core during these first six months of recovery. So, what are the key lessons to digest as we navigate the future?
Viruses are one of the stealthy and most problematic pathogens to ever roam the planet and they are devastating if not contained. Prevention is the decisive model of containment - through restrictions that reduce transmission. There is no magic pill. Vaccines contain further spread but are not developed overnight.
Viruses kill. This makes them merciless to families and communities who lose loved ones during this time. Acting responsibly collectively shows respect to those who have had to grieve those whose lives are equally important and valuable. Continuing to act responsibly is a sign of respect for life.
Safety first. Everywhere we travel from now on, the health and safety of everyone should be top of mind. This virus is not a hoax, it has proven itself beyond a shadow of a doubt. Our increasing freedom of movement will be reliant on our commitment to safety, of self and others.
Negligence does not pay. Anyone who continues to flout the law in favour of a short-lived good time behaving recklessly will eventually experience medical and legal consequences.
Positive health habits are in. If you have been wondering what the long-term 'fix' to life with Covid-19 is, this is ultimately it.
Cultivating a list of consistent health habits to improve your own wellbeing physically and mentally is the blueprint for survival, sanity and returning to the best that life still has to offer. These habits must include:
- Being actively involved in the ongoing screening campaign by signing up to the Covid-19 alert South Africa app, especially if travelling,
- Understanding your immune system and where appropriate being on supplementation to support its function,
- Joining health forums led by accredited health experts for the most accurate information on Covid-19 (do not consume all news as true, this is critical),
- Managing work demands on a sustainable office/remote work schedule,
- Assessing your current health plan to ensure it covers possible Covid-19 infection,
- Acting early when suspecting you may have contracted the infection,
- Understanding your company's policy when it comes to managing Covid-19 at the workplace,
- Negotiating health days if infected by Covid-19 with your employer,
- Educating your loved ones on how to communicate on their physical and mental health regularly,
- Encouraging open communication in the family to avoid members suffering from ongoing mental health distress,
- Understanding school policies on Covid-19 and supporting stakeholders to educate your children on the new world,
- Wearing personal protective equipment when interacting with the outside world until regulations deem it no longer necessary, and
- Being a positive and encouraging voice online that disseminates only accurate information when supporting others through the pandemic.
Our Future Re-imagined
The next few years will see all countries redesign the social, cultural and recreational activities to fit the demands of the post-Covid-19 pandemic. While South Africa starts to grapple with the first chapters of this, every citizen is encouraged to not lose sight of the hard work already done and to encourage others to adopt a mindful approach to self and community.
Throughout this pandemic, new life has been happening as much as the deaths. The future rests on our willingness to remember that every generation deserves to live in a world that has been handled with respect, responsibility and care by those who live in it. That sense of passionate advocacy not only rests on issues such as climate change, hunger, poverty, and violence. It now rests on the right to health, and we are all responsible for the execution of that right.
The Covid-19 storm is over, for now. It is important that this is the narrative we uphold for the months to come.
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