One 81 year old in ICU contracted the virus in an old age home in KZN (with update)
Minister Zweli Mkhize confirms total of 1170 cases of Coronavirus COVID-19
27 Mar 2020
Today, South Africa has 1170 confirmed cases. This is an increase of 243 new cases from yesterday’s announcement.
The total number of tests conducted to date is 28 537.
REPORTED DEATHS:
This morning we reported that two deaths had occurred as a result of the COVID-19 virus. The first patient was a 48 year old female who tested positive for COVID-19 on the 23rd March 2020. She was suffering from pulmonary embolism. This means she had an underlying disease.
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The second patient who died was a suspected case based on her clinical presentation. The clinicians who were treating her have reported to us that this was a 28 year old female who had presented at the hospital in respiratory distress. At the time of presentation she was hypoxic. She was intubated and transferred to hospital during the early hours of this morning, (ie 27 March 2020 at 3am). On arrival in ICU, she was declared dead. The clinical picture was suggestive of COVID-19 and therefore a test was conducted. Her laboratory results have since been received at 17:20 and were confirmed negative. Her immediate family was also tested and they are also negative. She is therefore no longer considered a COVID-19 case.
This therefore means there is only one confirmed death caused by COVID-19 in South Africa.
I have been informed that the health workers that managed this patient have been debriefed and counselled. I am aware that the public interest around COVID-19 may end up making them feel like they did not perform their duties with outmost care. As a clinician myself, I want reassure them that making such a diagnosis on presentation is line with our plea to them to keep a high index of suspicion so as not to miss a diagnosis of COVID-19.
This is common practice, medical doctors often make a diagnosis based on a clinical presentation and physical examination of a patient. They then conduct further tests to confirm or disprove the diagnosis. In this instance, doctors and all health workers involved exercised clinical judgment and took extra precaution in managing this patient. We support this approach.
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I therefore want to acknowledge and appreciate all our doctors, nurses and all the health workers who were treating these patients. We salute them for their dedication in the service of the nation. We urge them to remain courageous and focused. We also want to assure all our health workers in the country, who remain in the frontline of this pandemic, as the Department of Health and government as a whole, we will do everything in our powers to provide the support required for them to execute their duties. Overwhelming as circumstances may be, we ask you to keep up the fight. This is only the beginning and your commitment assures us that we will overcome.
COUNTRY SYNOPSIS:
To give a synopsis of what is currently occurring in the country in relation to confirmed COVID-19 patients:
- Total number of patients in hospitals (both public and private) : 55 - Total number of patients in ICU : 4 - Total number of patients in ventilation : 3 - Total number of recoveries : 31 - Contacts of the patients that have been identified : 4407 - Contacts of the patients that have been traced : 3465
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CLINICAL OBSERVATIONS WE HAVE MADE THAT ARE OF CONCERN:
1. The infection of people with underlying concomitant diseases is increasing. This is well illustrated by the COVID-19 patient that has passed away in the Western Cape.
We therefore urge our citizens to be vigilant, protect themselves and not unnecessarily expose themselves by making contact with a lot of people. It is important to remain in your home, create a distance between yourself and anyone, including family members, that are unwell.
These are some of the underlying medical diseases that make people vulnerable:
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- HIV Positive people with a low CD4 count: This therefore emphasises the importance everyone to know their status, get tested and immediately start treatment should they test positive. - Chronic Lung Diseases, including TB, Asthma and COPD - Auto Immune Diseases of Any Kind - Chronic Kidney Diseases - Cancer - Diabetes
2. Other population groups that are vulnerable are:
- Smokers & dependant alcohol consumers. We encourage smokers to quit smoking and for those who drink alcohol, to do so moderately.
3. The elderly population in our society is vulnerable. To illustrate this, in KwaZulu-Natal, one of the confirmed cases is an 81 year old female who is now in ICU and in a ventilator. She initially presented with pneumonia and was admitted and treated as such. Because of the severity of the pneumonia, she was tested for COVID-19 and was confirmed. This elderly woman lives in an old age home. As a result, all other elderly people from this old age home are regarded as being vulnerable and are being tested. Those who will test positive will then be put in isolation.
4. There is an increase in the rate of internal transmissions. Patients without a history of travelling abroad have been detected in many provinces. The Free State province is such an example. The majority of 61 patients infected arose from the church conference which had five international visitors who subsequently tested positive for COVID-19. Amongst these, were various local church leaders who have since tested positive for COVID 19, thus making their own church members direct contacts. These church members have had to be screened and tested. The church leaders and members who were tested have since been put in quarantine.
It must be noted that these confirmed cases in the Free State province are concentrated in Mangaung and this requires dedicated focus of interventions.
All the above factors have emphasised the need to rapidly expand testing, early detection and early treatment. We are intensifying the offensive.
5. TESTING FACILITIES & BACKLOG IN PROCESSING TESTS:
We are aware that there is a significant backlog especially from some private laboratories due to pressure caused by the increasing workload.
We are pleased that the National Health Laboratory Services has increased its testing facilities. There are five laboratories in our academic hospitals in the country. These are in Inkosi Albert Luthuli Hospital, Charlotte Maxeke, Universitas, Tygerberg and Groote Schuur, in addition to the laboratory at the NICD, which is the reference laboratory. We are now extending them to Tshwane Academic, Walter Sisulu and Port Elizabeth.
We have 7 mobile testing laboratories and in April we will have a total of 47 which will spread all over the country. By the end of April, we will be able to do 30 000 tests per day if required and we continue to source suppliers of test kits from different suppliers so that we can meet the demand.
WORLD HEALTH ORGANISATION INFORMATION SHARING MEETING WITH MINISTERS OF HEALTH
This afternoon, the WHO hosted an information sharing virtual meeting with Ministers of Health from all over the world. This follows the G20 leaders virtual meeting that His Excellency, President MC Ramaphosa attended yesterday with other world leaders.
Various informative presentations were conducted by the WHO and different countries. A series of questions that we had as Health Ministers were also responded to. It is clear that this pandemic is a major threat to all countries and we must join our hands together to fight it.
One of the important factors confirmed in this meeting is that there is no proven therapy for COVID-19. At this stage, there is ongoing therapeutic research and vaccine trials at different stages of progress. There are 50 different candidates of vaccines that are in their early stages. The WHO estimated that it may take a minimum of 18 months to have a vaccine that is confirmed. South African institutions are also participating in the global research program in search of a solution to the COVID-19, under the guidance of WHO.
The number of #Covid19SA cases has increased by 243 as of 27 March 2020 bringing the total number of laboratory confirmed COVID-19 cases to 1170. pic.twitter.com/4VoKw8MVe3
Fellow South Africans, as at today, the total number of confirmed COVID-19 cases is 1187. We must outrightly state that these numbers do not indicate a reduction in the number of infections. It is merely a reflection of positive results that were received, verified and ready for today’s reporting.
The provincial breakdown is as follows:
GAUTENG
533
WESTERN CAPE
271
KWAZULU – NATAL
156
FREE STATE
68
NORTH WEST
6
MPUMALANGA
10
LIMPOPO
11
EASTERN CAPE
10
NORTHERN CAPE
5
UNALLOCATED
117
HEALTHWORKERS INFECTED:
We have noted with concern a number of confirmed COVID-19 cases of health workers who work both in the private and public hospitals. This includes doctor and nurses. We mention this because health workers are in the frontline of this battle. They are exposed not only to their families but to the patients who they are meant to treat.
Some of the confirmed COVID-19 cases that involve health workers are as follows:
– In Limpopo, 1 medical doctor tested positive after he had travelled abroad for holiday started experiencing symptoms on his return. He immediately decided to quarantine himself. This young doctor remained in quarantine to ensure that he does not transmit the virus to other people. His 14 day quarantine period has ended and we are pleased to report that his results have now been confirmed negative.
– In Mpumalanga, 1 medical doctor who had also travelled for a holiday abroad returned to the Province with symptoms which emerged a few days after he returned. Before then, he had been having interactions with staff and patients. He then tested positive and was quarantined. This led to other health workers who had come into contact with him to be screened, quarantined and tested. A decision was also made for that section of the hospital to be closed in order to disinfect it. This has been completed and it will be reopening during the course of next week.
– In Free State, we have received a report that 3 doctors, 1 nurse and 1 neurophysicist have tested positive for COVID-19.
– In Gauteng, 6 medical doctors have been infected in Gauteng. All these health workers are in a good medical condition with most of them having mild or no symptoms. It is only one doctor in the Free State aged 70, who is in ICU. It must be emphasised that none of these health workers were infected by patients that they were treating. They came into contact with their family members, friends and other colleagues who had tested positive for COVID-19. All individuals who were identified as contacts of these health workers have been put in quarantine and are being monitored.
FLU VACCINES
We must inform our people that South Africa received a very limited stock of flu vaccines. These are pre ordered a year in advance. At the time the country (both public and private) placed its orders, we had not anticipated this COVID-19 pandemic. This means that as it stands, our flu vaccines are understocked.
As government we have engaged with the pharmaceutical industry and it became clear that the distribution of this vaccine has to be rationalised and prioritised. We have therefore taken a decision that health workers in the country will be given priority in receiving the flu vaccine. This is precipitated by the fact that the country cannot afford to have them sick especially as the flu season approaches. This is one of the major lessons that we have learnt from countries that have experienced the COVID-19 pandemic.
We therefore plead for the understanding of all South Africans who may unfortunately not have access to the flu vaccine this year.
RESEARCH TRIAL
We are pleased that South Africa is participating in the Public Health Emergency Solidarity Trial that has been initiated by the World Health Organisation to conduct a clinical trial to find effective treatment for COVID-19.
WHO has convened an independent group of experts to review evidence from laboratory, animal and clinical studies to prioritize treatments for inclusion in the trial. This independent group identified the following treatment options for inclusion in the trial:
– Remdesivir : a drug which was previous used in an Ebola trial;
– Lopinavir/ritonavir : a licensed treatment for HIV/AIDS
– Lopinavir/ritonavir with interferon beta-1a : used for multiple sclerosis;
– Chloroquine or hydroxychloroquine : drugs used to treat malaria and rheumatology conditions respectively
All participating countries will adhere to the same methodology in order to facilitate the worldwide comparison of unproven treatments. Other countries that have already confirmed their participation in this trial are Argentina, Bahrain, Canada, France, Iran, Norway, Spain, Switzerland and Thailand. The South African Solidarity research team is led by Professors Helen Rees and Jeremy Nel, working 30 senior academics, researchers and clinicians from eight medical schools in the country (WITS, SMU, UP, UCT, Stellenbosch, NMU, UKZN, UFS, and the SA Military Health Service). They will be undertaking the study in fourteen leading hospitals across the country.
CITIZENS FROM WUHAN
Three weeks ago, His Excellency, President MC Ramaphosa bid farewell to our brave men and women from the SANDF, SAA pilots and crew members, and the National Department of Health doctors who were travelling to Wuhan, China to fetch our citizens. As it is known, they returned to South Africa and were staying at The Ranch Hotel, in Limpopo.
We had assured all South Africans that these citizens were all negative, they did not present any symptoms and therefore did not pose any risk of infection. However, we took extra precautions and quarantined them for a 14 day period. On arrival medical screening and COVID-19 tests were conducted. They all came out negative. We are very pleased to report to South Africans that these citizens conducted their second test in preparation for their exit.
These have all come out negative. They are therefore being prepared for vacating the Ranch Hotel.
We take this opportunity to appreciate the Limpopo Provincial Government and the people of Limpopo who despite their initial reservation, they came out in full support and assisted us in making this mission a success.
We also thank the Ranch Hotel and all its workers who were prepared to serve our compatriots, despite this pandemic being taboo in our country at the time. They have done a sterling job in making our people feel welcome back at home. This, we sincerely appreciate.
Dr Zwelini Mkhize
Minister of Health
Statement issued 28 March 2020
As of March 28, 2020, the number of #Covid19SA cases increased by 112 bringing the total number of confirmed COVID-19 cases to 1187. pic.twitter.com/qCmgoXJfMV
As at today, the total number of confirmed COVID-19 cases is 1280. This is an increase of 93 from the previously reported cases.
The provincial breakdown is as follows:
GAUTENG
584
WESTERN CAPE
310
KWAZULU – NATAL
167
FREE STATE
72
NORTH WEST
6
MPUMALANGA
11
LIMPOPO
12
EASTERN CAPE
12
NORTHERN CAPE
6
UNALLOCATED
100
REPORT OF A SECOND DEATH
It is with sadness that we announce the second death of a patient who had tested positive for COVID-19. The 74 year old male had been in ICU and ventilation in a private hospital in Ladysmith. He had travelled to Kruger National Park with his family and came back with flu like symptoms. He was confirmed to be COVID-19 positive on the 27th March 2020.
It has been reported to us that the deceased patient had an underlying skin cancer condition (melanoma), which had already complicated. He presented with the following symptoms: respiratory distress, shortness of breath, cardiac failure, decreased saturation and his temperature was above 38 degrees.
The deceased’s family, 14 health workers, including 3 specialist doctors, who were in contact with him are now in quarantine and being monitored. We express our condolences to the family and we thank the doctors and health workers who looked after the deceased patient until his time of passing.