“Growing body of evidence shows that the fourth wave has been less severe and that COVID-19 cases have decoupled from hospitalisations and deaths. The time has come to normalise our COVID-19 response.”

During the fourth wave, we have seen a growing gap or “decoupling” between the high number of cases, and relatively low number of admissions and deaths compared to previous waves.

Our experts have found that while there were 14% more cases than the third wave peak, new admissions are currently only at 63% of the third wave peak. Deaths also stand at only 24% of the third wave peak.

This is attributed to high levels of protection among the general population as a result of vaccines and prior infection. There is also some early data suggesting Omicron may be less severe than Delta.

This is clear evidence that COVID-19 has reached an ‘endemic’ stage, and it supports normalising our response, which must be done by ending the National State of Disaster.

The National Minister of Cooperative Governance and Traditional Affairs, Nkosazana Dlamini-Zuma, must let the declaration expire this week, with the COVID-19 response integrated into normal public health provisions.

I also join the Western Cape Minister of Education, Debbie Schäfer, in calling for the scrapping of the 1M rule at schools, and for a full return to school for all learners, in all grades.

The consequences of not doing so, especially when noting this new health data, will be catastrophic for the future of our young people, especially for those in poorer communities. It must come to an end before Western Cape schools return next week.

“90% of the adult population in the Western Cape have protection against COVID-19 already”

The Provincial Department of Health has been closely studying the seroprevalence of COVID-19 in our communities and is finding higher levels of protection among the general population against COVID-19 already.

If we look at those who have protection from either prior infection or vaccination, we find that nearly 90% of adults had protection before the fourth wave.

If we look at those who had antibodies from infection only, we find that this figure varied between 40% and 72% depending on the patient analysed in the study.

We also found: 

25% higher protection in the public sector compared to the private sector.

People living with HIV (PLWHIV) have slightly higher protection, at 72% compared to public sector diabetics at 66%.

Hospitalised children have similar levels of protection to diabetics.

Our data also shows how being fully vaccinated resulted in a 3-times lower risk of COVID-19 admission, and nearly 4 times lower risk of COVID-19 death, when compared to those who were unvaccinated.

“We have recorded a notable decrease in patients dying from COVID-19 disease when comparing the fourth wave with the third wave”

The Western Cape Department of Health has also undertaken a rapid analysis of the first 50 deaths recorded in the public sector during the fourth and third waves. This was done to understand the impact of COVID-19, and whether the profile of those dying had changed.

The analysis was conducted by two highly experienced clinicians, independently, identifying four different categories of COVID-19 deaths:

COVID-19 disease: where there is evidence of COVID-19 pneumonia.

COVID-19 associated: where there is no evidence of COVID-19 pneumonia, but other underlying conditions worsened by COVID-19 infection including stroke, TB, and cancer.

Incidental: the death was clearly incidental and was recorded as such by the attending clinician.

Indeterminate: the data did not allow for the death to be classified in any of the above categories.
This analysis found that in the third wave 78% of the deaths analysed were caused by COVID-disease, but this reduced significantly to 50% during the fourth wave. At the same time, there was an increase in the proportion of COVID-19 associated deaths during the fourth wave, largely attributed to cancer and TB. Finally, the fourth wave started to see a noting of incidental deaths, when none were noted during the third wave analysis. This is when the death is not related to COVID-19 at all.

This corroborates our analysis of oxygen usage in the Western Cape during the fourth wave, which is a highly robust measure for COVID-19-caused hospitalisation. During the fourth wave, we did not record a growth of 50% in oxygen usage even at the peak, meaning that we stayed on the lowest tier of our trigger system.

All of this points to a less severe pandemic and is unequivocal support for the normalisation of our response to COVID-19.

“We have exited the peak of the 4th wave and we expect a continued decline in cases in the week ahead”

According to the South African COVID-19 Modelling Consortium (SACMC) case numbers were higher than predicted for the past week following a backlog in testing after the public holidays.

The SACMC are predicting fewer cases for the next week, which we will continue to monitor closely as it may point to us having left the fourth wave.

We will have exited the fourth wave once we have an average of 600 new cases a day. We currently have a total of 2013 cases a day, based on a 7-day moving average.

Our healthcare platform shows us that across the province:

The reproduction or “R” number remains below one. This shows us that we have exited the peak and that cases are continuing to decline.

The proportion of positive COVID-19 deaths has also decreased to an average of 40%.

New admissions to hospitals appear to have plateaued with 217 admissions per day.

We are seeing on average 25 deaths per day, which is comparably lower to previous waves.

“There has been a wave-on-wave decrease in hospital admissions since the second wave.” 

Since the second wave, we have seen a wave-on-wave decrease in the number of new admissions. At the peak of the second wave, we had a total of 369 new admissions a day in the public sector. In the third wave peak, this decreased to 297 and at the peak of the current fourth wave, we had 186 new admissions at peak, which includes incidental admissions.

Throughout the pandemic, our hospitals have been able to cope because, in anticipation of a fourth Wave, we established a 6-point resurgence plan. This plan uses hospital capacity as the most important measure, triggering and upscaling in its resource capacity to ensure we are always able to care for those in need.

Insofar as our healthcare platform is concerned:

The total daily bulk oxygen for the public sector is currently at 17.03 tonnes and we are using less than 50% oxygen compared to pre-COVID-19. This is significantly lower than previous waves and shows that our hospitals are coping well.

The Metro hospitals have an average bed occupancy rate of 90%; George drainage area hospitals are at 69%; Paarl drainage area hospitals at 73% and Worcester drainage area hospitals at 74%. Critical care bed occupancy rate for designated COVID-19 beds for the province at 51%.

COVID-19 and persons under investigation cases currently make up 13% of all available acute general hospital capacities in both Metro and Rural Regional Hospital drainage areas.

COVID inter-mediate care: the Brackengate Hospital of Hope currently has 95 patients and Mitchells Plain Hospital of Hope has 37 patients. Sonstraal currently has 31 patients, Harry Comay has 1 patient and Freesia & Ward 99 have 0 patients.

“Vaccines work – if you are at high risk, please get vaccinated.”

We continue to see low uptake in vaccines this month, following the festive season break. This is a trend that we are seeing across South Africa and globally.

I strongly encourage those of you who have not already done so to get vaccinated as we know it provides excellent protection against COVID-19, especially for those at high risk.

As a Provincial Government, we will continue to play our part and prioritise those at the highest risk of severe illness and death, including those 50 years and older and those who are immunocompromised.

By 12 January 2022, the total percentage of persons fully vaccinated in the province stood at 47.14% of the total adult population or 2 345 982 people. This is compared to 40.03% of the total adult population nationally.

The total number of adults who have received at least one dose of the COVID-19 vaccine stands at 2 663 359 people or 54% of the total adult population. The total number of children aged between 12 – 17 years, who are vaccinated stands at 115 871 or 17.93% of the total population.

Insofar as vaccine rollout for the total population is concerned:

Of those 60 years and older, 67.38% of the total population are fully vaccinated; 4.58% are partially vaccinated and 28.04% are unvaccinated.

Of those between 50 – 59 years, 58.58% of the total population are vaccinated, 4.53% are partially vaccinated and 36.88% are unvaccinated. 

Of those between 35 – 49 years, 49.72% of the total population are vaccinated; 5.73% are partially and 44.55% are unvaccinated.

Of those between 18 – 34 years, 34.31% are fully vaccinated; 8.11% are partially vaccinated, and 57.58% are unvaccinated.

By 12 January 2022, vaccinations administered in the Western Cape came to 4 530 563 and in the last 24 hours, the Western Cape administered 10 054 vaccines.

“Normalizing our response means greater personal responsibility. Let’s all play our part.”

As we push for a normalized response to COVID-19 and an end to the National State of Disaster, we will require greater personal responsibility by residents. Everyone has a role to play in ensuring we keep on moving forward.

How can you help?

If you have not yet done so, get vaccinated for additional protection.

Wear a mask, because the virus spreads through the air;

Ensure good ventilation, with lots of fresh air;

If you are gathering, do it outside; and

Adhere to the Golden Rules of Good Hygiene, including staying home as soon as you feel sick.

Issued by Western Cape Office of the Premier, 13 January 2022