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SA's COVID-19 roundup – 23 April 2020: 45,000 deaths expected over next 2-3 years

According to data from the National Institute of Communicable Diseases (NICD) as at 21 April, the total number of confirmed COVID-19 cases in South Africa is 3 465 with the death rate at 58.

The total number of tests conducted to date is 126 937, of which 5 427 were done in the last 24 hours.

Up to 45,000 South Africans are expected to die from COVID-19 over the next two to three years. The Times reports that this is according to one of the doctors advising President Cyril Ramaphosa, Professor Shabir Madhi, of Wits University who said: “We are not returning to normal for the next two to three years.” Also, we should prepare ourselves for waves of the epidemic over that period and accept that intermittent lockdowns will become part of life.

The report says this is a shocking number, but it is much lower than an earlier estimate of between 120,000 and 150,000 fatalities.

Madhi said new information showed that between 50 and 80 times more people are infected than we thought, but they are asymptomatic. This, in turn, showed that the mortality rate would be lower than expected. “The only information we had in the early days from China was that a vast majority would be symptomatic,” Madhi said. “Based on that modelling, we felt at least 120,000 would die in South Africa because of COVID-19.”
Since then, studies in the US, China and Iceland have shown that at least 50% of infected people are asymptomatic and that "changes the numbers completely”.

The Times report quotes Mahdi as saying, however: “This is not a short-term crisis that is going to be sorted out in the next few months. We might see a huge upsurge in cases and at least three to four epidemics over the next few years.” He said the new information had “huge implications in terms of quantifying the number of infections” and also had implications for lockdown.

The state laboratory says that it is collecting all the data that scientists need to monitor South Africa’s COVID-19 epidemic effectively, dispelling reports to the contrary. Business Day reports that at issue is the extent to which the National Health Laboratory Service (NHLS) is capturing information on the nationwide community screening programme currently under way, as it is vital for monitoring the trajectory of the disease.

Tracking the extent of community transmission is vital for gauging the effects of South Africa’s lockdown – one of the most stringent in the world – and helping the government decide how and when to lift some of the restrictions on trade, travel and social interaction, according to the government’s chief scientific adviser on COVID-19, Professor Salim Abdool Karim.

Until now, details about which cases were of people who had self-referred and which had been identified during community screening, were not routinely reported by the NHLS. But since the information is required on the forms that are filled out to request tests, it can easily be extracted, said Kamy Chetty, CEO of the NHLS. The NHLS has sent regular reminders to health-care personnel about the importance of filling in all the details on the forms, she said. The NHLS aims to provide up to 36,000 tests a day by the end of April. It is currently meeting demand for testing, and doing about 12,000 tests per week, Chetty is quoted in the report as saying.

Of the 6,947 contacts of people who tested positive for COVID-19 in Gauteng, nearly 3,000 have completed quarantine. But, Polity reports, according to the Gauteng Health Department, another 4,032 contacts remain under daily monitoring.

"The Gauteng Health Department has intensified the large-scale community screening and testing at various communities, hospitals, mental health facilities, primary health facilities and correctional services facilities," Kekana said. "After obtaining further information on contact numbers and addresses from law enforcement agencies, provincial outbreak teams and the National Institute for Communicable Disease (NICD), we are able to make corrections where a case might have been incorrectly allocated to a particular district," Kekana concluded.

[link url="https://www.timeslive.co.za/news/south-africa/2020-04-21-expect-45000-deaths-and-two-to-three-years-of-intermittent-lockdowns-says-expert/"]Full report in The Times[/link]

[link url="https://www.businesslive.co.za/bd/national/health/2020-04-20-state-lab-says-it-can-provide-all-the-data-needed-to-track-covid-19/"]Full Business Day report[/link]

[link url="https://www.polity.org.za/article/gauteng-health-dept-still-monitoring-4-032-contacts-of-people-who-tested-positive-2020-04-21"]Full Polity report[/link]

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