Keep hotspots in lockdown, Eastern Cape health boss pleads

As the superintendent-general of the Eastern Cape Department of Health, Dr Thobile Mbengashe, starts his presentation to President Cyril Ramaphosa on the province’s current status in the Covid-19 pandemic he opens four graphs showing future projections. On all four there is a red line and a blue line.

The red lines represent a pessimistic outcome and the blue ones an optimistic outcome. The graphs contain projections for the number of active cases, hospital beds that will be occupied by Covid-19 patients, intensive-care beds that will be needed for Covid-19 patients and deaths. Even the optimistic outcome puts the number of deaths in the province at between 5,000 and 6,000.

At the bottom of the slide, he has written:

Current trajectory of detected cases: Pessimistic.

“The lockdown has worked. We were given a better chance to survive. We understood that if the lockdown was not successful we would have seen a huge surge in infections and our healthcare services would have been overrun,” he said. 

“The lockdown has pushed the curve down and really gave us some space. But we have to do some more work. The crisis level in the Nelson Mandela Bay Metro, the Chris Hani District [stretching from Cradock to Queenstown/Komani] and Buffalo City is growing much faster.

“The blue line will tell you that we anticipate over 150,000 active cases. That could change. The hospitals that we will require – those without ICU capacity – our hospital facilities will still cope with our problem. But if we go for the red line the hospital services will be caught in the surge. Even if we get the blue line, our ICU capacity is still way below what will be needed.

“It is where we are most exposed and it will have an effect on the number of deaths,” he said.

On Monday 18 May the province had 15 patients in intensive care with 12 being treated in private hospitals and three in public hospitals.

Mbengashe said that there were places, mostly in the rural parts of the province, where lockdown had ensured that the number of infections was low enough that health workers could trace each person who tested positive, provide them with quarantine and make sure that they recover.

“In the OR Tambo District [the former Transkei] and the Chris Hani District, the virus has gone into villages and communities. We are, however, still able to follow, screen and quarantine until the outbreak has stabilised.

“But there are areas that are the hotspots in the two metros. For these we still need lockdown. It can be narrowed even to just where the hotspots are.”

He explained that fixed teams were in the hotspots to find each person who tested positive at their place of residence.

“This is what we hope will keep us in the blue line. We are going to need a lot of resources,” he said.

As of Sunday 17 May, the province had 1,936 confirmed cases of Covid-19, with 839 recoveries and 35 deaths. A total of 37,712 tests had been carried out.

The province’s biggest metro, Nelson Mandela Bay, had 717 cases and Buffalo City Metro 608. But it is the rural districts of Chris Hani, with 202 cases, and OR Tambo, with 132 cases, that are giving the Department of Health sleepless nights. These districts were identified as highly vulnerable by the index developed by the Centre for Scientific and Industrial Research and Right to Care.

Over the past few weeks, epidemiologists have painstakingly followed the footprints of the virus throughout the province.

In Nelson Mandela Bay, 89 cases were traced back to a funeral in KwaDwesi, a funeral in Zwide and a large shopping centre in Uitenhage. On the other side of town, the virus was tracked to two private hospitals and two large shops in Walmer in Port Elizabeth (38 cases), a house party that contributed six cases and the offices of the South African Social Security Agency (five cases).

In Buffalo City, 29 infections were linked to the Westbank prison, with another 35 in the Westbank community and several others were linked to family gatherings.

In the OR Tambo District, events held by traditional healers and funerals accounted for the most transmissions. Funerals accounted for 40 of the registered infections.

In the Chris Hani District, 58 cases were directly linked to four funerals. DM/MC