Lockdown necessary but more testing crucial

09 April 2020 | Story Supplied. Photo DarkoStojanovic, Pixnio. Read time >10 min.

It is easy to throw stones at idiosyncratic bits of South Africa’s COVID-19 lockdown programme, but it was the right move, said the University of Cape Town’s Professor Robin Wood, at a MedicalBrief webinar. Wood repeatedly stressed the need for more testing.

The webinar on Tuesday 7 April, titled “COVID-19 transmission: Aerobiology research implications for hospitals, medical practices and everyday life”, screened an interview with Wood by MedicalBrief Managing Editor William Saunderson-Meyer, followed by questions. 

Wood spoke, among other things, about the pandemic in South Africa, government actions, and whether high HIV and TB prevalence might make the country particularly vulnerable to COVID-19, or whether – as some have suggested – people on antiretrovirals might be less vulnerable.

Coronavirus and South Africa

Asked how COVID-19 might play out in South Africa, and whether there are things that should be being done but are not, Wood’s main concern was that not enough testing is being done. There are good reasons and nobody to point fingers at, but testing is an urgent need, he says.

There are two components to COVID-19 action advice. “One is separating people and decreasing the number of people you meet, which is obviously social distancing. The other is the efficiency of transmission – trying to decrease that using the other methods.”

 

“My highest priority is to protect the elderly.”

In principle, the government has done the right thing by implementing a lockdown. Even though some things have not been properly thought through, such as the secondary consequences of laying people off and the pre-lockdown wave of possibly infected young people returning to rural areas.

This reminded Wood of the 1918 Spanish flu pandemic: “We had double the mortality rate that happened anywhere else because we disseminated the virus very rapidly. I think we should have protected rural areas from the epidemic in the cities.”

On the positive side, South Africa has a young population, which “might reduce the impact of the virus, along with other factors”. But Wood is concerned about the effectiveness of distancing strategies for people living in very poor conditions. This should be a focus.

“My highest priority is to protect the elderly.” Older people in rural areas should have been given supplies and support, along with help for people in old age homes.

The COVID-19 death rate rises above the age of 60 to the 80s, “where it really takes off. The death rate is related to age factors and also to the availability of health care and the overwhelming of health care systems,” says Wood.

“We have to protect our health care system, because it is going to be stretched. We are a middle-income country, so we have to preserve our resources and our medical staff are a particularly important resource.” 

One reason why distancing strategies are being used, Wood continues, is lack of understanding of COVID-19. “We can’t identify the sick and the transmitters, so therefore we take the whole population and try to apply something that seems like the intuitively right thing to do.”

While there have been difficult unforeseen circumstances, “having seen the explosion of the epidemic in other countries, it is not unreasonable for our leaders and politicians to do the fastest and easiest thing”. Retrospectively, it is also possible to argue what the smartest strategy would have been.

 

“The other thing is we are coming in to the flu season, in the next two or three months.”

With its relatively low number of infections and deaths, South Africa will only see in the coming weeks whether it will follow the trajectory of countries in the northern hemisphere.

But it would have been wrong not take action against the virus in the hope, for instance, that a hot climate would make a difference – although time will tell, says Wood. Scientists are looking at climate but the feeling is that COVID-19 is probably less impacted by environmental conditions than seasonal flu. “The other thing is we are coming in to the flu season, in the next two or three months.”

And while South Africa’s low death rate is good news, “experience of other countries would suggest we don’t take too much encouragement from that”. It is also likely there will be COVID deaths that are not counted. “We are not testing. Testing ability also changes that.”

A crucial need for more testing

Given the difficulty in identifying COVID-19 and its rapid unfolding, Wood continues, “we have to put major effort into testing”. A problem has been starting with very few tests, although there have been efforts to increase the number.

“Biotech companies around the world are also increasing the spectrum of tests.”

New research and information needs to be accessed quickly and applied straight away. “We’ve got a moving target and we’re trying to measure aspects of that moving target.”

 

“So this is a rapidly changing field and we need to get an idea of which tests are likely to be most successful, and then they need to be scaled up.

There are various means of testing via respiratory sampling, such as a throat or nasal swab or sputum. Testing is “changing by the minute”. There is a reasonably affordable serological test coming available from Abbot, looking for antibodies in the blood, “which is a totally different way of diagnosing the disease as opposed to respiratory samples”. There are probably also blood tests coming. “They’re all racing like mad to get these things out.”

The so-called PCR respiratory sampling test Wood’s research uses amplifies the RNA – the genetic code of the virus. The results take a long time, whereas blood and other tests may be able to provide answers in minutes, or at least an hour or two.

“So this is a rapidly changing field and we need to get an idea of which tests are likely to be most successful, and then they need to be scaled up.

“Because essentially we’ve got two ways of tackling this epidemic. One is social distancing and decreasing the efficiency of transmission between people, and the other is actually finding out who has got the disease – who is transmitting it, and targeting those people. That would probably be a combination of respiratory sampling and blood sampling,” Wood says.

COVID-19, TB and HIV

There have been conflicting arguments over whether COVID-19 makes South Africa, with its high HIV and TB prevalence, more or perhaps even less vulnerable. 

In Europe researchers did not find the presence of HIV to be a major factor in the pandemic, and there is not enough data to suggest antiretrovirals might be protective. “The feeling is that HIV individuals on appropriate antiretrovirals are not particularly at excessive risk compared to the rest of the population. Obviously, age is probably more important as your risk,” says Wood.

He is concerned about a possible link between COVID-19 and TB. “There was one bit of preliminary data from China to say that there may be some link between the two epidemics. Certainly I think it is an interesting area of research.”

Wood pointed out that TB and COVID present with almost identical symptoms. “There is fever, shortness of breath and body aches”. There is a need for tests appropriate for TB and appropriate for COVID-19. “People may have either-or, or both.”

It is important, Wood stresses, to see early on if there is a link between TB and COVID-19, because South Africa has the highest TB rates in the world. Importantly, the country is also in a good position to find answers.

Listen to a podcast of the MedicalBrief webinar question-and-answer session.

This article was initially published by MedicalBrief.

For licensing information please visit the source website.

UCT’s response to COVID-19

COVID-19 is a global pandemic that caused President Cyril Ramaphosa to declare a national disaster in South Africa on 15 March 2020 and to implement a national lockdown from 26 March 2020. UCT is taking the threat of infection in our university community extremely seriously, and this page will be updated with the latest COVID-19 information. Please note that the information on this page is subject to change depending on current lockdown regulations.

Minister of Health, Dr Joe Phaahla, has in June 2022 repealed some of South Africa’s remaining COVID-19 regulations: namely, sections 16A, 16B and 16C of the Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions under the National Health Act. We are now no longer required to wear masks or limit gatherings. Venue restrictions and checks for travellers coming into South Africa have now also been removed.

In July 2022, the University of Cape Town (UCT) revised its approach to managing the COVID-19 pandemic on UCT campuses in 2022.
Read the latest document available on the UCT policies web page.

 

Campus communications

 
2022

Adjusting to our new environment 16:50, 23 June 2022
VC Open Lecture and other updates 17:04, 13 April 2022
Feedback from UCT Council meeting of 12 March 2022 09:45, 18 March 2022
UCT Council
March 2022 graduation celebration 16:45, 8 March 2022
Report on the meeting of UCT Council of 21 February 2022 19:30, 21 February 2022
UCT Council
COVID-19 management 2022 11:55, 14 February 2022
Return to campus arrangements 2022 11:15, 4 February 2022

UCT Community of Hope Vaccination Centre

On Wednesday, 20 July, staff from the University of Cape Town’s (UCT) Faculty of Health Sciences came together with representatives from the Western Cape Government at the UCT Community of Hope Vaccination Centre at Forest Hill Residence to acknowledge the centre’s significance in the fight against COVID-19 and to thank its staff for their contributions. The centre opened on 1 September 2021 with the aim of providing quality vaccination services to UCT staff, students and the nearby communities, as well as to create an opportunity for medical students from the Faculty of Health Sciences to gain practical public health skills. The vaccination centre ceased operations on Friday, 29 July 2022.

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.

 

“After almost a year of operation, the University of Cape Town’s (UCT) Community of Hope Vaccination Centre, located at the Forest Hill residence complex in Mowbray, will close on Friday, 29 July 2022. I am extremely grateful and proud of all staff, students and everyone involved in this important project.”
– Vice-Chancellor Prof Mamokgethi Phakeng

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.


Thank You UCT Community

Frequently asked questions

 

Global Citizen Asks: Are COVID-19 Vaccines Safe & Effective?

UCT’s Institute of Infectious Disease and Molecular Medicine (IDM) collaborated with Global Citizen, speaking to trusted experts to dispel vaccine misinformation.



If you have further questions about the COVID-19 vaccine check out the FAQ produced by the Desmond Tutu Health Foundation (DTHF). The DTHF has developed a dedicated chat function where you can ask your vaccine-related questions on the bottom right hand corner of the website.

IDM YouTube channel | IDM website
 

 

“As a contact university, we look forward to readjusting our undergraduate and postgraduate programmes in 2023 as the COVID-19 regulations have been repealed.”
– Prof Harsha Kathard, Acting Deputy Vice-Chancellor: Teaching and Learning

We are continuing to monitor the situation and we will be updating the UCT community regularly – as and when there are further updates. If you are concerned or need more information, students can contact the Student Wellness Service on 021 650 5620 or 021 650 1271 (after hours), while staff can contact 021 650 5685.

 

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