[imagesource: AP Photo/Themba Hadebe]

Sometimes, amidst the daily headlines, it’s tough to find a ray of good news.

Sure, the internet is full of memes and lockdown song remixes, and animals enjoying the lack of human presence (but not all to do with our absence), but it’s also a reminder of how long and hard the slog that lies ahead will be.

With that in mind, it’s worth taking a look at the Daily Maverick’s article that highlights a few “spots of hope”, although it does come with a caution that there will be a ‘but’ for each of these spots.

Written by Ferial Haffajee, the article looks at some of the data available, and why that’s cause for optimism.

First up, Hope Spot 1:

The hard lockdown has worked. The draconian Level 5 lockdown has kept South Africa’s case numbers at a level that places it among the countries with the lowest caseloads, as this chart shows. It’s from a presentation that Health Minister Zweli Mkhize made to Parliament’s health committee on April 27.

But, Dr Adrian Puren of the National Institute of Communicable Diseases warns that, “We are in the amplification stage of the pandemic that requires control and mitigation. We tried to contain the introduction of the virus by case definitions that focused on travellers and their contacts, but we are seeing sustained human-to-human transmission in communities and significant clusters.”

Those clusters are worrying, and show the ripple of infection that just one mass gathering can cause.

With the switch from alert level 5 to alert level 4 on Friday, many fear that exponential growth may lie ahead. The numbers of confirmed COVID-19 cases should be taken in the context of increased testing levels, though.

Over to Hope Spot 2:

While every death is one too many, South Africans are not dying in the same numbers (even per capita) as in other countries. This may be because we are not yet in the eye of the Covid-19 storm. This chart shows that although the number of deaths (87) in South Africa is higher than Singapore and Taiwan, both city-states, and which have the lowest deaths in the world, South Africa is among the countries with the lowest number of deaths so far.

But, [Puren] warns against trying to impute a mortality rate at this point in the epidemic:

“We should be cautious when trying to calculate a CFR during the course of an epidemic. There may be underestimation/overestimation of the actual number of cases or under/over-estimation of the number of deaths.”

Again, our testing will need to accelerate before we can accurately work out our CFR, which brings us to Hope Spot 3:

Testing is picking up as the 67 mobile units of the National Health Laboratories Services increase their ability for mass community testing. In a presentation by Mkhize on April 27, you can see that 168,000 tests across the private and public labs have been done…

Mass testing enables a country to build an accurate infection profile on which to base decisions such as the level of lockdown to be engaged.

Waiting for the ‘but’? Well, our testing per capita is still quite some way off where it needs to be. The latest stats from Worldometer show that the US is testing more than 17 000 people per million citizens, Italy close to 30 000, Germany close to 25 000, and South Korea around 12 000.

South Africa, according to the latest stats, is running around 3 000 tests per million citizens.

The turnaround time of a test is also very important, and the National Health Laboratory Service (NHLS) says this is being reduced.

Let’s move to Hope Spot 4:

Gauteng has kept deaths down and preparedness is high. This is important because the province is the country’s most densely populated with the highest number of closely packed areas. This can have implications for the exponential growth of infections.

These charts show where the highest number of deaths have occurred: the Western Cape and KwaZulu-Natal. While Gauteng was until recently the infection epicentre, it has now been overtaken by the Western Cape. In both provinces, cities remain the vectors of growth. Gauteng has contained the fatality rate through radical screening and testing as well as quarantine-ready sites.

I guess the ‘but’ here is that the Eastern Cape has seen a big spike in numbers, which is a serious concern for Health Minister Zweli Mkhize.

Over the weekend, he stepped up measures in the province – more on that here.

To finish, Hope Spot 5 is that we’ve bought our healthcare system time:

South Africa now has 288 quarantine sites for people who may not be able to self-isolate and it has 23,604 planned beds. This is insufficient for an exponential curve growth, but it is close enough to planning for a well-managed amplification stage…

Deep and detailed viral curve information is vital to plan and prepare hospitals, clinics and other health facilities as well as to prepare quarantine sites and field hospitals (for triage and diversion of cases) as required.

As with all of the data available, and what always proves to be the biggest ‘but’, the full extent of the virus’ spread in South Africa is not really known, and we’re always playing catch-up.

Only a rigorous testing regime, coupled with lockdown measures spanning various alert levels, can ensure that our healthcare workers are adequately prepared for what is to come.

Other than alert level 4’s “limited exercise”, which still needs to be clarified, it remains a case of staying home, and staying safe.

[source:dailymaverick]