COVID-19 Public Health Response · 9 Laboratory Service Through and including the 16th of April S...

COVID-19 Public Health Response

Daily Updates as of Friday, April 17th 2020

2

COVID-19: Global SituationBased on SITREP 88 with data as of 16th April 2020

Source: WHO

▪ As reported by the WHO, the

spread of coronavirus

continues to affect more

countries, thus registering

increased confirmed global

cases of COVID-19,

currently standing at

2 074 529 with 139 378

fatalities (16 April). This

illustrates a jump of more

than 82 967 new cases

over 24 hours (WHO

COVID-19 SITREP 88).

▪ The European Region

remains the worst affected

and the epicentre of the

pandemic reporting 1 050

871 with 93 480 fatalities.

3

COVID-19: African RegionBased on SITREP 88 with data as of 16th April 2020

▪ The African Region also continues to register a steady increase of confirmed

cases in 47 countries/territories. Fourteen SADC countries continue to register

increased number of cases.

➢ The Africa region reported12 360 confirmed casesand 586 fatalities

➢ The SADC Region has reported 3 620 confirmed cases with 95

fatalities; 72% of the total cases and 51% of the total deaths are in

South Africa

SADC Country Total Confirmed

Cases

% of Confirmed

Cases Deaths % of Deaths

South Africa 2,605 72% 48 51%

Mauritius 324 9% 9 9%

DRC 287 8% 23 24%

Madagascar 117 3% - 0%

Tanzania 94 3% 4 4%

Zambia 48 1% 2 2%

Mozambique 29 1% - 0%

Zimbabwe 23 1% 3 3%

Angola 19 1% 2 2%

Namibia 16 0% - 0%

eSwathini 16 0% 1 1%

Malawi 16 0% 2 2%

Botswana 15 0% 1 1%

Seychelles 11 0% - 0%

Total 3,620 95

4

COVID-19: Cumulative Number of Cases – Global ComparisonThrough and including the 16th of April , by number of days since 1st reported case

5

COVID-19: Cumulative Number of Deaths – Global ComparisonThrough and including the 16th of April , by number of days since 1st reported case

6

COVID 19: South Africa Overview Epidemiology and SurveillanceThrough and including the 17th of April

▪ The total cases reported on16th April was 2605; post adjustments and harmonization with provinces, the total cases went down by 6 to 2599 (see below)

▪ The total cases reported on 17th April is 2783 reflecting a 7.08% increase from yesterday and an additional 184 new cases (2599 to 2783)

Reported Cases Updated Cases Post Adjustments / Harmonization

ProvinceReported cases 17 April 2020

Adjusted numbers

harmonisation with provinces

Updated cases on 16 April 2020

New cases on 17 April

2020

Total cases for 17 April

2020

% Total Cases

# of Deaths Reported as of 17th April

2020

Case Fatality

Rate

Eastern Cape 220 0 220 26 246 8.8% 4 1.6%

Free State 98 -1 97 3 100 3.6% 4 4.0%

Gauteng 969 5 974 44 1018 36.6% 6 0.6%

KwaZulu-Natal 539 2 541 50 591 21.2% 20 3.4%

Limpopo 26 0 26 0 26 0.9% 1 3.8%

Mpumalanga 22 0 22 1 23 0.8%

North West 24 0 24 0 24 0.9%

Northern Cape 16 0 16 0 16 0.6%

Western Cape 675 0 675 42 717 25.8% 15 2.1%

Unknown 16 -12 4 18 22 0.8%

Total 2605 -6 2599 184 2783 50 1.8%

7

Epidemiology and SurveillanceThrough and including the 17th of April

New Cases: 42Total Confirmed Cases: 717Total Deaths: 15



Gauteng

KwaZulu-Natal

Western Cape

New Cases: 1Total Confirmed Cases: 23

Mpumalanga

New Cases: 0Total Confirmed Cases: 26Deaths: 1

Limpopo

New Cases: 3Total Confirmed Cases: 100 Total Deaths: 4

Free State

New Cases: 26Total Confirmed Cases: 246Deaths: 4

Eastern Cape


North West


Northern Cape

8

Epidemiology and SurveillanceThrough and including the 17th of April

Total Confirmed Case (as of April 17th) Daily New Cases Deaths (as of April 17th) Fatatlity Rate

2783 184 50 1.80%

9

Laboratory ServiceThrough and including the 16th of April

Sector Total tested New tested

PRIVATE 71298 71% 2936 51%

PUBLIC 29529 29% 2831 49%

Grand Total 100827 5767

Province Total tests Total tests %

Detection rate (%)

New tests

New tests %

EASTERN CAPE 5530 5% 4.7 753 13% FREE STATE 2554 3% 5.0 231 4%

GAUTENG 27828 28% 4.1 1906 33%

KWAZULU-NATAL 13225 13% 5.3 810 14% LIMPOPO 1660 2% 1.5 60 1% MPUMALANGA 2647 3% 1.5 175 3%

NORTH WEST 1417 1% 1.7 113 2% NORTHERN CAPE 762 1% 2.4 36 1%

WESTERN CAPE 17369 17% 4.8 1475 26% UNKNOWN 27835 28% 0.5 208 4% Grand Total 100827 3.3 5767

▪ A total of 100 827 tests have been conducted to 16th

April. The number of tests performed in the public sector continues to improve and the total new tests were 5 767 reflecting the increase as a result of community screening and testing

▪ The volume of tests increased from 4545 the previous day to 5767. As more tests are performed, more cases will be found.

▪ The biggest increase in case numbers was in KZN, 50 new cases compared to the previous day of 18. Additionally, in Western Cape, 42 new cases compared to 18 the previous day.

10

Laboratory ServiceThrough and including the 16th of April

▪ The volume of tests increased from 4545 the previous day to 5767. As more tests are performed, more cases will be found.

▪ The biggest increase in case numbers was in KZN, 50 new cases compared to the previous day of 18. Additionally, in Western Cape, 42 new cases compared to 18 the previous day.

▪ The positivity (new cases/total new tested) also increased from 2.2% the previous day to 3.2%.

▪ It is clear that test volumes and cases are closely related and explain the day to day variation to a large extent.

▪ The trend is most useful and the next few days will be important to monitor to see if the cases plateau or continue to increase.

▪ It should be noted that the number of tests has increased in the more recent days and may be due to application of a less restrictive case definition and also introduction of the community screening and testing.

11

Community ScreeningThrough and including the 15th of April

▪ As of 15th April 886 225 individuals have been screened in the community and 11 043 have been referred across the provinces and thus we are on track to reach a target of 1 million individuals screened by the 19th of April.

▪ Screening teams are following 2 approaches observed including house to house screening and mass screening which is the approach followed in high burden and surrounding areas i.e. hotspots.

▪ Overall case finding (Referred over Screened) stands at 1.25%

▪ It should be noted that there is wide variably in case finding rates between provinces ranging from .09% in the North West to 6.2% in the Western Cape. Work with provinces to improve case finding / detection through more targeted screening such as focusing on supermarkets, workplaces and funerals are underway.

Date National

Eastern

Cape Free State Gauteng

KwaZulu-

Natal Limpopo* Mpumalanga North West

Northern

Cape

Western

Cape

April 8th 49,788 22,141 14,424 6,866 2,966 - 447 - - 2,944

April 9th 107,852 19,369 8,605 26,841 4,116 - 2,139 12,508 26,059 8,215

April 10th 47,764 12,494 2,855 7,732 4,653 - 9,649 6,108 4,273 No Activity




April 14th 221,757 24,743 8,455 4,221 13,962 128,332 15,094 22,051 TBC 4,899

April 15th 237,001 Confirming 18,455 3,297 22,049 151,913 3,538 20,531 6,036 11,182

Total 886,225 107,998 60,390 74,302 65,976 280,245 84,296 136,663 49,115 27,240

Date National

Eastern

Cape Free State Gauteng

KwaZulu-

Natal Limpopo* Mpumalanga North West

Northern

Cape

Western

Cape

April 8th 632 201 43 276 36 - 76 - - -

April 9th 1,713 336 22 821 20 - 16 16 33 449

April 10th 230 89 26 Confirming 80 - 29 5 1 No Activity

April 11th 1,152 458 23 311 12 - 19 21 308 No Activity



April 14th 1,791 988 13 Confirming 48 327 30 17 TBC 368

April 15th 4,473 Confirming 13 217 96 401 46 22 219 873

Total 11,043 2,285 211 1,625 364 728 251 127 1,176 1,690

Case Finding

(Referred/Screened) 1.25% 2.12% 0.35% 2.19% 0.55% 0.26% 0.30% 0.09% 2.39% 6.20%

Number of People Screened

Number of Referred for Testing

12

Contact TracingThrough and including the 15th of April

▪ As of 15th April, 12 845 contacts have been screened and 10 950 have been traced across the provinces.

▪ Most provinces have reached coverage above 85%, except North West (78%) and Western Cape (68.1%).

Contact Tracing National

Eastern

Cape

Free

State Gauteng

KwaZulu-

Natal Limpopo

Mpumalan

ga

North

West

Northern

Cape

Western

Cape

Number contact tracers on the

ground 5,019 1,053 26 1,380 620 589 39 181 996 135

Total number of identified

contacts 12,845 711 2102 2511 1813

428612 350 164 4154

Number of contacts reached 10,950 647 2091 2209 1733 397 612 273 160 2828

% of Contacts Reached 85.2% 91.0% 99.5% 88.0% 95.6% 92.8% 100.0% 78.0% 97.6% 68.1%

Number of contacts not yet

reached 527 64 11 302 40 31 - 75 4

Not

Reported

% of Contacts Not Yet Reached 4.1% 9.0% 0.5% 12.0% 2.2% 7.2% 0.0% 21.4% 2.4% Not

Reported

Number of contacts taken specimen 2,012 95 327 144 1,217 118 28 6 66 11

Number of contacts tested positive 190 9 70 26 54 3 10 1 5 12

Number of contacts that have

completed 14 days’ monitoring 2,377 67 244 876 256 192 405 115 24 198

13

HospitalizationThrough and including the 15th of April

▪ As of 15th April 2020, there are a total of 241 hospitalized patients in the private and public sectors.

▪ Most patients that have been hospitalized are in isolation (137 of the 241); the majority in isolation are from KZN (83).

▪ There are 31 ICU beds currently occupied, 36 of which are in the private sector, the majority of ICU beds occupied are in Gauteng (10) and Western Cape (16)

▪ There are 23 patients on a ventilator of which 15 are in the private sector, the majority of patients on a ventilator are from the Western Cape (12) and Gauteng (4)

▪ There are 34 patients on oxygen, 20 of which are in the private sector; the majority of patients on oxygen are from Gauteng (12) and Western Cape (12)

Hospitalized Patients National Eastern Cape Free State Gauteng KwaZulu-Natal Limpopo Mpumalanga North West Northern Cape Western Cape

Public 79 15 9 9 22 1 0 1 0 22

Private 162 14 0 72 61 0 0 0 0 15

Total Hospitalized 241 29 9 81 83 1 0 1 0 37

Recoveries (Cumulative) 943 10 71 511 96 18 13 13 6 205

Isolation

Public 59 14 9 2 22 1 0 1 0 10

Private 78 8 0 0 61 0 0 0 0 9

Total Isolation 137 22 9 2 83 1 0 1 0 19

High Care 0

Public 1 0 0 1 0 0 0 0 0 0

Private 3 0 0 2 0 0 0 0 0 1

Total High Care 4 0 0 3 0 0 0 0 0 1

ICU Beds

ICU Admissions Public 9 1 0 1 2 0 0 0 0 5

ICU Admissions Private 27 6 0 9 1 0 0 0 0 11

Total ICU 36 7 0 10 3 0 0 0 0 16

Ventilators

Public 8 1 0 0 2 0 0 0 0 5

Private 15 3 0 4 1 0 0 0 0 7

Total Vents 23 4 0 4 3 0 0 0 0 12

On oxygen

Public 14 6 0 2 1 0 0 0 0 5

Private 20 3 0 10 0 0 0 0 0 7

Total on Oxygen 34 9 0 12 1 0 0 0 0 12

14

QuarantineCurrent Statistics as of 14th April 2020

14

Quarantine NationalEastern

Cape Free State

GautengKwaZulu-

NatalLimpopo

Mpumal-anga

North West

Northern Cape

Western Cape

# of Total Activated Quarantine Sites

33 - 2 5 8 2 2 8 4 2

# of Total Planned Beds for Quarantine Sites

8982 328 1462 - 1156 772 2083 458 1141 1582

# of Total Activated Beds for Quarantine Sites

3870133 33 952 952 80 229

269831 391

% of Activated vs Planned Quarantine Beds

43% 41% 2% - 82% 10% 11% 59% 73% 25%

# of people placed in quarantine (as at April 13th)

873 - 3 359 359 0 13 80 23 36

15

Port HealthCurrent Statistics as of 17th April 2020

▪ From the total number of travellers being monitored through the travel scanners, 122 travellers were from high-risk

countries

▪ Of the 2 811 travelers who were monitored through thermal scanners, none were found with elevated temperatures

▪ The Ports are being continuously monitored on a daily basis

Airports Sea Ports Land Ports

The number of conveyances arrived at port:

3 7 317

Total number Aeromedical conveyances arriving from high-risk countries

0 0 0

Number of travelers sent to quarantine

199 0 0

The number of travelers sent to a health facility:

0 0 0

Airports Sea Ports Land Ports

Places from which vessels/conveyancers come from:

▪ Two conveyancers from the United States of America

▪ Maputo

▪ Nigeria ▪ Netherlands ▪ Congo ▪ Singapore▪ Durban

(Fishing)▪ Spain

▪ Lesotho▪ Botswana▪ Namibia

16

Environmental HealthCurrent Progress Update

▪ Reports are generated from the information that is received from 52 Districts and Metropolitan Municipalities as well

as any other activities and incidentsdealt with

Site of incidence Nature of Incidence Action taken

Progress to report as of 16/04/2020.

As of 16/04/2020, we had captured that we

have 32 739 storage capacity for human

remains in the country. As follows:

a. Forensic – 2 570

b. Hospitals – 4 215

c. Private undertakers – 25 737

d. Police – 186

e. Crematorium – 31

f. University - 0

One Private provider has mobile Mortuary

services and biodegradable Coffins.

The total number of available coffins in five

Provinces is 10742


Draft database developed, process is ongoing

as more information is received from

Municipalities.


Meeting was held on 16/04/2020 to discuss the

matter.

Agreed that EH will draft a paper with issues of

concern for amending IPC guidelines,

amendments will be incorporated into a

version two of the Guidelines

CountrywideAssessment of Funeral

undertaker`s Premises

CountrywideDevelopment of database for

Old Age Homes.

Civitas

Discrepancies between the

Environmental Health

Guidelines on the

management of Human

remains and the IPC

guidelines.

17

Emergency Medical Services (EMS)Current Initiatives

▪ The Draft South African Medical Evacuation Plan Standard Operating Procedure (SOP) is being finalized

⁃ The draft SOP applies to South African citizens or foreign nationals entering or exiting South Africa requiring

medical evacuation of people with life threatening medical conditions, including COVID-19 asymptomatic or

symptomatic patients, in the context of the COVID-19 pandemic.

▪ Implementation of zero-rated 3-digit 111 short code

⁃ Telkom will have the system up and running in 5 days and the rest of the Cellular network providers are presently

working on modifying their systems to accommodate the 111 short code.

⁃ ICASA agreed to the allocation of111 as the zero-rated 3-digit short code for COVID-19.

▪ EMS Readiness Plan for COVID-19 Surge

⁃ An EMS Readiness Plan is currently being developed in anticipation of the COVID-19 surge and will be complete by

24 April 2020.

18

CommunicationCurrent Initiatives

▪ IEC Material on cloth masks has been created

⁃ Translation of social media banners and pamphlets into 8 official languages has been completed.

⁃ Translations into 2 outstanding languages in progress.

⁃ This material will be complemented by video tutorials and radio live reads to promote the use of cloth masks by the public.

▪ The NDoH’s in partnership with SABC Education, DG Murray Trust, Innovation Edge and Ilifa Labantwana are to produce a daily Covid-

19 radio broadcast.

⁃ The daily 8-10 min pre-recorded shows will be aired on 15 SABC radio stations from Monday 20th April 2020, running for 13

weeks, messages will be updated as required by the situation, and packaged for social media.

▪ Partnerships with the private sector are continuing to amplify government’s messaging to the public:

⁃ Discovery Health, in partnership with the NDoH have produced and finalised 3 videos highlighting signs and symptoms of COVID-

19, hand hygiene and the flu vaccine.

⁃ Translated versions of these scripts are in development.

⁃ Additional videos highlighting social distancing are also in development.

19

CommunicationWhatsApp Daily Dashboard

20

Supply Chain, Finance & ProcurementNeeds Analysis

▪ The needs analysis was based on epidemiological modelling and assumptions of the logarithmic growth of an infectionrate of 60% and projected for six months for PPE needs nationally.

▪ The projected demand for PPE is huge across all items needed to respond to COVID-19.

Public Sector- National Need

(Quantities)April May June July August September 6 month need total

Apron 2 929 483 3 808 703 3 915 013 3 587 368 3 357 862 3 197 316 20 795 746

Biohazard bag 1 165 539 2 470 528 2 752 028 2 266 234 1 800 742 1 562 703 12 017 772

Boot Covers 588 153 5 135 081 5 813 752 4 069 626 2 848 738 1 994 117 20 449 467

Gloves, non sterile 9 052 545 16 049 537 19 858 608 17 126 170 12 575 849 11 236 955 85 899 663

Gloves, sterile 66 069 586 585 659 646 461 752 323 227 226 259 2 323 537

Goggles/Face-Shield/Viser 379 181 2 558 235 2 847 526 2 036 157 1 440 015 1 042 444 10 303 558

Gown 2 473 217 7 020 144 8 641 347 6 897 221 4 733 802 3 879 180 33 644 910

Coveralls - - - - - - -

Heavy duty gloves 615 615 923 923 615 615 4 306

Particulate respirator, grade N95 609 302 5 156 229 5 837 976 4 093 850 2 869 887 2 015 265 20 582 508

Sanitizer 181 824 355 822 454 655 389 883 266 517 234 779 1 883 479

Scrubs 38 440 47 140 66 873 63 634 42 675 41 088 299 850

Surgical mask - HCW 6 725 790 8 038 924 10 067 996 9 578 777 7 365 319 7 125 601 48 902 406

Surgical mask - Patient 4 914 742 15 675 846 15 993 996 12 139 386 9 441 159 7 552 400 65 717 527

Total 322 824 730

Quantities Required

21

Supply Chain, Finance & ProcurementStock on Hand

▪ A gap analysis was performed to determine the Provincial stock on hand and the total orders placed per item byprovinces.

▪ The gap analysis is the difference between the six-month need and the total ordered and the stock on hand.

Item

NDOH

Orders

(quantity)

NDoH Orders

(ZAR amount)

NDOH

Delivered

(quantity)

Provincial

SoH

Provincial

Orders

(quantity)

Provincial Orders

(ZAR amount)

Provincial

Delivered

(quantity)

SF Orders

(quantity)

SF Orders

(ZAR amount)

SF Delivered

(quantity)

Donations

(quantity)

Donations

Delivered

(quantity)

Donations Delivered

Not Cleared

(quantity)

Apron 620 030 199 780 30 2 328 872 2 867 600 2 242 139 - - - -

Biohazard bag - - - 199 302 2 034 000 47 263 750 - - - -

Body bag - - - 5 395 26 000 865 031 - - - -

Boot Covers 2 000 289 800 2 000 855 957 2 700 100 1 526 886 - 11 000 11 000 11 000

Coverall 2 000 391 000 2 000 31 222 390 674 107 083 300 - 3 060 3 060 2 000

Disinfectant 1 380 60 157 1 380 28 538 987 001 4 260 362 - - - -

Gloves 2 400 320 1 204 760 320 2 144 094 19 677 025 146 259 164 - 898 100 2 730 224 898 100 11 000 11 000 11 000

Goggles/Face-Shield/Visor 105 500 2 846 460 5 500 16 130 379 552 24 011 491 - 20 000 1 041 200 3 000 3 000 2 000

Gown 933 000 17 727 000 - 1 822 618 1 278 145 160 485 130 - 3 000 3 000 3 000

Heavy-duty gloves - - - 10 500 4 905 000 2 719 745 - - - -

Particulate respirator, grade N95 1 025 425 9 522 876 25 425 279 005 7 738 818 128 640 258 - 1 000 000 9 200 000 2 000 000 58 500 58 500 11 000

Sanitizer 42 000 2 068 275 5 000 130 229 2 674 481 292 349 625 - - - -

Surgical mask 11 100 000 31 262 200 - 2 444 517 20 880 125 329 176 011 - 22 500 000 229 540 000 5 000 000 102 500 102 500 50 000

Thermometer 350 353 528 - 1 479 17 780 32 530 057 - 500 500 500

Ventilator - - - - - - - 200 19 464 806 - - -

TOTAL ZAR amount 65 925 836 1 279 412 948 261 976 230

NDoH SoH & Orders Provincial SoH & Orders

Donations

(Solidarity Fund, Motsepe, and Naspers)

Donations

(Chinese Government)

22

Supply Chain, Finance & ProcurementPipeline Orders and Donations

▪ The National Department of Health has placed orders for PPE through the Solidarity Fund, to the total

value of ~R148million

▪ Orders for PPE have been placed with various suppliers and the lead delivery time for orders placed is from 18 to 31

days.

▪ The donation of 2 million three-ply patient masks from the Solidarity Fund have been received and will be distributed

to Community screening programme, Quarantine sites, Port Health and the Department of Correctional Services

(Eastern Cape Province).

▪ A commitment was received for 4 million N95 respirator masks was received from Naspers.

▪ 270 000 respirators masks are due to arrive in SA on the 19th of April.

▪ In addition to this delivery, 100 000 visors will also be delivered which will be distributed to all nine provinces during

the week of the 20th of April by Takealot.com.

23

Modeling and Costing: Number of expected COVID-19 patients and costs

Estimated number of positive patients by September (3.1m – 5.8m)

▪ PPE budget required: R1.15b▪ Cuban doctors (12 months): R255m▪ Number of additional beds (500 beds in 10 field hospitals at R220m per field

hospital): R2.2b▪ Number of triage sites at PHC facilities (1000 clinics @R250 000): R250m▪ Ventilator costs: R195m▪ Medicine costs: R524m

Total costs: R3.745b- R5.532b (May – September)

COVID-19 Public Health Response · 9 Laboratory Service Through and including the 16th of April S...

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