It’s happened before: Couples stuck at home during blizzards, hurricanes or other natural disasters enjoy some “alone time” – and a baby boom follows.
But a new survey from researchers at the University of Florence in Italy suggests the same probably won’t unfold during the Covid-19 pandemic.
Why?
“What we found the main reasons that led people to not wanting to conceive included worries related to future economic difficulties and consequences on pregnancy,” said study author Elisabetta Micelli, from the university’s Assisted Reproduction Technologies Center.
The researchers conducted nearly 1 500 online interviews and found that nearly 82% of those surveyed said they didn’t plan to conceive during the coronavirus pandemic.
Fear of future instabilities
The survey was conducted in the third week of the lockdown in Italy and included men and women in a stable heterosexual relationship for at least one year.
The findings were published early in May in the Journal of Psychosomatic Obstetrics and Gynecology.
Of the 268 participants who said that, prior to the pandemic, they had plans to have a child, more than one-third abandoned their intentions when the pandemic struck. The main reasons were worries about future economic struggles (58%) and any potential consequences on pregnancy (58%) from the new coronavirus.
Even though almost half of those who responded to the survey had not lost their jobs or income, “the fear of imminent and future economic instabilities led those who were searching for a pregnancy to stop their intention in 58% of cases,” Micelli said in a journal news release.
Interestingly, 140 (11.5%) of the participants – mostly women – expressed a new desire for parenthood during quarantine, with the main reasons being “the will for change” (50%) and “the need for positivity” (40%).
But only six of the 140 (4.3%) actually tried to get pregnant during the lockdown.
No decrease in sex
“Again, fear of consequences on pregnancy in addition to the economic impact on families are probably the reasons why almost the whole group of couples who unexpectedly started to express a desire for parenthood during quarantine did not translate this dream into a concrete attempt,” said study co-author Gianmartin Cito, a specialist training in urology.
The study also asked participants about their levels of sexual activity and found that two-thirds of those who didn’t express a wish to conceive before or during the pandemic reported no decrease in sex. The same was true for 60% of people already trying to conceive.
It’s “unknown whether these findings will result in a substantial modification of birth rate in the near future,” the authors concluded.
Taxis and buses will be allowed to operate throughout the day with no time restrictions, but with limited passengers from Monday.
Transport Minister Fikile Mbalula has announced minibus-taxis will remain at 70% loading capacity, while buses, e-hailing transport, metered taxis and shuttles as well as chauffer and charter services will stay at 50%.
He said public transport vehicles were only permitted to ferry people who were allowed to travel between provinces in terms of the regulations.
Mbalula added such travel was restricted to people undertaking work responsibilities or performing a service permitted under Level 3, provided they were in possession of the requisite permit.
Limited domestic air travel will be allowed under Level 3 of lockdown, phased in for business purposes, Transport Minister Fikile Mbalula said on Saturday.
While this could be good news for businesses that have to date been hamstrung by travel restrictions, it also raises questions of feasibility for airlines themselves, which are already facing crippling losses in the face of the coronavirus pandemic.
Speaking during a briefing on updated transport regulations, Mbalula said the number of flights allowed each day will be restricted and based on the reason for travel, as well as the availability of port health services.
In Phase 1, only so-called “golden triangle” airports will be phasing in business travel. OR Tambo International Airport and Lanseria Airport will be open in Gauteng, as well as King Shaka International Airport in KwaZulu-Natal and Cape Town international Airport in the Western Cape.
Game parks and private game farms may open their gates to visitors again from Monday, when Alert Level 3 kicks in, tourism minister Mmamoloko Kubayi-Ngubane announced on Saturday night.
Kubayi-Ngubane was describing upcoming regulations for her sector under Level 3, which had not yet been published 29 hours before they are due to come into effect.
“Public and private game farms have been opened for self-drive excursions,” she said, stressing that no group tours will be allowed, and visitors will have to use their own vehicles.
Visitors may not cross provincial boundaries to reach game parks for such drives. Under Level 3, provincial borders are technically closed to those who can not show a need to travel on essential business.
Experts have warned against using coronavirus “disinfection” tunnels that some people think will stop the spread of the virus.
Instead, they have suggested that strict personal hygiene, washing hands, wearing masks and keeping a 1.5m distance from others to prevent the spread of the virus.
“Human spraying is harmful with almost no benefit,” said Professor Salim Abdool Karim, who is the chairperson of the Ministerial Advisory Committee on Covid-19.
He said spraying hands properly with a sanitiser was the way to prevent the spread of the virus.
The European Union on Saturday called on the United States to “reconsider” the decision to sever ties with the World Health Organisation over its handling of the coronavirus pandemic.
President Donald Trump said on Friday he was severing US ties with the WHO, accusing it of failing to do enough to combat the initial spread of the virus.
The United States was the largest contributor to the WHO budget, providing at least $400 million in annual funding.
“The WHO needs to continue being able to lead the international response to pandemics, current and future,” Commission president Ursula von der Leyen and foreign affairs chief Josep Borrell said in a joint statement.
“For this, the participation and support of all is required and very much needed.”
Ten percent of Covid-19 patients with diabetes die within a week of entering the hospital and 20% need a ventilator to breathe by that point, a new French study found.
Researchers analysed data on more than 1 300 Covid-19 patients with diabetes, average age 70, who were hospitalised in France during March. Of those, 89% had type 2 diabetes, 3% had type 1, and the rest had other types of diabetes.
The study found that one in five patients had been placed on a ventilator in intensive care within seven days of entering the hospital; one in 10 had died; and 18% had been discharged.
“The risk factors for severe Covid-19 [in patients with diabetes] are identical to those found in the general population: age and BMI [weight],” said researchers led by diabetes specialists Dr Bertrand Cariou and Dr Samy Hadjadj, from University Hospital Nantes.
A new study finds that prescriptions rose sharply for two drugs that President Donald Trump claimed could help prevent or treat Covid-19.
This happened despite the fact that multiple studies found the medicines might only bring harm to patients with coronavirus illness.
The study, conducted by researchers at Harvard-affiliated Brigham and Women’s Hospital in Boston, found that prescriptions for the two drugs – hydroxychloroquine and chloroquine – rose by a staggering 2 000% during the week of 15 March to 21 March.
Early in the pandemic, Trump repeatedly touted hydroxychloroquine and chloroquine as a potential means of preventing or treating coronavirus illness.
• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing
• Practise frequent hand-washing, especially after direct contact with ill people or their environment
• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus
• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.
Study finds the odds of a false-negative test result is 1 in 5
The first four days after infection seem to be the highest risk
We spoke to an expert about how this impacts testing backlogs
Health24 recently reported on a general backlog in coronavirus testing in South Africa, and explained how our tests work.
Currently, our laboratories make use of one of the most-used diagnostic tools – the reverse transcriptase-polymerase chain reaction test (RT-PCR). This test makes use of a swab from the nasal passage or throat, where viral particles are then isolated from the sample.
While these tests play a huge role across the globe to help determine the spread of Covid-19, researchers at John Hopkins have found that they might be likely to give a false negative – where a virus cannot be detected through the sputum sample, even when a person is infected.
What are the odds of a false negative?
According to the research that was published in the Annals of Internal Medicine, the odds of a false negative through RT-PCR is one in five, and sometimes, even higher.
In the report on their findings, they found that the probability of a false negative decreases from 100% on day one of being infected to 67% on day four. The false negative rate further decreases to 20% on day eight.
On the day patients actually started to experience symptoms, the average false negative was 38%.
The researchers analysed seven previously published studies on RT-PCR to interpret their current research.
Could this be problematic given SA’s current situation?
As we reported on testing backlogs in several provinces around the country, we asked Professor Glenda Davison, laboratory expert and head of the Biomedical Sciences Department at Cape Peninsula University of Technology, if false negatives could also be experienced in South Africa, and what the implications would be.
She believes that like other countries that currently use the RT-PCR testing methods we are also likely to be experiencing false negatives. But unlike the reasons stated in the research paper, there are other factors that could also cause false negatives:
Sampling from the nose and throat may not always be adequate. The reason for this is that individuals may shed the virus in different rates and quantities and that the viral particles in the nose or throat sample are not enough to be detected, which can lead to a false result.
The amount and quality of the RNA (viral particles). “It is recommended that once a sample has been taken that it is immediately transported to the laboratory and that if this can’t be done, then it should be stored at 2–8 degrees for a maximum of 72 hours or frozen. If a sample is left at room temperature and not processed immediately, the RNA will begin to degrade, again leading to a false negative result as there just isn’t enough to be detected,” Professor Davison explains
She states that this is a difficult situation and that healthcare professionals and community screeners must be made aware of these causes to try and avoid as many of them as possible, avoiding the possibility of a false negative.
Could false negative results increase our Covid-19 spread?
According to Professor Davison, false negative results have all sorts of consequences, not only for those who are sick, but also for the effectiveness of contact tracing and screening.
“In many cases, tests are being performed on people who do not have any symptoms, but who have been in contact with a positive individual. If it is in the early stages (days one to four), or the specimen is not processed properly, they could very well test negative and not go into quarantine. This could, of course, lead to increased spread unless all contacts are made to self-isolate irrespective of a test result,” she told Health24.
But, we shouldn’t only look at testing and false negatives as a reason for increasing rates. “As we go into level three of lockdown and more people are returning to work, taking public transport and shopping, it is inevitable that the infection rate is going to increase,” she adds.
It is, however, important not to become complacent with the current measures and test methods we have in place.
“The fact is no laboratory test is foolproof and all have advantages and disadvantages. I think that when other forms of testing such as rapid antibody and antigen tests are made available, it will offer an alternative way to screen patients and those who have had the infection and recovered.
“However, these tests also have their pitfalls. In the meantime, it is important that we are all aware of the limitations of the RT PCR test and that false negative results are possible,” Professor Davison said.
There’s good news for women: Getting a mammogram regularly can cut their odds of advanced and sometimes fatal breast cancers, a new study says.
European researchers tracked data from nearly 550 000 women in Sweden who were eligible for mammography screening.
The team compared rates of advanced and breast cancers that were fatal within 10 years after diagnosis for women who got mammograms and those who didn’t.
The result: Compared to the women who didn’t get mammograms, those who did had a 25% lower rate of advanced breast cancer and a 41% lower rate of breast cancers that went on to be deadly within 10 years.
Cuts the risk of dying
The study was published earlier in May in the journal Cancer.
“This study shows that participation in breast cancer screening substantially reduces the risk of having fatal breast cancer,” study co-author Stephen Duffy, of Queen Mary University of London, said in a journal news release.
Earlier studies had suggested a real health benefit to mammograms, but some experts thought that benefit may have been due to improvements in breast cancer care, not the advent of mammography. However, Duffy and his colleagues believe their study got around that potential confounder.
Because the study participants were tracked for both mammography screening and breast cancer treatment over the same period of time, the results are “not affected by potential changes in treatment of breast cancer over time”, Duffy noted.
So, the research suggests that mammography cuts the risk of dying from breast cancer above and beyond what can be achieved with current therapies, emphasised study co-author Dr Laszlo Tabar, of Falun Central Hospital in Sweden.
“Some may believe that recent improvements in breast cancer treatment make early detection less important,” he said in the news release, but “our study shows that nothing can replace finding breast cancer early.”
Guidelines relaxed
Two US breast cancer experts agreed that the message for women is clear.
“Screening catches cancers earlier and decreases the incidences of advanced cancers and deaths – get your mammogram,” said Dr Alice Police. She is regional director of breast surgery at the Northwell Health Cancer Institute in Sleepy Hollow, New Year.
Police noted that in recent years, some guidelines have been relaxed regarding the timing of mammograms. For example, in 2016, the influential US Preventive Services Task Force upped the age for first mammogram for women from a prior recommended age of 40 to 50 years of age, for women at average risk. Women in their 40s should talk to their doctor about their use of mammography screening, and the decision “should be an individual one”, the expert panel said.
But Police believes the new study “proves [again] that screening is important to reduce the rates of advanced and fatal breast cancers and should start at age 40”.
Dr Kristin Byrne is chief of breast imaging at Lenox Hill Hospital in New York City. She said “the conclusions of the study are very clear and reaffirms the significant importance of screening mammography in detecting a breast cancer when it is small and it has not spread to the lymph nodes or elsewhere.
“This is why it is so important for women 40 and over to have yearly screening mammograms as long as they are in good health,” Byrne stressed. “Women at high risk may need to start [even] younger and should discuss it with their doctors.”
While coronavirus testing increased week-on-week since early in April, a decrease in testing has been observed in the week ending 17 May, according to a report from the National Institute for Communicable Diseases (NICD).
The week-on-week increase, the NICD said, was on the back of “a larger network of testing laboratories and the implementation of targeted community symptom screening, and referral for testing”.
However, according to the NICD, for the week ending 17 May, a decrease in testing volumes has been observed – likely due to a limited number of testing kits, and laboratory testing backlogs.
In the report, laboratory delays are indicated by an increase in the number of days between the day the test is done and the specimen collected, and the reporting of the result. Currently, the turnaround time for the public sector increased from two days to more than six days (in the weeks leading up to week 20 – the week ending 17 May), while the turnaround in the private sector remained less than two days.
A reduction in testing volumes was also observed over weekends and public holidays, according to the report from the NICD.
The delay between tests and results was seen in the public sectors of all five provinces where the largest number of tests were done, but a significant delay was reported in Gauteng.
In Gauteng, where it previously took an average of 2.3 days from test to result, it is now more than eight days.
Test kits not interchangeable
Professor Glenda Davison, head of the biomedical sciences department at the Cape Peninsula University of Technology, told Health24 that test kit availability would definitely be a reason for a decrease in testing.
“I would say the decrease in test kits is one reason for the decrease in testing,” she said.
“The test kits are acquired from a number of international companies and are most often imported which could result in delays. The reason being that countries throughout the world are doing these tests and the supply just can’t keep up with the demand.”
Another problem, she explained is that laboratories are often locked into using a specific company’s test kits as they are specifically designed for the instrument that they have purchased.
“For example, the National Health laboratory service has a number of GeneXpert machines which should be able to produce test results quickly and within 24 hours. However, these machines can only use test kits/cartridges from the machine manufacturer (Cepheid).
“Cepheid also cannot seem to meet the demand, and although there are a number of other companies (e.g. Roche) who also manufacture test kits, these kits cannot be used on the GeneXpert as they are designed for the machine they are specifically made for.
“In other words, the test kits are not interchangeable.”
So why the reliance on kits from international companies?
Professor Davison says although the method to develop our own test kits is available, and we certainly have the capability, this is a long process, and once again they would not be suitable to use on the large commercial automated machines.
“And at this point, we need to be able to process tests on an automated platform”.
Understanding how a test is done
Professor Davison tells us that another reason could be in the process of viral RNA extraction.
To understand this, she briefly explains how the test is done.
“The method currently used to diagnose Covid-19 or detect the SARS-CoV-2 virus is a molecular test known as RT-PCR (reverse transcript real-time polymerase chain reaction). Once the nasal or throat swab arrives in the laboratory, the first thing that is required is to extract the viral RNA from the sample.
“This is a long process and is often done manually. It is here that delays often occur as the technologists or laboratory scientist must ensure that the quality and amount of RNA are adequate.
“Ideally, this process should be automated so that the RNA is extracted quickly and the backlog of unprocessed specimens can be cleared. After this has been done, the RNA can be converted to DNA using reverse transcriptase and then using the relevant instrument and test kit, is amplified and detected using PCR.”
So, she says a delay could take place at the point where the viral RNA is extracted from the throat or nasal swab, especially if this is a manual method.
Rectifying the situation
With the expectation that things will get worse, before getting better, regarding Covid-19 infections, Professor Davison has expressed concerns about the backlogs.
“This could have huge repercussions. One of the first things I think of is the contact tracing process. If someone is suspected of having Covid-19, one would like to know as soon as possible so that all the contacts can be traced and tested in order to prevent spreading.
“By delaying the tests it makes this process very difficult. It also makes the daily data which is released to the public less accurate and up to date. This makes it difficult to predict how the numbers are going to increase and what action should be taken.”
Epidemiologists need up-to-date data to detect hotspots so that they can be contained and controlled.
Also, worryingly, she tells us that, from a technical point of view, RNA degrades fairly quickly, and so if samples are left too long it could result in a false-negative result.
“So, it is important that we rectify this situation,” she says.
Two new studies offer hope for an effective coronavirus vaccine – and for the notion that prior infection also confers immunity.
Both studies were conducted in rhesus macaque monkeys, so testing in humans is required for more definitive proof. But in one study, monkeys developed immunity against the new SARS-CoV-2 coronavirus after receiving experimental vaccines.
“Our findings increase optimism that the development of Covid-19 vaccines will be possible,” said lead researcher Dr Dan Barouch. He directs the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.
As part of the new research, macaques were given experimental coronavirus vaccines that expressed six different forms of the SARS-CoV-2 spike protein, a structure on the virus’ surface that it uses to bind with and invade human cells.
High levels of antibodies
The vaccines provide DNA that enables host cells to make the spike protein so that they can then generate antibody responses to it. In this way, the immune system is trained to recognise coronavirus and quickly respond to it if it appears.
The vaccines were given to 25 adult macaques in initial vaccinations and also in follow-up boost immunisations. Another 10 monkeys got a sham vaccine.
All of the macaques were infected with the new coronavirus six weeks after vaccination, and those that had received the real vaccines produced levels of antibodies in their blood that were high enough to neutralise the virus within two weeks.
In fact, eight of the 25 vaccinated monkeys showed no detectable virus at any point following exposure to SARS-CoV-2, and the other vaccinated animals showed only low viral loads, the researchers reported in the 20 March issue of the journal Science.
In all cases, as the production of immune system antibodies rose, viral load declined. That suggests that there’s a direct correlation between the two – an important factor to consider as vaccine development goes forward, the researchers said.
In another important finding, a second study conducted by the same team found that monkeys who were infected with the new coronavirus developed immunity.
Protection against re-exposure
In that research, nine adult macaques were infected with the virus, but then cleared it from their bodies when they were re-exposed to it 35 days later. All nine also had few or no symptoms after re-exposure and had immune responses that appeared to protect them against a second infection.
Further research is needed to find out how long this natural immunity lasts, the study authors noted.
Still, “In these two studies, we demonstrate in rhesus macaques that prototype vaccines protected against SARS-CoV-2 infection and that SARS-CoV-2 infection protected against re-exposure,” Barouch said in a Beth Israel news release.
However, he stressed that research conducted in animals sometimes fails to pan out in people, so, “further research will be needed to address the important questions about the length of protection, as well as the optimal vaccine platforms for a SARS-CoV-2 vaccine for humans”.
A drug supported and even taken by United States President Donald Trump as a potential weapon against the new coronavirus simply doesn’t seem to work, another major study finds.
In fact, hydroxychloroquine, as well as a related medicine, chloroquine, may even raise the risk for death and serious heart rhythm disorders in people who use it, an international team of researchers reported.
The two drugs are approved to help treat illnesses such as malaria and lupus. Early on in the Covid-19 pandemic, Trump labeled the drugs potential “game changers” against the disease, despite little good evidence supporting such claims. Google searches by Americans looking for the medicines surged after his endorsement.
And last Monday, Trump told reporters he’d been taking hydroxychloroquine for about a week and a half in an effort to help prevent infection or illness with SARS-CoV-2, the new coronavirus. He said he was taking the drug with the approval of the White House physician.
However, the new research, published May 22 in The Lancet, is the latest in a long line of studies suggesting that the drug is useless against the new coronavirus and Covid-19. And its authors say it may offer the most definitive proof yet.
Robust evidence
“This is the first large scale study to find statistically robust evidence that treatment with chloroquine or hydroxychloroquine does not benefit patients with Covid-19,” said lead author Dr Mandeep Mehra, executive director of the Center for Advanced Heart Disease at Brigham and Women’s Hospital in Boston.
“Instead, our findings suggest it may be associated with an increased risk of serious heart problems and increased risk of death,” he said in a journal news release.
The researchers said their observational study findings suggest that the use of the two drugs in Covid-19 patients should be restricted to clinical trials until there’s proof from “gold standard” randomized clinical trials that the medications are, in fact, safe and effective.
Mehra’s group analysed data from nearly 15 000 hospitalised Covid-19 patients who were given hydroxychloroquine or chloroquine, with or without the antibiotics azithromycin or clarithromycin, and a control group of about 81 000 hospitalised patients who didn’t receive the drugs.
The patients were admitted to 671 hospitals between December 20 and April 14, and all had either been discharged or had died by April 21.
The death rate in the control group, which did not receive either hydroxychloroquine or chloroquine, was 9.3%, the Boston team reported.
That’s far lower than the 16.4% death rate for the group that received chloroquine alone, or the 18% death rate for those patients who received hydroxychloroquine alone.
Randomised clinical trials essential
Adding antibiotics to the mix didn’t help, either: For those receiving chloroquine and an antibiotic the death rate was 22.2%, and it was 23.8% for those who got hydroxychloroquine and an antibiotic, the researchers said.
Even though other factors – including age, obesity and pre-existing health conditions such as heart disease, lung disease and diabetes – might have played a role in the differences in death rates, hydroxychloroquine/chloroquine was still associated with an increased risk of death, the researchers concluded.
As well, serious heart rhythm problems were more common in patients who received either of the four treatment regimens, Mehra’s group added.
The highest rate (8%) was among patients given hydroxychloroquine and an antibiotic, compared with 0.3% of patients in the control group.
After accounting for other factors, the researchers calculated that this drug combination was associated with a more than fivefold higher risk of serious heart rhythm problems.
“Randomised clinical trials are essential to confirm any harms or benefits associated with these agents,” Mehra said. “In the meantime, we suggest these drugs should not be used as treatments for Covid-19 outside of clinical trials.”
Other studies concur
Prior studies have concluded much the same.
For example, one US study published in late April found the death rate for people with Covid-19 who took hydroxychloroquine on top of usual care was actually higher than those who didn’t – 28% vs. 11%, respectively.
Soon after, the US Food and Drug Administration issued a statement that “hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing Covid-19.”
The FDA also warned that “hydroxychloroquine and chloroquine can cause abnormal heart rhythms”.
On May 8, New York City physicians reporting in the New England Journal of Medicine tracked outcomes for nearly 1 400 patients with severe Covid-19. Those who received hydroxychloroquine fared no better than those who did not.
And now this latest “well-conducted observational study adds to preliminary reports suggesting that chloroquine, hydroxychloroquine, alone or with azithromycin, is not useful and may be harmful in hospitalised Covid-19 patients”, Dr Christian Funck-Brentano, of Sorbonne University in Paris, wrote in a journal commentary accompanying the new study.
Cooperative Governance Minister Nkosazana Dlamini-Zuma has told the National Coronavirus Command Council (NCCC) that the sale of tobacco and alcohol should continue to be banned until the country reaches Level 1 of the lockdown.
News24 was reliably told that Dlamini-Zuma was supported by Home Affairs Minister Aaron Motsoaledi when she told the NCCC this week that she believed it would be too much of a health risk to allow the sale of cigarettes and alcohol on 1 June when the country is expected to go to Level 3 of the nationwide lockdown.
This prompted a debate in the meeting, chaired by President Cyril Ramaphosa, with no resolution on the matter.
A high-ranking insider with intimate knowledge of the meeting said Dlamini-Zuma had come prepared with academic papers that argued against the sale of tobacco and alcohol during the Covid-19 pandemic, citing health risks.
Internationally recognised epidemiologist and infectious diseases specialist Professor Salim Abdool Karim has weighed in on the debate about schools reopening in the midst of the Covid-19 pandemic.
He said the country should expect small outbreaks in schools – although they would be handled and dealt with accordingly.
Karim stated this during an interview with broadcast channel eNCA, where he said there was no good reason for children not to return to school if there were health protocols – such as hand sanitisation and social distancing – in place to curb the spread of the virus.
He added scientific evidence showed children seemed to be infected at a much lower rate than adults and were less susceptible to the virus.
Almost 230 000 people have been charged for contravening lockdown regulations since they were enforced on 26 March, Police Minister Bheki Cele has revealed.
Cele, who briefed the media on Friday, said the number of people charged for breaking the regulations had almost doubled as the country started moving into Level 4 of the lockdown.
“At one point towards the end of April when we were still on Level 5, we had about 107 000 cases opened with 118 000 people charged for contravention of the lockdown regulations. In just over a month, this number has more than doubled and is almost at 230 000 for contraventions,” he added.
Cele said the provinces with the highest number of arrests almost mirrored the provincial infection statistics, with the Western Cape recording the most arrests and highest number of confirmed cases of Covid-19, followed by the Eastern Cape, KwaZulu-Natal and Gauteng.
The Western Cape is starting to see increased pressure on its hospital systems ahead of the coronavirus peak, but it has not yet reached peak capacity, the Premier’s office said on Friday.
It warned however that, while it was ready to meet current critical care needs, at the peak, “even in the best-case scenario, we will still fall short of ICU beds”.
“The public sector has an existing capacity of 2 162 acute beds, and an 1 428 additional care beds will be provided by temporary ‘field hospitals’ in the Western Cape, including the 850 additional beds at the Cape Town International Convention Centre, 330 beds at a temporary hospital facility in Brackengate, 68 at the Khayelitsha Thusong Centre, 150 at the Cape Winelands Sonstraal Hospital, and 30 additional beds at Tygerberg Hospital,” said Premier Alan Winde’s spokesperson Bianca Capazorio.
She said the 850-beds planned for the CTICC remained on schedule to be completed by the first week of June, and that work was “progressing well”.
The temporary hospital at the convention centre will cater for patients presenting with milder clinical signs, and who are in need of hospitalisation and treatment, including administration of oxygen, but not to those with severe clinical signs requiring intensive care treatment.
The CTICC agreed to waive the hiring costs of the venue, welcoming the opportunity “to be part of the solution”.
Brazil has emerged as a coronavirus hotspot, and President Jair Bolsonaro seems to be taking a page out of US President’s Donald Trump’s playbook to tackle the growing number of cases.
Over the past several days the country’s daily spikes of cases have grown. On Tuesday, the country recorded 1 179 fatalities. On Wednesday, Brazil has the largest spike of cases in 24 hours with close to 20 000 cases, about a fifth of the overall record 106 000 new global cases the World Health Organisation recorded.
The country holds the third-highest number of cases behind the US and Russia, with over 310 000 infections and more than 20 000 deaths.
Vox reported that Bolsonaro mishandled the outbreak from the start by “continuously downplaying the seriousness of the virus, vocally opposed state governors’ decisions to impose lockdown measures, personally attended anti-lockdown protests, and pushed for businesses to reopen despite the growing outbreak.”
Hydroxychloroquine, a drug used to treat lupus and rheumatological disorder, has received a massive amount of publicity this year. The reason? Its role in the Covid-19 pandemic.
The drug made headlines after being proposed as a preventative measure (prophylaxis) against Covid-19, as reported in the New York Times.
While hydroxychloroquine has generally fewer side-effects than its cousin chloroquine, which was also researched as a possible Covid-19 treatment, it was generally declared as ineffective against the novel coronavirus, based on several studies.
But, besides the fact that the hydroxychloroquine hype may cause those who really need the medicine for lupus not being able to find it, the drug can also have irreversible side effects, as discussed in the journal Nature.
As schools in South Africa are set to reopen for Grades 7 and 12, there is a debate whether children are less at risk from Covid-19 than adults and those with underlying conditions.
While the general consensus has been that children are not as severely affected by Covid-19 as the elderly, more severe cases in children have been recorded throughout the world.
A new report from paediatric anaesthesiologists, infectious disease specialists and paediatricians at the Children’s Hospital at Montefiore and Albert Einstein College of Medicine describes some of the most significant clinical characteristics of children hospitalised with severe Covid-19.
This report was published in the Journal of Pediatrics and compared the cases of 46 Covid-19 patients aged between one month and 21 years. These patients were either admitted to the general unit or the Pediatric Critical Care Unit (PCCU) at Montefiore.
The Covid-19 crisis is sweeping across the planet, becoming “the greatest disruptor the world has seen in generations”, according to a statement by the International Union Against Tuberculosis and Lung Disease (Union). But as the infection rate continues to surge, it should not result in other serious diseases, such as tuberculosis (TB), being neglected, a Union panel discussion on TB and Covid-19 on Wednesday concluded.
As of 21 May, South Africa has 369 confirmed Covid-19 deaths. Projections indicate that this figure could rise to more than 40 000 by November this year. However, according to the latest statistics by the World Health Organization (WHO), TB caused around 63 000 deaths in South Africa in 2018 (figures for 2019 are not yet available).
Following the recent release of modelling on the impacts of the initial Covid-19 response on TB – commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University – key leaders in the Union panel discussed what the results of this modelling study mean, and how governments can all work together to prevent the potential 1.4 million TB deaths worldwide, caused by the Covid-19 pandemic.
A major factor indicated in the study was an estimation that, globally, a three-month lockdown and a protracted 10-month restoration could lead to an additional 6.3 million people falling ill with TB and an additional 1.4 million TB deaths over the next five years. As a result, the world would face a setback of around five to eight years in the fight against TB.
• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing
• Practise frequent hand-washing, especially after direct contact with ill people or their environment
• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus
• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.
The now-trendy keto diet is said to turn fat into fuel. But a new, small study says it may also change the vast array of microbes residing in your gut (the microbiome).
That could be a good thing, as those changes may ultimately strengthen the immune system by tamping down inflammation, researchers say.
The keto diet, which severely restricts carbohydrates and emphasises fats and protein, has been touted as a way to rein in epilepsy, diabetes and expanding waistlines. Yet despite rising popularity, it remains controversial, and much is unknown about its true impact on health.
The new finding follows a two-month study that tracked diet-related shifts in microbiome content among 17 overweight or obese men, with follow-up tests in mice.
Changes to gut microbes
“There has been a lot of work on ketogenic diets,” noted study author Peter Turnbaugh, an associate professor of microbiology and immunology at the University of California, San Francisco.
“But we didn’t know much about how these diets differ from other high-fat diets, how exactly they impact microbes, or whether or not these diet-induced changes to gut microbes matter,” he said.
To find out, Turnbaugh and his colleagues first placed half the men on a one-month “standard” Western diet composed of 50% carbs, 15% protein and 35% fat.
The other half started off on a keto diet made up of 5% carbs, 15% protein and 80% fat. After a month the two groups switched.
Stool sample analyses revealed that when participants switched over to a keto diet they experienced “significant shifts” in levels of 19 bacterial “families.”
The researchers then extracted microbial samples from the guts of the keto group and inserted them into the guts of mice. The result: a drop in levels of a critical infection-fighting cell that’s also known to promote inflammation in autoimmune diseases.
Levels that promote ketones
The mice were then exposed to low-fat, high-fat and low-carb keto diet options, with fat content respectively rising from 12% to 75% to 90%. And those results were surprising on several levels, Turnbaugh said.
For one, gut microbe levels driven up by a relatively high-fat diet were actually driven down by the low-carb keto diet, and vice versa.
This suggests the microbiome responds differently as dietary fat increases to levels that promote ketones when carbs are restricted.
And while mice on both the high-fat and keto diets gained more bodyweight than those on a low-fat diet, those on keto diets gained “significantly less” weight.
The other surprise, said Turnbaugh, was the role of so-called “ketone bodies”.
“Ketone bodies,” he explained, “are chemicals produced in our body when our cells do not have access to dietary carbohydrates,” such as when following a keto diet. That forces the body to use fat reserves for energy, instead of carbs. And scientists know that the by-product of that shift is a steady rise in ketone production.
But Turnbaugh and his colleagues discovered that in mice a gradual rise in ketone levels (sparked by a keto diet) was accompanied by a gradual shift in gut composition.
The tip of the iceberg
And that begged the question, could boosting ketone levels alone – independent of diet – also alter gut composition? More mouse research, said Turnbaugh, suggested that the answer is yes: “Ketone bodies can directly affect gut bacteria even in the absence of the full diet.”
Still, Turnbaugh cautioned that the current effort is “likely the tip of the iceberg” when it comes to better understanding the complex interaction between a keto diet, ketone bodies, the microbiome and disease risk. The study was small and more research is needed.
A similar note of caution was struck by Lona Sandon, who reviewed the findings. She is an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas.
“I am surprised that the keto diet showed potential effects on the gut microbiome that would lead to reduced inflammation in mice,” Sandon said. She added that prior research actually “suggests high fat/high protein diets are detrimental to the microbiome and increase inflammation”.
Sandon stressed that a keto diet comes with downsides. For one, although popular because it “can help control appetite”, people should know that the “benefits seen initially typically wane over time”, she said. And, she warned, patients prescribed keto to tackle other medical issues “often end up overweight and with increased cardiovascular risk factors”.
The study was published in the 20 May issue of the journal Cell.
The world post Covid-19 could see more regional integration with countries working together, but there are also concerns of rising economic nationalism, which was already in the works before the crisis hit, deputy finance minister David Masondo has said.
Masondo was on Wednesday afternoon part of a panel discussion hosted by the University of Johannesburg’s Institute for Future Knowledge, where he shared views on what the world may look like in the wake of the coronavirus crisis.
Other panellists included Grant Harris, a former advisor on Africa to President Barack Obama, and Professor Dong Wang of Peking University’s Institute for Global Cooperation and Understanding.
The virtual panel discussion also broached issues such as opportunities for countries working together to fight the pandemic and the global risks of rising nationalism.
Nine Eastern Cape healthcare workers, including five nurses, have been suspended for allegedly refusing to attend a Covid-19 patient as they apparently did not have personal protective equipment.
This after Bhisho Hospital was closed after a senior nurse died and her three colleagues tested positive for Covid-19.
Eastern Cape health department spokesperson Sizwe Kupelo confirmed the suspension of the workers at Grey Hospital in King William’s Town.
He said Bhisho Hospital had been closed following the cases, saying this would allow for decontamination and deep cleaning.
While Gauteng Premier David Makhura says he believes his province is ready for Level 3 of the Covid-19 lockdown, that decision will still be made by President Cyril Ramaphosa’s National Coronavirus Command Council (NCCC).
On Wednesday, the premier and his executive visited manufacturing companies around the province to assess the level of compliance ahead of the relaxation of lockdown regulations at the end of May.
South Africa is currently under a lockdown, which has 5 alert levels, with Level 5 being a hard lockdown with reduced economic activity, while Level 1 would see sit-down restaurants and sporting facilities being reopened.
On Tuesday, Makhura told the Gauteng Legislature that the entire province would move to Level 3 in June. He said it couldn’t work for some parts of the country’s economic hub to be on Level 3, while others remained on Level 4 or some even shifted to Level 2 as regions and districts were all interconnected.
The “early flare-up” of Covid-19 infections in the Western Cape is an indication that a similar explosion can happen elsewhere, hence there will be a “focused intervention” in the Western Cape, Deputy Minister of Health Joe Phaahla told Parliament’s health committees.
This after several ANC MPs expressed their concern to the Department of Health at Wednesday’s meeting of the Portfolio Committee on Health and the Select Committee on Health and Social Services.
The committees were being briefed on the health department’s annual performance plan, budget and strategy for 2021 to 2025.
ANC MP Tshilidzi Munyai wanted the national government to intervene in the DA-governed Western Cape’s handling of the Covid-19 pandemic.
Western Cape Premier Alan Winde has advised schoolchildren and teachers with comorbidities to stay at home as the province rides out the coronavirus pandemic, even though schools are due to partially open on 1 June.
“If you are a learner and you do have one of those comorbidities, my advice would be that you would need to continue your lessons from home,” he said during a virtual press briefing on Wednesday.
Winde said the department would have to get the lessons to the pupil.
He added that the same applied to affected teachers – that they should stay home.
This was after Basic Education Minister Angie Motshekga announced on Tuesday that Grades 7 and 12 could return to school on 1 June.
According to the province’s head of the Department of Health, Dr Keith Cloete, the Western Cape is heading into its peak coronavirus period.
The global economy could be set back by a harrowing $82 trillion (the equivalent of R1.47 quadrillion, or one thousand four hundred and seventy trillion rand) in damages related to the coronavirus pandemic over the next five years, according to recent findings by a University of Cambridge department that examines systemic risks.
These cost projections are based on 2019 gross domestic product volumes which stood at $69.2 trillion for the world’s 19 leading economies. The contrast, in comparison, is visibly massive.
The Centre for Risk Studies at the University of Cambridge Judge Business School determined that the potential toll could range between what it called an “optimistic loss” of $3.3 trillion in case of rapid recovery, and $82 trillion in the event of an economic depression.
While lost value of $82 trillion is the worst case scenario, the centre’s consensus projection was a loss of some $26.8 trillion, or 5.3%, of global GDP in the coming five years.
Covid-19, the disease caused in humans by the SARS-CoV-2 virus, remains a mystery that needs a lot more unwrapping. At first, experts believed that the conditions caused by the novel coronavirus were just respiratory diseases.
But as the virus circled the globe, doctors saw a wider range of diseases in their patients, fatal in many cases.
These complications include heart failure, heart attacks and blood clots, which were all reported by emergency doctors in a new scientific paper.
The paper was published in the American Journal of Emergency Medicine.
A Canadian newborn is a “probable” case of infection with the new coronavirus while still in the womb, doctors report. Other such cases have been suspected and reported in prior studies.
But the mother’s active case of Covid-19, along with the fact that the baby boy was delivered via C-section, add weight to the notion that maternal-foetal transmission of the SARS-CoV-2 virus can occur, the Toronto doctors concluded.
There was good news, however: Although the baby was born preterm (about 36 weeks), he was a healthy 6.5 pounds (just under 3kg). And even though testing positive for coronavirus, he did not develop Covid-19.
Still, the case “represents a probable case of congenital SARS-CoV-2 infection in a liveborn neonate,” said researchers led by paediatrician Dr Prakesh Shah, of Toronto’s Mount Sinai Hospital. They published their report on 14 May in the Canadian Medical Association Journal.
The coronavirus pandemic could scuttle more than 28 million elective surgeries across the globe this year, according to a new study. British researchers gathered information from surgeons at 359 hospitals in 71 countries about elective surgery plans, and used that data in a statistical model to estimate numbers in 190 countries.
Based on a 12-week period of peak disruption to hospital services caused by the pandemic, 28.4 million elective surgeries worldwide could be cancelled or postponed in 2020, the study found.
Each additional week of hospital service disruption would cause 2.4 more million cancellations.
“Although essential, cancellations place a heavy burden on patients and society,” said study author Dr Aneel Bhangu, consultant surgeon and senior lecturer at the University of Birmingham.
• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing
• Practise frequent hand-washing, especially after direct contact with ill people or their environment
• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus
• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.
