Minister Zweli Mkhize: National COVID-19 Conference

Speaking Notes for Hon. Dr Zwelini Mkhize National COVID-19 Conference: Harnessing Science, Technology and Innovation in Response  to COVID-19

Minister of Higher Education, Science and Innovation Hon. Dr Blade Nzimande
Minister of Trade, Industry and Competition Hon. Ebrahim Patel
Director-General of the World Health Organisation Dr Tedros Adhanom Ghebreyesus
African Union Commissioner for Human Resources, Science and Technology Prof. Sarah Anyang Agbor
All Panelists and Participants
Members of the Media
Ladies and Gentlemen

It is an honour to participate in this exciting initiative and I would like to open by extending my heartfelt thanks to the Honourable Ministers Nzimande and Patel for organizing this important conference.

South Africa finds itself in the midst of an unprecedented global health crisis which saw the novel Coronavirus mushroom in China and spread ubiquitously across the planet in seven short months, reaching a total of 17 440 632 cumulative cases and 675 328 fatalities.

It’s clinical manifestations have been mind boggling; affecting pulmonary, cardiovascular, neurological, musculoskeletal and other systems thus mimicking different medical conditions with the resulting mortality being compounded by pre-existing conditions.

Worse is its impact on society beyond health: the pandemic has affected social, political, economic and other aspects of our lives; changing them for good.

We identified our first patient on 5 March in KwaZulu-Natal. From that first case we were alarmed to witness a doubling time of two days and were compelled to move swiftly and decisively to institute a hard lockdown on the 26 March 2020. The lockdown was undeniably effective as we observed an increase in doubling time to 15 days with demonstrable flattening of the curve. We needed time to prepare our health services to be able to manage the large influx of patients during the inevitable surge.

However after 5 weeks of hard lockdown hunger, lack of food and income security resulted in social and economic distress and it became necessary to focus on saving both lives and livelihoods. Thus began the differentiated approach of easing restrictions through our alert level system. We embarked on this re-opening of the economy with the full understanding that an increase in numbers of cases was inevitable. Indeed we have seen an explosion in the numbers to reach 482 429 with 400 00 of these cases being registered in the past two months.

Despite the huge surge that made South Africa to rank fifth highest in positive cases in the world we have reasons to be hopeful

We have mobilized support from medical experts who advise on protocols to put in place for containment, to control cluster outbreaks and to guide day to day management.

1. Lessons on case management and discovery of effective medications such as dexamethasone, early use of oxygen (including preference for non-invasive oxygen support) and other treatment regiments has resulted in a low mortality consistently below 2%. Our current fatalities stand at 7812 and we extend our condolences to all South Africans that have lost loved ones due to COVID-19
2. The recovery rate is encouraging. It has increased to 64% indicating that more people have overcome the infection than those who are infected and test positive.
3. Western Cape has passed the peak and maintained a plateau for the past two months whilst early indications of promising decline are observed in Eastern Cape and Gauteng. For these reasons we have to intensify the non pharmaceutical interventions and emphasise behavioral change to force reduction of new infections in all provinces.

As such, we have established a multi-sectoral Ministerial Advisory Committee which focuses on ground mobilization for behavioral change. This seeks to forge collaboration with behavioral scientists, civil society, communities, traditional leaders, traditional healers, religious organisations, labour and all stakeholders who are able to effect change at grassroots level.

We continue to manage a number of concerns and challenges:

• bed capacity to manage the surge is an ongoing battle, however, it is one we are determined to overcome
• triaging mechanisms in facilities to ensure nosocomial transmission is disrupted continues to be re-emphasised and refined

• contact tracing for quarantine and isolation remains key to breaking the cycle of community transmission- we have now augmented our track and tracing functions to be supported by a digital system called COVIDConnect where users can interact with the health care system on a digital platform for case identification, tracking and tracing and referral to quarantine, isolation or hospitalization.
• Strain on Personal Protective Equipment availability due to high demand, overutilisation, sometimes poor quality, corruption, price gouging and maldistribution now requires our urgent attention and innovative stock surveillance solutions. This requires immediate resolution to protect our health workers as they are the backbone of our health services and also to avert labour disputes.
• We still need to work on increasing human resources for health of all categories, expedite the filling of vacancies and recruit new staff
• Additional ventilators and oxygen supply is pivotal and the National Ventilator Programme is an important development in this regard.

A total of 2 918 049 tests have been conducted. Increased testing capabilities beyond our community screening programme allowed us to identify low transmission and high transmission areas.. Our shift to a targeted testing strategy was necessary to optimize the use of available resources in the midst of a surge. Antibody testing can still play a role in assessing community impact.

Participating in trials, for example, the Solidarity Trial for therapeutics and the ChAdOx-1 study for vaccine development is extremely important to position the country favourably for access to these tools when they become available on the market- it is for this reason we are investing a huge amount of resources to safeguard our future.