“While we are still in COVID-19 plateau, third wave will come and we cannot relax”
During my weekly digital press conference today, I provided an update on the health platform, progress on our Covid-19 vaccine rollout strategy and the national Ministerial Advisory Committee (MAC) guidelines for the third wave.
Based on all our data, I’d like to issue a strong message to the residents of our province: there is no doubt that we will experience a third wave and we simply cannot relax.
This is based not only on international experience, where in some countries the third wave is well established, but also on data from other provinces within our own country. The NICD recently issued an alert to say that there are indications that in the North West, Free State and Northern Cape, signs of a third wave have already been detected.
Our goal – as government and as residents – must be to flatten our potential curve and push out the onset of the third wave while we vaccinate as many residents as possible.
Flattening the curve and pushing it out is in all of our hands. I am concerned that some residents seem to be acting as if COVID-19 is no longer with us. What we need is a strong and fast behavior change response to any increase in cases. We cannot let our guard down now.
At the same time, the Western Cape Government team is working extremely hard to ensure a slick vaccination rollout. In this regard, we are on track to start our mass vaccination campaign on 17 May 2021, with vaccinators trained and vaccination sites selected across our province.
Our goal is to vaccinate as many residents as possible, as quickly as possible, to mitigate the severity of the coming third wave.
“We must all take responsibility to register over 60”
The national government’s EVDS registration system is currently open for people over 60-years-old. In the Western Cape, there are 720 000 residents over 60, and we are aiming to complete the vaccination of this age band by the end of June. Key to this is ensuring we register, register, register.
Yesterday I was in Atlantis visiting a Neighborhood Watch and asked its members to please play a strong role in helping community members over 60 to register. But my call does not only apply to community organisations – each and every family member, neighbor and friend should be asking those over 60 around them if they are registered, and if not, “can I help?”.
If any resident is struggling to register, and has not been able to clarify their concerns via the www.sacoronavirus.co.za/evds/support/portal, they are urged to contact our call centre on 0860 142 142. Our teams are trained and on stand-by to talk residents through the simple, 8 step process.
Once the majority of the age band has been vaccinated, we will push to have the EVDS system opened to lower age bands. We will ensure, through a strong communication campaign, that residents are aware of the opening of the system to younger residents.
“Health platform shows we are still in containment phase”
While new Covid-19 cases have plateaued out, the Department of Health remains highly vigilant of possible clusters or other indications of the onset of the third wave. Our daily huddles continue, which have shown no significant developments in any district of our province.
I am pleased to note that admissions and daily deaths have decreased slightly, but the absolute numbers involved are very small. We are currently seeing on average 135 new cases, 20 admissions and 2 deaths each day. The average test positivity rate remains low at 4.13% as at 16 April.
In the Cape Metro:
- Cases are continuing to show a slight increase from 2 April to 9 April 2021;
- With the recent public holidays, we are comparing a week with 5 full days of testing to a week with only 3 full days of testing. This is affecting the percentage change; and
- The percentage changes are large, but the absolute numbers of cases in the sub-districts are small.
In the Rural Districts:
- Case numbers are mostly unchanged;
- There is a wide variation across the districts, but the absolute numbers involved are very small. For example, the Central Karoo went from on average 1 to 2 cases; and
- Our teams on the ground are watching closely for any outbreaks or clusters. No major clusters have been identified.
Insofar as our health platform is concerned, there are:
- 713 Covid-19 patients in our acute hospitals with 413 in public hospitals and 300 in private hospitals. This excludes persons under investigation (PUI) for Covid-19 and cases in specialised hospital settings.
- Covid-19 hospitalisations have continued to decline. The non-Covid-19 service remains busy particularly in the metro. This is due to a combination of trauma and medical cases.
- The Metro hospitals have an average occupancy rate of 90%. George drainage area hospitals are at 64%. Paarl drainage area hospitals are at 77% and Worcester drainage area hospitals are at 68%.
- Covid-19 and PUI cases currently make up 5% of all available acute general hospital capacity in both Metro and Rural Regional Hospital drainage areas.
- Covid-19 inter-mediate care: the Brackengate Hospital of Hope currently has just 15 patients (3 320 cumulative patients), Freesia and Ward 99 have 0 patients, Mitchell Plain Hospital of Hope has 0 patients and Sonstraal currently has 0 patients.
- The Metro mass fatality centre has capacity for 240 bodies; currently 1 decedent (cumulative total of 1391 bodies), 0 admitted. The overall capacity has been successfully managed across the province.
“MAC guideline issued for third wave: 5 point mitigation strategy in place, concern for upcoming holiday”
It remains difficult to determine when the third wave will begin due to uncertainty in the rate at which contacts will increase, which is largely determined by the behaviour of residents.
The COVID-19 Ministerial Advisory Committee (MAC) has issued guidelines for the third wave, including the need to have containment measures in place, as well as to prepare for an oncoming surge in terms of human resources, PPE, medical equipment, beds and oxygen. The MAC has also taken lessons for South Africa from the Western Cape, and has urged all provinces to adopt a data dashboard for planning and tracking purposes, as well as to host daily huddles to improve rapid detection through local intelligence.
At this stage, it is predicted that due to having relatively high levels of protection from previous infections, we can see a lower third wave if we all behave responsibly. It will take extra effort from residents to stick to good COVID-19 behaviour over the winter period, but we must all try our best.
As the Western Cape Government, we have a strong 5-point mitigation strategy in place to delay the third wave and respond accordingly when it does occur in our province:
1. Behaviour change
The upcoming school holiday and the long weekend is cause for concern, and requires of all of us to increase our vigilance by incorporating these 6 habits:
- Limit travel to high-risk areas – avoid spread from high transmission areas
- Keep outdoors, if at all possible – avoid sharing breathing space (enclosed spaces)
- Keep gatherings small – avoid crowds
- Keep your distance – avoid close contacts
- Wear a mask – protect yourself and others
- Wash your hands thoroughly and often– stop spread through physical touch
We will shortly be rolling out a wide-scale community communications campaign to advise residents on how to play their part in delaying the third wave, and we will roll out a vaccination campaign which is aimed at assisting residents with information on our vaccine rollout programme.
2. Outbreak response
We have a strong surveillance system in place based on excellent data to monitor the onset of an outbreak. In this regard, we continue to monitor our seroprevalence levels, which stand between 30% and 50% province-wide but are lower in some settings. We continue to track our cases, hospitalizations and deaths on a daily basis, and we monitor our wastewater.
Our testing capacity is currently strong, with testing on the go for both diagnostic and surveillance purposes. Our contract tracing teams remain intact to detect super spreader and cluster events. We have quarantine and isolation facilities in place to assist residents who may not be able to safely isolate in their living environment.
3. Scale up our health platform’s Covid-19 capacity
We stand ready to scale up our health platform to ensure that it is agile and able to respond to a COVID-19 surge. Two key factors in doing so are managing bed capacity and oxygen.
Bed occupancy as a result of COVID-19 is currently low. Based on a series of trigger points, such as whether we see a sustained 20% increase in the 7-day moving average for new cases, we can rapidly increase beds for COVID-19. We have 761 beds, in addition to in-hospital operational beds, available for activation:
- 336 beds at Brackengate Hospital of Hope
- 200 beds at Mitchells Plain Hospital of Hope
- 30 beds in Ward 99 at Lentegeur Hospital
- 59 Beds at Sonstraal
- 136 beds at Tygerberg Hospital
- We have put systems in place to ensure that we have good stocks of oxygen. We are currently using just 13 tonnes of oxygen per day, down from 51 tonnes per day in the first week of January.
4. Maintain comprehensive services
Maintaining comprehensive services requires a redesign of our built environments, and the consolidation of non-COVID services within smaller footprints. We may be required to downscale non-emergency, non-COVID services should the demands of the third wave require us to do so.
5. Safeguard and protect healthcare workers.
Finally, we will continue to safeguard and protect our healthcare workers through vaccinations, infection prevention control, and health and wellbeing programmes. We will ensure that a total of 132 000 healthcare workers are vaccinated under phase 1 of the vaccine programme. Non-pharmaceutical interventions, including hand washing and PPE, will be used to prevent infection among healthcare workers. Finally, we will continue in our efforts to relieve pressure on our healthcare workers by providing appropriate psycho-social support. Healthcare worker infections remain at a low.
“Western Cape Government remains on track to roll out phase 2 of the vaccine strategy”
The Johnson & Johnson (J&J) Sisonke Programme or Phase 1 of our vaccine strategy was launched on 17 February 2021. To date, a total of 53 507 healthcare workers have been vaccinated in the province. This includes healthcare workers in the public and private sectors.
Given the 6 reported cases of rare blood clots in the USA (out of 6.6 million vaccinations), the J&J Sisonke programme has been temporarily paused.
SAHPRA has evaluated the information and proposed the continuation of the use of the J&J vaccine in South Africa. Pending approval from the Research Ethics Committee, it is very likely that in the next few days, the use of J&J vaccines will resume. I look forward to the conclusion of the Sisonke programme which will see approximately 68% of health care workers vaccinated. We are preparing to scale up our vaccination programme during April to complete Phase 1 (all healthcare workers). This will be supported by the expected arrival of 34 000 doses of the J&J vaccine by early May 2021.
We will then start with Phase 2 of our vaccine strategy on 17 May which will operating concurrently during May 2021 with both Pfizer and J&J vaccines being used. Our approach to the rollout of vaccines at this time is according to age, starting with our oldest residents first, as follows:
1. Phase 2a: Over 60s
We are aiming to conclude the vaccination of the 723 160 people over 60 in our province before 30 June 2021.
2. Phase 2b: 40 – 59 year olds
We aim to conclude the 1,588 million residents in this age band by 30 October 2021.
3. Phase 3: 18 – 39 year olds
We are aiming to conclude the 2.665 million residents in this age group before 28 February 2022.
National Health Minister Zweli Mkhize visited our province earlier this week, and assured us of the delivery of vaccines to cover 4.977 million people in our province, with rolling delivery commencing in the next few weeks.
We continue to keep our vaccine acquisition team engaged in the event of indications of a shortfall.
“Keep safe this holiday period and into the future so that we can mitigate the impact of the third wave”
This holiday period and beyond, we call on all residents to play their part through strong safety behaviours so that we may delay the third wave while we roll out our vaccine campaign.
We also call on residents to help those over 60 to register on the EVDS system, which can be found at: https://vaccine.enroll.health.gov.za/
Should you need assistance with the registration process, do not hesitate to visit www.sacoronavirus.co.za/evds/support/ or call our call centre on 0860 142 142.
