Premier Alan Winde: Western Cape Weekly Digital Press Conference 

“We are noticing a gentle easing of pressure in the Metro, but continued vigilance is essential”

The Western Cape Government understands that the hard lockdown was an important intervention to slow the spread of the virus and therefore to buy the time needed to prepare our health system for the peak of infections that were to come.

This was essential so that every single person receives the medical care that is needed, when it is needed. Our teams therefore worked around the clock to ensure that we have enough staff, supplies and additional temporary care facilities (or ‘field hospitals”) available to provide this care.

They have faced, and continue to face, enormous pressures. This is an unprecedented crisis, that has pushed our systems, finances and capacity.

I know it has not been easy for our frontline staff, be it nurses, teachers or police officers. I therefore want to thank all the officials, across our government departments, for their hard-work and dedication displayed during this challenging time.

I also want to say a big thank you to every single resident, wherever you are, for playing the most important “lead” role in our Covid-19 response.

I know that millions of people across our province are following the golden rules, wearing a mask, washing their hands, and keeping a safe distance. Yes, there are still some who are not – but the overwhelming majority of people are playing their part. Thank you for leading from the front and being role models for other members of our community to follow.

Early indication of pressure easing, but we cannot let our foot off the pedal

From the first digital press conference, that I hosted months ago, I set out that our response to Covid-19 would be evidence based and data-led. We would follow the best scientific advice in making projections on what was needed from our health platform, so that we were as prepared as possible.

We have done this to the best of our ability - planning for the very worst, but always intervening to get the best possible outcome. This has happened in the context of inevitable uncertainties, as our scientists learn about the virus and how it impacts our communities.

We have thus far undertaken an early provisioning scenario, and two additional calibrations with the National Covid-19 Modelling Consortium. We are now working towards a third calibration with this grouping, using the latest available data as we seek to continuously re-assess our projections and provisioning scenarios. We will make this public when it is received.

However, I can reveal that we are starting to see a gentle easing of pressure in the Metro in particular, with a possible decline. This is noticed in the most robust data available to us: hospitalisations and deaths.

But let me be crystal clear: it is simply too early to say the worst is over. We simply do not know enough about the virus to claim so. We are still in the midst of a serious health pandemic.  

So, if anything, we must be even more vigilant and alert than before so that we can continue to flatten the curve and save lives in the Western Cape.

Our health platform is managing

The Western Cape Department of Health manages its health platform in an integrated manner, allowing us to closely monitor capacity at any given point. This allows patients to be moved between different facilities, if capacity is reached.

We note the following observations regarding Covid-19 in the Western Cape:

• The hospital admissions for Covid-19 have stabilised over the last 10 days, across public and private hospitals.
• The critical care bed occupancy rate reached a daily maximum of 320 patients. It is currently at 270-280 patients.
• Total Covid-19 admissions reached a daily maximum of 1900 patients, and now currently stands at 1600-1700 patients.
   

In the Cape Metropole, the most populous district in the Western Cape and which accounts for the sub-districts with the most infections, our acute care hospital capacity, including all patients (Covid-19 and non Covid-19) is as follows:

This means our acute care capacity has not yet exceeded 70%.

Our intermediate care facilities or “field hospitals” have provided an enormous support in alleviating this pressure:

• The Hospital of Hope has admitted 1069 patients over time, as of 14 July 2020, and has discharged 751 people since opening.
• The Thusong Centre in Khayelitsha has admitted 198 patients and discharged a total of 138 patients so far.
• The 330-bed Brackengate Field Hospital is set to come online on 20th July.
• The Sonstraal Hospital, which will have a total capacity of 150 beds, is expecting the first 63 beds online soon.
• Additional beds will be provided in Hermanus (32 beds), Vredendal (20 beds) and George (20 beds).

We also continue to open new testing and triage centres at health facilities across the Western Cape:

• We have 19 such facilities operational
• Construction is completed at an additional 7 facilities, and they will become operational soon
• Testing and triage centres are under construction at 15 facilities

To ensure that we can provide the best possible care to our residents when they need it, we have also made sure that we have the right supplies available in our facilities:

• We had a significant platform of medical equipment assets available prior to the pandemic, including 324 ICU ventilators, and 94 transport ventilators
• 25 additional ventilators have been added to our health platform
• A decision support tool was developed to optimally manage key processes (needs assessment, procurement and allocation) on an ongoing basis
• Approximately R250 million has been invested in health technology to strengthen our response. This ensures our health facilities can provide different levels of care and helping ensure effective screening, testing/diagnosis, referral and treatment of Covid-19 patients
• We have thus far employed 620 people at our field hospitals
• We have piloted a National Track and Trace system, and look forward to the launch of it by the National Government
• We have finalised key agreements with private sector, to access their services should the need arise
• We have ensured adequate supplies of oxygen to our facilities, and currently utilising 60% of our total capacity.
• We have made use of High-Flow Nasal Oxygen Devices at our facilities, which has proven to an effective, life-saving support intervention for Covid-19 patients.
   

The Western Cape to start process of scaling up non-Covid health services from 1 August 2020

Our Department of Health will now be working on plans to scale-up non-Covid health services and responses, which has been negatively impacted by the pandemic.

This includes:

• Scaling up chronic disease management (Diabetes, Hypertension), HIV and TB management, and Child and Women’s health services. This is done via Community Health Workers and primary care services.
• The systematic re-introduction and scaling up of elective surgery, over the next 8 months, considering the Covid reality over the next 12-18 months.
• The recovery of the health care delivery system to reach pre-Covid levels of performance.

Diabetics at high risk of severe illness, must present for testing as soon as any symptoms develop

I was very pleased to welcome endocrinologist, Associate Professor Joel Dave, to today’s digital press conference. He discussed his research on the impact of Covid-19 on diabetic patients. This is something very close to my heart because I am type 2 diabetic.

The research found that while diabetics are not at higher risk of contracting the virus, they are at higher risk of developing a severe illness from Covid-19. That is why the Western Cape Government’s Department of Health has developed a specific action plan on diabetes.

A key pillar of this action plan is that diabetic residents who develop Covid-19 symptoms must get tested immediately. We are also making some space in our intermediate care facilities available for diabetic residents who get ill with Covid-19.  The clinical outcomes for those who are identified early are much better than those who wait until they are severely ill.

My message to our diabetic residents today, as a fellow diabetic, is to please take every precaution possible to protect yourself. And if you do start developing any symptoms to urgently get tested for Covid-19. We have the healthcare available to support you, please make use of it. Also remember to take your medication and to live a healthy lifestyle with a balanced diet. This makes a major difference.

The virus is going to be with us for some time, so behaviour change is our best long-term defence

The Western Cape Government has been engaging with behavioural science experts on how best to get the behaviour change needed in our communities.

The reality is that the virus is going to be with us for some time and we need every single person to play their part in keeping themselves and their families safe in the months ahead. If we don’t do this, we could risk new outbreaks emerging.

I want to make an important point here: behaviour change is not easy. We are asking residents to act in ways that are not normal in our cultures and communities. This will require lots of innovation by government, and this is a challenge we are taking seriously.

I want every resident in our province to know that I am extremely grateful for the changes you have made in your lives already. I know it has not been easy. I want you to share the same gratitude and praise with fellow members of the community when you see them wear a mask or follow the other golden rules.

This praise, I believe, will be more effective in creating role models and encouraging emulation than scolding. So always be kind and say thank you to someone when they act in a way that keeps you and your family safe.  Let’s create a movement of behaviour change in our communities in this way, with care and in the spirit of solidarity.