WESTERN CAPE NEWS - Western Cape Premier Alan Winde in his weekly digicon said there is "no doubt" that the province will experience a third Covid-19 wave.
He said although the province is still in COVID-19 plateau, "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."
He said the goal of government and residents must be to flatten the potential curve and push out the onset of the third wave while as many residents as possible are vaccinated.
"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 behaviour change response to any increase in cases. We cannot let our guard down now."
He said the Western Cape Government is on track to start a mass vaccination campaign on 17 May with vaccinators trained and vaccination sites selected across the province. "Our goal is to vaccinate as many residents as possible, as quickly as possible, to mitigate the severity of the coming third wave."
Call on over 60s to register
In the Western Cape, there are 720 000 residents over 60, and province is aiming to complete the vaccination of this age band by the end of June. "Key to this is ensuring we register, register, register," said Winde.
He called on community organisations and family members, neighbours and friends to ask those over 60 around them if they are registered, and if not, to offer their 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 can contact the call centre on 0860 142 142.
Trained teams are 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. Daily huddles continue, which have shown no significant developments in any district of the province.
Hospital admissions and daily deaths have decreased slightly, but the absolute numbers involved are very small. There are 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
- The teams on the ground are watching closely for any outbreaks or clusters. No major clusters have been identified.
Insofar as the health platform is concerned, there are:
- 713 Covid-19 patients in the 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," said Winde.
The Western Cape Government has a strong 5-point mitigation strategy in place to delay the third wave and respond accordingly when it does occur in the 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
The province has a strong surveillance system in place based on excellent data to monitor the onset of an outbreak. In this regard, monitoring of seroprevalence levels continues, which stand between 30% and 50% province-wide but are lower in some settings.
The teams continue to track cases, hospitalizations and deaths on a daily basis, and monitor the wastewater.
Testing capacity in the Western Cape is currently strong, with testing on the go for both diagnostic and surveillance purposes. Contract tracing teams remain intact to detect super spreader and cluster events. There are quarantine and isolation facilities in place to assist residents who may not be able to safely isolate in their living environment.
3. Scale up the health platform’s Covid-19 capacity
The province stands ready to scale up its 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.
a. Bed occupancy as a result of COVID-19 is currently low. Based on a series of trigger points, such as whether there is a sustained 20% increase in the 7-day moving average for new cases, the province can rapidly increase beds for COVID-19. It has 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
b. Systems are in place to ensure that the province has good stocks of oxygen. Currently it uses only 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," said Winde.
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," said Winde.
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