As the number of confirmed coronavirus cases in South Africa continues to increase daily, the Western Cape government is confident in its “proactive” plan. The province has the second highest number of cases after the epicentre of Gauteng, standing at a total of 490 cases as of Tuesday afternoon. Nationally, 1 686 people have been infected and 13 people have died.
Playing its part in President Cyril Ramaphosa’s announcement of nationwide screening and testing unprecedented in scale, head of the Western Cape health department Dr Keith Cloete spoke to VOC to give clarity on its rollout.
Cloete began by noting an increase in the amount of “ill people” and expressed condolences to the provinces third death- that of a 57 year old man who suffered from underlying health issues. A total of 28 people have been hospitalized for Covid-19, with 10 receiving care in ICU. He added that the number of people who have fully recovered is being verified.
“We have quite a few people that have gone through the 14 days (isolation) and we are busy validating exactly how many people have completed the 14 days, but it’s in excess of about 100 people,” he said.
The HOD explained that healthcare workers will be moving from door to door to conduct screenings. The screening “interview” is designed to test whether or not you have Co-VID 19 symptoms.
It is based on the questions whether you have the symptoms that’s consistent with Co-Vid 19.
“Based on how you answer the questions, we would then advise some people that have positive answers to the questions to go for the test. So not everybody gets off with the tests. Thereafter, either go to the closest health facility that’s prepared for running the tests with a special stream to allow for that. Or we will have a mobile testing facility close where the community health workers enter the community,” he said.
Dr Cloete noted that it’s only about 6-7 questions which asks basic details about you and your health.
“If you are being asked the questions and you say no to all the questions and you don’t show symptoms, you will not be offered the test. And then, once you have said yes to those questions -most of them- we will offer you the test,” he elaborated.
He emphasised that the department is working closely with the police and that the fieldworkers will be clearly identifiable.
“The people that will come to you will come as a group. It is very unlikely be that there’s only one or two people knocking on your door. (They) come as a group of people that will all be clearly identified. They will have special bibs. They will have identification. There will also be the presence of probably law enforcement or police close by. So, it is a big operation. It’s not a few people strolling down the street,” he added.
When going for the test, the HOD explained that healthcare workers will be in full Personal Protective Equipment (PPE) and that the samples taken from you- will either be a throat swap or nasal swap- under strict conditions.
“You will see it’s a professional taking it (because that) somebody will be fully kitted out. It is a sealed sample, highly validated and very correct (and is) opened under sterile conditions. The sample is taken, which is the throat swab. It gets put back into something that gets sent to the laboratory (a biohazardous bag) and the result is available within 24 hours.”
The next step, is to wait and see what the results are. If it is positive, self-isolation will be your next step. If it is negative, you will receive the necessary medical advice.
“If it is positive, the first question to ask the person is, “are you able to isolate yourself from others in the home where you are? Is there arrangements, can you be in a back room? Can you separate yourself from other people in the room? If you cannot and that’s what the public is going to find in many densely populated areas, we then offer alternate place for you to be isolated. That is where isolation comes in.
One of four forms that is required for the process to be completed is the Contact Line List form, where the details of the people you’ve come into contact with will be documented.
“If you have been in close contact with a lot of people, that means within a meter, people have touched you while you had symptoms etc; we identify all of those people and ask them because they not positive but they’d been in close contact with somebody that’s been positive. We then check with them, can they all be quarantined? Quarantine means you can keep yourself also away safe from others for 14 days to see whether you develop symptoms if you do develop symptoms in that time, we also offer you a test. If that’s negative, you serve out your 14 days. If you’re positive, then you also go to isolation,” explained Dr Cloete.
Regarding the refusal of tests due to concern caused by news that is presumably fake or sensationalized, Dr Cloete said getting tested is in the best interest of everyone. He urged citizens to verify the information they receive from reliable sources.
Referring to the latest case where a man was arrested for claiming that testing kits were in fact contaminated, he said it’s easy to understand why people would be fearful.
“I can understand the panic but the call us when somebody sends random WhatsApp like that, sitting somewhere with no credibility attached to where they get the evidence from. And the appeal is to seek validated information from reliable sources,” he said.
The HOD however urged everyone to be on the safe side and gave assurance that the test is of a high quality.
“What we’re doing is of public health importance. So, we will do this activity or this exercise. And you can understand it’s a huge logistic effort. This is to safeguard everyone. It is for the best interest of the person that’s being approached and it’s the best interests of the community,” he said.
“The appeal is that everybody participates, for your own good and for the rest of the community.”
“Obviously, you’ve got the right to say, I do not want to participate. I wouldn’t advise anybody to do that because you place yourself and your family and your community at risk.”
When questioned about shutting an area like Bo-Kaap down due to factors such as it’s elderly population, that it’s frequented by tourists and has a registered death; Dr Cloete explained that the department makes decisions based on data that has collected.
“We don’t have enough information to suggest that there is widespread local transmission in Bo-Kaap. What we are doing with this exercise is to see where there is and why it’s contagious. That’s why it’s important to understand, rather than just assuming that this is widespread, we do the testing, ask the questions realistically and we will learn from it.”
South Africa was one of the few countries to initiate a lockdown before any fatalities were recorded. Dr Cloete said that this has given the country an advantage and fighting chance to overcome the outbreak.
“We also need to understand we are learning things here when people in other countries have not yet learned. We’re taking we’re taking a very bold step is to going to communities, going door to door to take it to take people have done it. We need to learn so that we know for next week and the week after that and next month- what are the right steps and this is the time to learn. We (can) arm ourselves with knowledge.
The Health department will be conducting the screening and testing in various areas and has committed to updating the public regularly.
“Every day we will be adding additional sites. We’re choosing the places where we have been monitoring all the new cases that’s been coming through. And we are first going to the places where we know there’s been cases in the geographic areas and there is a risk of local transmission. It doesn’t mean they’re not going to go through all the other places,” said Dr Cloete.
On Monday, screening was conducted in Mbekweni, Kwanonqaba, and Bishop Lavis, Netreg and Valhalla Park.
Community screening was conducted in Philippi, Bishop Lavis, Valhalla Park, Netreg, Kraaifontein, Scottsdene and the Bo-Kaap on Tuesday.
On Wednesday, the community screening will be conducted in Elsiesriver, Ruyterwacht, Bothasig, Durbanville, Klipheuwel, Fisantekraal and the Bo Kaap.
“It is systematically rolling out to all the places until we eventually get to every area, and that will take us obviously a while, but we are working our way up to them,” he assured.
“We thank all of those who welcomed the community health care workers and enabled them to fulfill their important role in stemming the spread of coronavirus, by being screened and where necessary, tested,” read a statement by the Western Cape government.