Top Covid-19 experts have warned that unless the resurgence in Nelson Mandela Bay is contained immediately, SA risks spending January engulfed in a second wave of the pandemic.
The warning comes amid a surge of cases in Nelson Mandela Bay, and ahead of hundreds of thousands of people travelling across the country for the festive season.
The mass migration began this weekend, when thousands of matric pupils headed for coastal towns to celebrate the end of exams, despite warnings from medical experts that these parties are super spreader events.
Officials in the Eastern Cape city have gone into emergency mode, with proposals to halt the on-site consumption of alcohol at taverns and pubs, extend the curfew and reduce the permitted size of social gatherings. These proposals are expected to be made to the National Coronavirus Command Council (NCCC) next week.
Widespread disregard for safety protocols has been blamed for the outbreak in Nelson Mandela Bay, which now accounts for more than 50% of SA's daily infections.
In less than a month, the daily number of Covid-19 cases in the municipality grew from 103 to 765. By Thursday, there were 4,526 active cases and 1,647 deaths. Total cases stand at over 40,000.
Though hospitals still have capacity, health workers are “exhausted, stressed and frustrated”, according to the chair of the South African Medical Association (Sama), Dr Angelique Coetzee.
The head of the Covid-19 ministerial advisory committee, professor Salim Abdool Karim, said if the Covid-19 resurgence in Nelson Mandela Bay is not contained immediately, the country risks spending January engulfed in a second wave.
“I am worried about December 16, when the factories close and hundreds of thousands of people travel across the country, some of them to the Eastern Cape. Three weeks later when the holidays are over they will be taking the virus throughout the country,” he said.
“Unfortunately the Eastern Cape health department does not have the kind of capability that we see in many of our provinces. They could not quell the outbreak. It was not controlled adequately and, before we knew it, had spread. The way to stop a national outbreak is to get the Eastern Cape situation under control now.”
Professor Mosa Moshabela, chief medical specialist of rural health and dean of the University of KwaZulu-Natal's School of Nursing and Public Health, concurred: “We are witnessing a second surge localised to the Eastern Cape currently, and spreading throughout the province.
“This will likely trigger a surge in the Western Cape and Gauteng. Gauteng will trigger all other provinces after the holidays, towards the end of January, and through February and March.”
Moshabela said a limit on travel could be an early precaution.
“If fewer people travel, and fewer people to the Eastern Cape, then there is chance we might limit the spread. Those who opt to travel should avoid gatherings. They should also self-quarantine for seven to 10 days, and follow standard preventive measures.”
Moshabela said the Western Cape and Eastern Cape are feeding each other with infections, given the amount of movement between the provinces.
Health minister Zweli Mkhize held a meeting in Port Elizabeth on Friday with local business and political leaders.
He denied there were talks about placing the metro under heavier restrictions, but an ANC leader in the region said Mkhize's meeting with the business community had agreed that the area should move back to level 3 of lockdown regulations.
“The decision was welcomed even by taverners. The initial thinking by the minister was that we move to level 4. But the meeting reached a compromise that we should move to level 3. This means all taverns will have to close down. They will be no on-site drinking and a stricter curfew will be introduced. The details will be finalised by the NCCC.”
Mkhize told reporters on Friday: “No decision has been taken about putting Nelson Mandela Bay on level 3. We are looking at what needs to be done in terms of restrictions that will help to support our facilities as well as also reinforce [compliance] in the community. We will be able to announce that once a decision has been taken.”
We need drastic measures. we are a city in very big trouble
— Nelson Mandela Bay acting mayor Thsonono Buyeye
He said his department is communicating with the Western Cape government regarding the management of the Garden Route.
Nelson Mandela Bay acting mayor Thsonono Buyeye said a final decision will be made in about a week.
“We need drastic measures. we are a city in very big trouble,” said Buyeye.
Suggestions on how to curb the infection rate in the metro have been made, he said.
“Some of these decisions include increasing the curfew from 12am-4am to 10pm- 4am. This is because of the challenge around law enforcement and policing of regulations. Taverns and nightclubs close at [midnight], which means people, when they leave, automatically violate the curfew.”
He said tavern owners have proposed that customers be stopped from consuming alcohol on site and that taverns only sell alcohol for off-site consumption.
“Tavern owners are really worried. Many of them are apparently dying.”
Buyeye said another suggestion is that social gathering numbers be reduced.
“Gatherings and social get-togethers, like funerals and nightclubs, are super spreaders. The [upper limit] of 100 is not working.”
He said it is very difficult to say exactly why the metro's residents are not complying with regulations, especially those to do with wearing masks and social distancing.
“We have been conducting numerous awareness campaigns, and have ramped up law enforcement operations, shutting down taverns, nightclubs and other venues where there is non-compliance.”
However, the Eastern Cape health department said reports that it is not coping with the growing number of Covid-19 cases are “fake news”.
“This is an unfortunate, gross exaggeration of the situation, which is causing unnecessary alarm. Nelson Mandela Bay has 2,100 beds and of these, 199 are at Livingstone Hospital, which has also created an additional 73 beds. ICU bed occupancy at Livingstone is currently at 50%. The hospital has appointed six additional doctors and over 100 various nursing categories,” said department spokesperson Sizwe Kupelo.
The department said irresponsible behaviour has led to an increase of Covid-19, and to ease the burden on state facilities, taverns that flout the regulations should be shut down.
“Total disregard of the regulations by the public, gatherings, alcohol consumption and massive movement of people have led to this increase. We are going to recommend closure of taverns that are disregarding the regulations,” said Kupelo.
He said it was unfair to call the department “poorly run”.
But Sama, which represents doctors, said that simply having beds available is not enough — hospitals need to be adequately equipped and staffed.
Coetzee said: “Lack of funded posts puts a significant strain on doctors. The current number of staff members in most hospitals is grossly inadequate, and health-care workers are exhausted, stressed and frustrated.”
Sweetness Stokwe of the National Education, Health and Allied Workers' Union agreed that nurses and support staff are exhausted.
“If there was a staff complement of 20, five died from Covid-19 and another five are off ill with the virus. That now means that 10 nurses are doing the job of 20. The department refuses to acknowledge that it needs more staff,” she said.
Western Cape premier Alan Winde said he is deeply concerned about the growing number of Covid-19 infections.
“Over the past week alone, the province has witnessed a 52.1% jump in new cases, from 125,919 to 126,571 — an increase of 652. A day later they increased by 1,072. This growth is primarily driven by two districts, the Garden Route and the Cape metro.”
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