GARDEN ROUTE DISTRICT NEWS - A Covid-19 model developed by the Actuarial Society of South Africa (Assa) confirms that Covid deaths in the country may exceed 48 000 within the next four months if Government does not maintain a strict approach to flattening the infection curve.

In a recent media release, healthcare actuary and Assa President LusaniMulaudzi said conservative modelling indicates that the peak is likely to be reached between August and September.

The baseline scenario of the Assa model assumes that one infected person is likely to infect three others, and that 75% of infected people present as asymptomatic. The most optimistic scenario assumes that the lockdown initiative reduces the reproduction number to 1, 5 and that non-pharmaceutical interventions(NPIs) after the strict lockdown period result in a reproduction number of 2,1.

In this scenario, hospital bed usage would peak at 70 000 between August and September this year and requirements for ICU beds at just over10 000. 

"Expected cumulative deaths stop short at just over 48 300," said Mulaudzi. However, as more data becomes available, it may be that the actual mortality figures are significantly different to what has been projected.

'Readying for best possible response'
Western Cape Premier Alan Winde said during a provincial media briefing on Thursday 7 May that "a few more weeks" are needed to get all health care systems in place for the best possible response to Covid-19 during the anticipated peak of infections in the coming months. 

Already the number of infections in the Western Cape is doubling every week.

Winde said although the highest number of deaths are recorded in the Western Cape, it is not because the death rate is higher than in the rest of the country. At 1,8%, it is in line with international data on the progression of the virus in other countries. 

"As it stands now, the death rate is not higher in the Western Cape than it is elsewhere in the world and is likely to be the same rate countrywide, accurate reporting of data assumed."

Refining screening and testing to protect vulnerable
Dr Keith Cloete, head of the Western Cape Health Department, said one of the most important things in their preparations for the peak, is to focus on the most vulnerable people. 

This entails focusing community screening and testing especially on people with comorbidities and the elderly, to make sure they are found and protected against transmission.

At the peak of the infections, 90% of people will not need hospitalisation. To deal with these people, places where bigger numbers of testing can be done are being prepared. 

Such facilities already exist at 10 hospitals / community health centres (including George Hospital) and will also be established at a further six hospitals / centres.

Testing will also be done at 106 primary care facilities that are being readied. The department has furthermore established five "isolation booths" that enable a health care provider to take a sample from a person under investigation without coming into direct contact with that person.

Equipping the Cape Town International Convention Centre (CTICC) as a field hospital for Covid-19 with over 850 beds is starting this week. Agreements for three more facilities in the metro are being finalised (two in Cape Town and a third in the Cape Winelands), which will contribute over 1 400 additional beds during the peak.

New ways to manage Covid patients
Cloete said clinicians in the province have been looking at innovative ways of managing the disease, learned from what has been tried across the world. They are excited about two methods. In the "proning" method, the patients lie on their stomach instead of their back while oxygen is administered. 

Early signs are that this improves the recovery of patients. The other method is the use of high-flow oxygen instead of putting the patient on a ventilator.

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