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South Africa’s COVID-19 testing capacity increased

1 April 2020

Minister of Health Dr. Zweli Mkhize launched 60 new mobile laboratories to boost the country’s capacity to test for COVID-19.

During a media briefing in Johannesburg, Mkhize announced that the National Health Laboratory Service (NHLS) has procured 60 mobile sampling and testing units which will be deployed nationwide to all priority districts and metros.

This brings the total number of mobile testing units to 67.

Speaking at the launch, Mkhize said the mobile testing units, which are uniquely-fitted vans, have been equipped to carry out the same function as a laboratory.

“They will focus on sampling a range of specimens for PCR tests. These mobile units will also be used for rapid test kits when these become available,” Mkhize said.

South Africa currently has the capacity to conduct 5,000 tests for COVID-19 daily. However, with the addition of mobile testing units, combined with 180 testing sites and 320 testing units across the country, this number will now increase six-fold.

“44,201 people have been tested largely in private labs, of which just over 6,000 [have been tested] in public national health laboratory services. This for us is way too few for the size of the population, the inequality, poverty and the underlying burden of diseases and immune suppression that we have,” Mkhize said.

“So even though this number seems high, it is still way to low for the kind of challenges that South Africa faces.”

In a statement Mkhize cautions on the slower growth of COVID 19 positive cases in the past few days and ascribes this to several factors:
Firstly we closed borders and reduced importation of infection
Secondly, enforcing quarantine of the inbound travelers and returning citizens has slowed down the infection from the traveling community to a resident community
Thirdly the lockdown slowed internal transmission by reducing the risk of spread through large gatherings and overcrowded transport routes in trains buses and taxis.

However there are areas we must be alert to. We need more vigilance now than ever before Internal transmission has started and it may have tendency to spread silently as people with less means and slight symptoms may be slow to seek medical help as they are few and far apart initially.

Our testing criteria of patients with symptoms is currently reactive and restrictive By and large, people with access to private family practitioners have tested- most of whom had history of travel to epicenters in western capitals and are easy to suspect if they develop symptoms This means we don’t yet have a true picture of the size of the problem We need to test hundreds of thousands of the population to get a better picture to refine our containment strategy The lockdown may have had the inadvertent effect of limiting access to health facilities for those who depend on public health services in poor and densely populated and underserved communities because of transport difficulties.

This means that the release of a lockdown may have a huge rebound effect of releasing every constraint that made the infection slowdown and we may have a runaway train with no way to apply brakes.

We need to engage all community leaders and call for volunteers in community and civil society formations to support the campaign, spread the message and teach our people to take the containment measures seriously and support all affected individuals and families.

The message of stay at home and importance of hygiene must be made more emphatically. The message must be that COVID-19 is serious but can be defeated and we need each person to make this a personal fight to save the nation.

Those on antiretroviral treatment and other chronic ailments must stick strictly to their medication.

Each person’s actions will count.

Let us break the chain of the coronavirus infection.

Next month the flu season starts, thus making more people sick with similar symptoms, and therefore no way of distinguishing common colds from an upsurge of COVID-19 infection.

These will flood our clinics and hospitals and create fertile ground for Coronavirus to spread or be masked in its presentation.

This means what we may currently be experiencing is the calm before a heavy and devastating storm.

There will therefore be no further warning before the pounding descends upon us.

There will not be time to prepare what we will not have put in place in the next seven days.
 
My plea to all my colleagues was to move with speed on the following:
1) Setting up of mobile units of health workers to move into communities with cases or contacts and set up testing and screening in communities initially starting with the symptomatic and then extending to the greater community. We will now procure rapid test kits, taking into account any of the flaws anyone may point out. We will roll out testing and surveillance and start isolation treatment of patients and quarantine of contacts at an accelerated pace.
This means we will go out look for and find patients and not wait for them in hospital.
We will focus on dismantling the infection cycle by proactive action, rather than a reactive approach adopted up to now. We now combine the offensive strategy with the current defensive strategy used up to now .
There must be clearly defined targets at district and sub district levels structures with a clear short command line led by experienced professionals who can take clinical decisions quickly and act on the spot.

2) We need to procure additional beds and dedicated treatment Centres where only COVID 19 patients will be treated in every town. Where necessary we will find treatment centers and places to treat near communities where the burden of infection is high
3) More quarantine beds must be identified with clear lines of control and food supplies as well as monitoring of temperatures daily, beginning with areas where the disease has been detected already.

4) Health professionals must be earmarked for release to focus on COVID 19 when the storm hits us. We are requesting reinforcements from countries such as Cuba and China via WHO and these should be expected from next week. They must find our machinery well organized to reinforce effectively.

5) Encourage the release from hospitals of those patients that can be managed as outpatients and reduce hospital patient load and risk of cross infections.

6) Every institution, that is hospitals or clinics, must do daily reports of suspected or confirmed COVID-19 cases and take necessary steps to protect staff and patients and prevention of further spread.

7) All treatment and PPE requirements must be stocked for several weeks of supplies. National Department of Health and Provincial Departments must assess areas where interventions are necessary to prepare for heavy loads of patients from end of this week Protective gear must be available for all health workers and every staff member must be taught to suspect infection and prevent spread and protect themselve.

8) Gauteng, Western Cape, KwaZulu Natal and Free State must prepare dedicated capacity for additional hospital beds for COVID 19 and report progress every week.

Based on personal observations the pounding of COVID 19 has started and it will intensify from this week and we may see rising mortality rates. We are losing families friends colleagues community members health and other professionals across all age groups.

We will look at scientific models when these are ready but we now have enough evidence to indicate that unless we move fast we will soon be swarmed.

We no longer have time.
We need to be strong focused and courageous.
We need to be decisive in our actions.
We need to escalate our response to a higher level.

I appealed for a focus on implementation and less on arguments and debates.

There can never be a perfect plan in a battle. Ground experience will refine our actions. Academic debates have their place but during this ground offensive we will entertain advices that refine and improve our effectiveness.

The country’s future will depend on our swift coordinated actions.

Ministry of Health of South Africa

www.sacoronavirus.co.za

 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
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February/March 2020

 
 
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