Category: COVID

Netcare CEO Recounts Challenges and Lessons of 2020

In an interview posted on Moneyweb, the CEO of Netcare, Dr Richard Friedland, related how the company had weathered a very hard financial year.

“We have certainly felt the effects financially and we haven’t been able to pay a dividend to shareholders. But, as I’ve said to all of our frontline workers, we paid a dividend to South Africa in terms of looking after so many thousands – more than 28 000 Covid patients. That is far more significant than anything we could have done in monetary terms,” said Friedland.

The company learned valuable lessons, being at “the tip of the spear” of the COVID pandemic. Following their first cases on March 9, a large outbreak occurred at St Augustine’s, followed by a much smaller one at Kingsway. 

Friedland spoke of the sacrifices the staff had made over the past months, saying “This is not a time to abandon them. It’s a time to stand with them. It does mean our recovery will be longer, but we’ll do that together. And I think it’s critically important, given the headwinds we’re facing in South Africa.”

The company made much of its profit from asset disposal, but Friedland said that they were seeing a return to demands for elective surgery, excepting their two hospitals in the Nelson Mandela Bay area. He noted that there was a noticeable uptick in cases, similar to what they had experienced in the first wave, and that their hospitals were relatively full. However, they were putting their lessons learned into practice by having readied adequate stores of PPE and oxygen, for example. The length of stay has been reduced from 22 days to seven. He remarked on how stressful the pandemic had been for all concerned, but he said that continued efforts must be made.

“[…]Covid nearly robbed us of our humanity, and we need to be very careful about that going forward, particularly as healthcare workers, when patients cannot see their loved ones, when they’ve got to communicate with us through masks and spaces. We’ve managed to find other ways, through Facetime and mobiles, to communicate with their loved ones; but there’s no excuse for [not] improving communication all the time. I think Covid exposed that and there’s been a lot of anxiety as a result that we still need to manage,” concluded Friedland.

SA Medicinal Plants Show a COVID Treatment Promise in New Study

Researchers at the Durban University of Technology and the University of KwaZulu-Natal have been examining plants used in traditional African medicine to see if they have any application in treating COVID.

There has been increasing interest in investigating medicinal plants for compounds to use in the treatment of COVID, which still lacks an effective treatment despite effective vaccines being demonstrated.

The researchers began with 29 compounds from medicinal plants known to be effective in treating the common cold, flu, other respiratory conditions, as well as their antimalarial, antiviral and antioxidant activity.

Using a biocomputational approach that does simulated “molecular docking” with various compounds and the known molecules of SARS-CoV-2, the researchers found a number of plants, including the Rooibos bush, contained useful compounds. These displayed favourable binding orientations and were thus identified as being potential inhibitors of the SARS-CoV-2 receptor binding domain and SARS-CoV-2 RNA-dependent polymerase. Four compounds showed extremely good binding to the virus, indicating that they may prevent viral replication.

The next stage of their work will be an in vitro study, before moving onto animal models but is contingent on the team being able to secure funding.

Source: The Conversation

Effectiveness of COVID Government Interventions Compared

Currently, the most widely used tool to deal with the spread of COVID are non-pharmaceutical interventions (NPIs), which involve measures such as social distancing. In the face of the sudden emergency of the COVID pandemic, governments around the world implemented a wide range of NPIs, some based on scientific advice and some not. The effectiveness of these government interventions is compared in a new study.

In order to evaluate the effectiveness of these responses, researchers studied government interventions across 79 countries and territories. Each item was ranked, making a comprehensive dataset of 6068 interventions and compared to the reproduction number, Rt. They were analysed with four computational methods, including machine learning.

The study found that the most effective interventions were those that restricted movement such as travel restrictions and lockdowns, as well as social distancing. Cancellations of gathering also seemed to be effective. The least effective were appeals for international aid, tracking and tracing, disinfecting surfaces had the least impact.

Interventions also had differing effectiveness depending on what stage of the pandemic they were implemented in.

The most consistently effective intervention across all locations was contact tracing and quarantine.

Source: News-Medical.Net

China in discussion with WHO over possible use of its vaccines worldwide

Despite not having clinical trials not being completed, essential workers in China have been given Chinese-developed vaccines, writes the Daily Maverick. The World Health Organisation (WHO) had reportedly held the first talks aimed at getting the Chinese COVID vaccine. Socorro Escalate, WHO’s coordinator for essential medicines and health technologies in the Western Pacific region, said:

“Potentially through this emergency use listing the quality and safety of these vaccines and efficacy could be assessed. ..and then this could be made available for our licensees.”

The Daily Maverick continues:

China has at least four experimental vaccines in the final stage of clinical trials – two are developed by state-backed China National Biotec Group (CNBG), and the remaining two are from Sinovac Biotech and CanSino Biologics respectively.

They are tested in such countries as Pakistan, Indonesia, Brazil, Russia and the United Arab Emirates.

Last month, the UAE authorized the emergency use of a CNBG vaccine, the first international emergency clearance for one of China’s vaccines, just six weeks after human trials began in the Gulf Arab state.

Philippines President Rodrigo Duterte said last month it would prioritise China and Russia in his country’s global shopping for a vaccine. 

Researchers calling for loss of smell to be recognised globally as Covid-19 symptom

Health 24 reports that scientists are calling for loss of smell to be recognised as a main COVID symptom, based on studies which showed that a majority of people who listed loss of sense of smell as a symptom would test positive for COVID antibodies. This could have important ramifications for policymaking, which they go on to discuss:

Currently, many guidelines still urge members of the public to only self-isolate or test when they display flu-like symptoms.


Although the study has limitations, it strongly suggests that an acute loss of smell should be considered as a sign to isolate or test. It also suggests that there is an over-reliance on coughing and fever as the main Covid-19 symptoms.

Prof Batterham said, “Early self-recognition of Covid-19 symptoms by the members of the public, together with rapid self-isolation and PCR testing are vital in order to limit the spread of the disease. Currently, most countries around the world do not recognise a sudden loss of smell as a symptom of Covid-19.”

Global COVID study, fewer people are willing to give cardiopulmonary resuscitation (CPR)

The Daily Mail reports on a global study has found that, as a result of COVID, significantly fewer people are willing to give cardiopulmonary resuscitation (CPR) than before:

Compared to before the Covid-19 era, 20 per cent fewer people would give mouth-to-mouth to a stranger, if they weren’t breathing. And 14 per cent fewer claimed they would give chest compressions, which could be the difference between life and death.   


The findings are concerning because it is already known that Britons are reluctant to carry out CPR, with around three in ten claiming that they would not assist in saving a dying stranger.

Survival rates for cardiac arrests — which are different to heart attacks — stand at less than 10 per cent. But CPR can more than double a person’s chance of survival outside hospital, according to the British Heart Foundation.

Scientists urged people not to be put off giving first aid due to Covid-19 and insisted the odds of getting the infection this way was tiny.

Chest compressions can still be done with a towel, while wearing a face covering to avoid catching the disease. But health regulators have already urged Britons not to carry out mouth-to-mouth over Covid-19 fears.

COVID and Vaping Lung Injuries can be Confused

Three recent case studies show that breathing problems in teens could be a result of vaping or COVID, according to a UC Davis Health paediatric team.

Known as e-cigarette, or vaping, product use-associated lung injury (EVALI), it is present in large numbers. As of February 2020, 2758 cases of EVALI were hospitalised, with 64 deaths in the United States, and over half of those hospitalised were under 25 years old.

“EVALI and COVID-19 share many symptoms but have very different treatment plans,” said lead author Kiran Nandalike, associate professor of paediatrics. “For this reason, providers caring for pediatric patients with unexplained respiratory failure should consider EVALI and ask for relevant smoking/vaping history.”

EVALI and COVID patients often present with fever, cough, nausea, abdominal pain and diarrhoea. Bilateral ground glass opacities are seen in chest imaging in both conditions.

Adolescents often use vaping with marijuana obtained through friends, family and unlicenced dealers, with products often containing vitamin E acetate, an additive which is strongly associated with lung injury. Isolation and stress as a result of the COVID pandemic increased usage.

In the case studies, all of the patients had fever, nausea and cough, as well as a high heart rate, rapid breathing and low blood oxygen levels. Laboratory results showed higher white blood cells (WBC) count and elevated inflammation, pointing to COVID inflammation. Chest imaging revealed nonspecific ground glass opacities. Despite all other findings indicating COVID, SARS-CoV-2 testing was negative. The patients were successfully treated with steroids, a potentially life-saving treatment for EVALI.

“To help reduce risk of EVALI recurrence, providers would recommend vaping cessation counseling to patients and close outpatient monitoring,” advised Nandalike.

Source: Medical Xpress

COVID Most Infectious Early On, Says New Review

According to a meta-analysis of COVID research published in The Lancet, individuals with COVID are most infectious early on.

In a meta-analysis of 79 studies from around the world, they examined viral load dynamics, duration of viral RNA shedding, and viable virus shedding for SARS-CoV-2, and for comparison, 8 studies on MERS-CoV and 11 on SARS-CoV. The study only looked at symptomatic individuals.

For SARS-CoV-2, the average duration of viral RNA shedding was 17 days in the upper respiratory tract and 14.6 days in the lower respiratory tract. Similar durations were found for stool (17.2 days) and serum samples (16.6 days). 

The maximum duration of viral RNA shedding was 83 days in the upper respiratory tract, 59 days in the lower respiratory tract and 126 days in stools.  No role could be discerned for faecal shedding. Average shedding duration was positively correlated with age. No studies detected live virus after 9 days.

The viral load in the upper respiratory tract reached a peak in the first week of illness, which was shorter than SARS-CoV (peaking at days 10-14) and MERS-CoV (days 7-10). Most studies indicated faster viral load clearing in asymptomatic versus symptomatic SARS-CoV-2 carriers.

In view of these findings, the researchers suggest that repeat testing may not be necessary for patients no longer deemed infectious, and that isolation could be set for 10 days after the onset of symptoms.

The researchers concluded that early containment was key in fighting the spread of COVID, especially with regard to acting on atypical symptoms that might appear before other symptoms. Still, this could prove challenging to effect in practice. 

Source: The Lancet

Controversial Study: Cloth Masks Don’t Prevent Catching COVID

In a controversial result, researchers in Denmark have shown real-world evidence that masks do not protect against becoming infected with COVID.

4860 participants completed the study in Denmark, which at the time had a 2% infection rate. Half received surgical masks and were told to wear them outside while the other half were told not to wear masks. The researchers had hoped to see the masks halving the infection rate among wearers, but 1.8% of mask wearers became infected with COVID vs 2.1% of non-mask wearers.

“Our study gives an indication of how much you gain from wearing a mask,” said lead author Dr Henning Bundgaard, a cardiologist at the University of Copenhagen. “Not a lot.”

The results were met with scepticism by some, and noted that the lower prevalence of COVID in Denmark at the time made differences hard to detect.

Dr Thomas Frieden, chief executive of Resolve to Save Lives, an advocacy group, and former director of the CDC outlined the limitations of the study, saying, “There is absolutely no doubt that masks work as source control. The question this study was designed to answer is: Do they work as personal protection?” Frieden said that the answer to those questions lay in the amount of virus exposure and the nature of the masks involved.

“An N95 mask is better than a surgical mask,” he said. “A surgical mask is better than most cloth masks. A cloth mask is better than nothing.”

Dr Christine Laine, editor in chief of the Annals of Internal Medicine, characterised the evidence that masks were protective of wearers as weak.

“These studies cannot differentiate between source control and personal protection of the mask wearer,” she said. 

She added that the new study reinforced the need for other methods, such as social distancing. Masks “are not a magic bullet,” she said. “There are people who say, ‘I’m fine, I’m wearing a mask.’ They need to realise they are not invulnerable to infection.”

Source: Japan Times

Activists to Pressure SA Government over COVID Vaccine

With the recent news that Pfizer’s and Moderna’s vaccines both have over a 90% efficacy, and air cargo carriers are standing ready to transport them, concerns are mounting that South Africa, with no deals to access vaccines, will be left out in the scramble by richer countries to secure vaccines.

Mark Heywood, executive director of Section27 and a veteran activist, said: “Now that vaccines are becoming available, our government must use all its powers to ensure that people in South Africa have equal access. Neither price nor patents should be an obstacle, and government must start now to think about the systems that will be needed to ensure the smooth distribution of the vaccine, starting for those with the highest risk of Covid-19.”

Dr Anthonet Koen, principal investigator at a COVID vaccine trial site, said: “It’s important that we get a vaccine that’s right, especially for South Africa. We often get overseen and get left behind when it comes to life-saving treatments. If you think about HIV, we were last in line to get access to antiretrovirals, and we don’t want that to happen.”
Koen dispelled any possibility of a vaccine being available before the year is out. “We need to be realistic about this… but hopefully within the first quarter of 2021 we will have something.”

Health Minister Zweli Mkhizi reiterated that there was no vaccine for now, “so we need to adhere to containment measures”.

Not only the vaccine’s acquisition but its logistics for distribution must be taken into account. Economist Mike Schussler said, “The entire supply chain will have to be considered. What we know is that if we had to do half of the South African population it would cost about R40  billion, and that’s highly problematic and unaffordable so we have to think strategically about this.”

Source: IOL