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Covid-19: Second wave ‘exceeding first peak’ on Garden Route, Cape Town cases on the rise

Covid-19-related hospital admissions have increased from 1 020 on 26 November to 1 253 on 2 December in the Western Cape.Most are on the Garden Route and Cape Metro, with cases in Central Karoo, Theewaterskloof and Cape Winelands also on the rise. A Beaufort West hospital staffer has died, and exhausted health care workers are also becoming infected in increasing numbers. 

The Western Cape health department says the Garden Route’s Covid-19 second wave is exceeding its first peak in terms of admissions, while active cases across the province have jumped from 7 793 to 10 442 in the past week.

Covid-19-related hospital admissions in the province have increased from 1 020 on 26 November to 1 253 on 2 December.

Most are on the Garden Route and Cape Metro, with cases in Central Karoo, Theewaterskloof and Cape Winelands also on the rise.

Healthcare workers are also increasingly becoming infected, with a staffer at Beaufort West Hospital dying.

Health officials are hammering home the message of wearing a mask, hand washing, avoiding gatherings, and social distancing, and will bring in extra law enforcement capacity to monitor compliance with regulations where necessary.

President Cyril Ramaphosa’s address to the nation on Thursday night is expected to clarify whether there will be area-specific tighter lockdowns and curfews, but Premier Alan Winde feels that, if there is careful compliance with regulations, and safe behaviour, it might not be necessary and the holiday season can go ahead to keep businesses from collapsing again.

The Garden Route’s municipalities are already shutting public facilities, with some municipal services offices closing for deep cleaning and reopening, akin to the first wave across the country.

READ | Winde believes Level 1 lockdown is sufficient, but wants ‘consequences’ for not wearing masks

Winde will also ask Ramaphosa to consider introducing “consequences” for people not wearing masks in public, and implored businesses to make sure they are Covid compliant to avoid being closed.

Western Cape health department head Keith Cloete said metro and rural hospitals were running at a 79% occupancy and stressed that it was crucial not to overburden the system, so that other services like psychiatric and maternity care could continue.

Cases of Covid-19, and people under investigation for the virus, make up 9% of admissions in the metro areas and 15% in rural areas.

“These hospitalisations have now come to increase sharply, while we are also experiencing the trauma burden, and alcohol related trauma puts a big burden on the healthcare system and hospitals,” said Cloete.

“When Covid-19 comes up, and we have to create the capacity for Covid; it is at the expense of the other things that the health care system is keeping itself busy with,” said Cloete.

He said behaving responsibly not only prevented extra Covid cases, but also protected the overall healthcare system and the ability to care for maternity, psychiatric and surgical cases.

Second wave exceeding first peak

He said the second wave in the Garden Route was exceeding the first peak.

“The hospitalisation data shows a rapid increase at this point and mortality rates are starting to increase.”

The number of active cases in the Western Cape increased from 7 793 on 26 November to 10 442 on 2 December. 

On 25 November, the daily report showed there were 5 322 new Covid-19 cases in the previous seven days. This was up to 7 518 new cases in the past seven days by 2 December. Of the 1 253 Covid-19 patients in acute condition, 680 were in public hospitals and 573 in private hospitals. There were 227 people in isolation facilities, most on the Garden Route.

There were also 209 people in intensive care or high care units, receiving critical care with ventilators or high flow nasal oxygen.  

One-hundred-and-two people are in the Brackengate Hospital of Hope in Cape Town, and four people are in the Sonstraal facility in Paarl, which is also treating 18 tuberculosis patients.

“We also now sadly expect the number of deaths to increase, as was experienced at this point in the ‘first wave’,” said Cloete. 

The proportion of positive tests is now at 20%, up from 16% a week ago, and is matching levels seen in the middle of May. 

The reproduction number is at 1.4 – which means every one case is causing an average 1.4 increase in cases. The aim is to bring it to below 1.

The numbers of tests has also increased from about 10 000 a week in the public sector, and about 10 000 in the private sector, to about 14 000 tests in the public sector in the last week.

Healthcare workers getting infected

The positive cases among healthcare workers in September and October was five cases a day for the whole province, but has peaked at 38 cases in one day for health workers infected. Hospitals like Groote Schuur (30) and Groote Schuur (28) had increased staff infections in the five-week period monitored. George Hospital, which has fewer staff than the big hospitals, has had 26 cases in the last five weeks, followed by Mossel Bay Hospital (20) and Knynsa Hospital (16).

Health MEC Nomafrench Mbombo said that, in addition to the increased Covid-19 hospitalisations, the department would also have to manage the usual higher trauma admissions as a result of car crashes over December. 

While launching the holiday road safety campaign on Thursday, Transport MEC Bonginkosi Madikizela said a 5 445 719 vehicles had entered the province in the 2019/20 festive season and another influx again this December.

“… While this is good news for the tourism economy of the Western Cape, it will require us to take extra measures to keep our roads safe and to contain Covid-19,” he said. 

To help prevent accidents and hospitalisations, interventions include forcing long distance public transport drivers to stop every 200km to rest, preventing drunk driving, promoting pedestrian safety, and compliance in public transport with Covid regulations. 

ALSO READ | Western Cape lockdown: Winde to announce new Covid-19 interventions

The daily cluster briefings are isolating and monitoring problem areas, which included a school gathering of about 500 pupils for a World Aids Day event, a toy run, holiday home swops, work place infections and people working in rural areas travelling on the back of crowded bakkies. 

Cape metro waste water analyses shows 24% resurgence

Public health specialist Mary-Ann Davies said waste water analysis of the Cape Metro also shows the resurgence of virus traces in all areas across the Cape Metro by 24%, with the greatest increases in Camps Bay, Gordons Bay, Green Point, Kraaifontein and Wildevoelvlei. It has been expanded to the Breede Valley and Theewaterskloof area. This is regarded as a good predictor of rising case numbers on the way. 

Davies said the Garden Route’s cases were often found to be between people going to a large gathering, and then returning home.

A number of clusters were identified in long term care facilities in Knysna, and there were clusters in the winelands fruit growing and packing areas of Bella Vista and Witzenberg. The places affected include the Ceres fruit growing and juice industry.

Awareness programmes include loud-hailing.  

Cloete said the recovery and resurgence strategy until there is a vaccine is to change community behaviour with the help of law enforcement where necessary, to manage clusters with continued surveillance of outbreaks, to scale up hospital capacity, maintain comprehensive services and safe guard health care workers.

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