South Africa’s health systems already struggling. Public services are not up to scratch. And this is before the potential effect of Covid-19. In Gauteng, with a population nearing a quarter of that of the country, the pandemic is being seen as a chance to “step up” public services in the province.
This is according to Gauteng Premier David Makhura, who on Wednesday addressed the media about the provincial government’s plan to contain Covid-19. Half of the country’s confirmed cases are in Gauteng.
Makhura said Gauteng is “the most vulnerable province” to the outbreak because it is densely populated and a main port of entry for people coming to South Africa.
He called the pandemic “a tragedy”, but said “it also gives us an opportunity to sort out generally the things we are supposed to sort out”.
One of the areas that will need “sorting out” is the public health system, Makhura said. “This pandemic also gives us an opportunity to ensure the public health system can reach all of our citizens which we are able to reach them.”
One of the cornerstones of the Gauteng government’s plan to contain the outbreak is the province’s “huge army” of 9000 community health workers, Makhura said.
The provincial health department is training them to be part of the tracing teams, who track tuberculosis patients who have defaulted on their treatment. Gauteng Health MEC Bandile Masuku said the department aims to increase the number of tracers from 249 to 1000.
Makhura called community health workers the “troops on the ground”. The province will arm these workers with information about Covid-19 and “what families and households can do”, he said.
“So basically, this is the job for a healthcare system to be able to function optimally at crisis moments like now. And even at normal times, when we talk of the capacity of the state, it is not just rhetoric. It is not just some ideological claptrap,” he said.
“When we talk about the capacity of the state, we mean so. And this moment presents us with an opportunity to step up.”
Addressing the nation on Sunday night, President Cyril Ramaphosa announced that a national disaster had been declared in response to the country’s rising number of Covid-19 cases. He outlined “extraordinary” measures to curb the spread of infection, including improving the capacity of designated hospitals in all provinces.
On Wednesday, Makhura said the Gauteng government is aiming to set up facilities in addition to the current hospitals and health centres in each of the province’s five districts.
These additional facilities will either be used to quarantine or admit more people “should the outbreak get to that level”.
Masuku said the provincial government appreciates that many of its residents may not be able to self-isolate.
The Gauteng government is in the process of negotiating with a private company to acquire 250 hospital beds in the West Rand for quarantine purposes, Masuku said. He later told the Mail & Guardian that Gauteng currently has 463 beds for this purpose.
The provincial government has also decided to “downscale” its outpatient services and elective procedures for the next month to relieve the pressure these put on public healthcare services.
“We are also in the process of procuring more test kits, which will make it easier for us to rapidly get results in terms of detecting and diagnosing the infection,” Masuku said.
On Monday the director general of the World Health Organisation, Tedros Adhanom Ghebreyesus, emphasised the importance for countries to test all suspected cases of Covid-19.
“You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected,” he said at a media briefing on the rapid escalation of cases of Covid-19 worldwide. “The most effective way to prevent infections and save lives, is breaking the chains of transmission. And to do that, you must test and isolate. We have a simple message for all countries: test, test, test.”
Testing will be necessary to tackle the outbreak beyond containment, Masuku said. “But we still want to emphasise that we are going to follow the old preventative measures”.
These measures include regular hand washing, social distancing, coughing and sneezing into one’s elbow.
Cape Town’s public facilities closed
The City of Cape Town has decided to close a number of its public facilities in an effort to contain the coronavirus outbreak.
The city’s mayor, Dan Plato, released a statement this week announcing the closure of swimming pools, camping sites, museums, art centres, community halls, resorts and nature reserves amid calls for social distancing.
Cape Town is the largest city in the Western Cape, which has the second highest number of confirmed cases of Covid-19.
When the city closed its facilities on Wednesday, the Western Cape had 31 confirmed cases.
Plato also announced that library hours “will be reduced incrementally and these facilities will provide only basic services, namely, taking out and returning reading material”.
“The number of persons allowed into the library will be controlled. Needless to say, this might change at short notice.”
Plato asked people “to ensure that all non-essential contact is avoided and that social distancing is strictly enforced”. — Sarah Smit