SARS-CoV-19 and COVID-19
Note - The novel coronavirus has been renamed as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the illness that it causes in people is now referred to as COVID-19 (coronavirus disease 2019).
Reliable and trusted sources of information and links
FOR MEMBERS OF THE PUBLIC
- Department of Health hotline for general enquiries about 2019-nCoV: 0800029999
National Institute for Communicable Diseases (NICD)
World Health Organization (WHO)
US Centers for Disease Control and Prevention (CDC)
- Members of the public are advised to contact their healthcare providers if they have any personal health concerns
FOR HEALTHCARE PROFESSIONALS
The novel coronavirus (SARS-CoV-2) has brought a question into sharp focus: just how prepared is South Africa for a large outbreak?
Is South Africa ready to deal with this novel virus (SARS-CoV-2) should it reach our shores?
What procedures does South Africa have in place to deal with large outbreaks?
What systems do we have in place to rapidly identify and detect any cases that may reach our borders? How are people entering the country being monitored?
- South Africa has successfully responded to large outbreaks and has systems at the national, provincial, district and facility level to detect and respond to outbreaks.
- As an example, the National Institute for Communicable Diseases (NICD), a division of the NHLS, recently led an investigation of and response to a large national outbreak of listeriosis.
How does South Africa score on the Global Health Security Index?
- The NICD/NHLS has active national surveillance in place to detect cases of COVID-19. This surveillance is being coordinated through the now-activated Emergency Operations Centre at NICD in Sandringham. Temperature and symptom screening has been set up at all ports of entry aimed at early identification of suspected cases. Screening at ports of entry may not identify asymptomatic cases (e.g. those incubating the infection but not symptomatic). For this reason, clinicians in private and public sector are on high alert for individuals meeting the case definition for testing. Case definitions have been widely distributed by the NICD and Department of Health along with guidance on what to do if a clinician identifies a suspected COVID-19 case (also referred to as “a person under investigation (PUI)”. The case definitions are updated as new information arises. Guidance includes information on clinical management, appropriate isolation to prevent onward spread and specimen collection for testing. Active follow up of all close contacts of the PUI begins immediately after laboratory confirmation as a confirmed case. All clinicians who identify a case who they think should be tested are encouraged to call the dedicated 24-hour hotline for health workers (manned by NICD doctors) where each case can be discussed with a doctor who will provide guidance on whether testing is indicated.
- In addition, there is a toll-free line for the public to call if information is needed.
What is the state of South Africa’s containment facilities?
- SA ranked 34th out of 195 countries in 2019, with the highest score on the continent
Is there collaboration between SA and other African countries when it comes to fighting SARS-CoV-2?
- Laboratory - The laboratory at the NICD’s Centre for Respiratory Diseases and Meningitis (CRDM) offers a 24-hour, 7-day a week service of diagnostic testing for SARS-Cov-2 and also acts as a reference laboratory for South Africa. Training of laboratory personnel from major cities within South Africa as well as other countries in Africa to detect SARS-CoV-2 in clinical specimens is ongoing.
- Healthcare facilities – Currently, certain hospitals in each province have been designated for managing cases of COVID-19. This is reasonable at the early stages of an in-country outbreak when few cases are diagnosed. However, this novel virus named SARS-CoV-2 seems to be more transmissible than other similar coronaviruses and causes a wide range of illness from mild to very severe (based on current data from China, most people seem develop a mild illness). There may be a potential gap in SA if there is wider community transmission and many people with very mild illness seek care at already over-burdened hospitals. We also have a limited number of ICU beds to manage severe cases in both the public and private sectors. There is also a relative shortage of isolation facilities in hospitals, particularly in the public sector, which may potentially increase the risk of SARS-CoV-2 transmission in hospitals. These gaps need to be addressed.
Where do we stand at the moment? Will we have to confront SARS-CoV-2 in the near future?
- Yes. The NICD’s CRDM serves as a referral laboratory for other African countries and is training lab personnel from other African countries. The NICD also has close links with other public health agencies, including the Africa Centres for Disease Control and Prevention (Africa CDC).
- As of 18 February 2020, NICD has tested 67 people within South Africa who met the case definition for COVID-19 PUI criteria. An additional 42 people have been tested who did not meet the case definition. Expanded testing of additional cases not meeting the PUI criteria is done to make sure that we are testing widely to identify a case.
- Training for healthcare workers is being rolled out in all 9 provinces of SA. To date, more than 850 healthcare workers have been trained in the public and private sector and additional training sessions are planned.
- Information is updated regularly on the NICD website and public health messages are being sent through social media. Daily situation reports are shared among teams and a summary published on the NICD website and social media. FIDSSA encourages members of the public and healthcare workers to obtain information from reliable sources.
- South Africa has a relatively high importation risk (see above mentioned modelling study) so we would expect to see cases of COVID-19 in the future