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Covid-19 deaths revised

The number of COVID-19 deaths in South Africa has been revised down from two to one mortality, after a subsequent investigation found that one patient was negative for the virus.

Earlier on Friday 27 March 2020, the Health Minister, Dr Zweli Mkhize, said South Africa had recorded its first two deaths. The cases were in private and public institutions in the Western Cape.

As of Friday, South Africa had recorded 1 170 positive cases. This is an increase of 243 new cases from the announcement made the previous day. The total number of tests conducted to date is 28 537.

On Friday evening, the Minister in a statement said laboratory results on the 28-year-old, which were received at 5h20pm, showed that the deceased was COVID-19 negative.

“This morning we reported that two deaths had occurred as a result of the COVID-19 virus. The first patient was a 48-year-old female, who had tested positive for COVID-19 on 23 March 2020. She was suffering from pulmonary embolism. This means she had an underlying disease,” the Minister said.

The second patient who died was a suspected case, based on her clinical presentation.

“The clinicians who were treating her have reported to us that this was a female, who had presented at the hospital in respiratory distress,” said Mkhize.

At the time of presentation, she was hypoxic, a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level.

Said the Minister: “She was intubated and transferred to hospital during the early hours of this morning (27 March 2020 at 3am). On arrival in ICU, she was declared dead.

“The clinical picture was suggestive of COVID-19 and therefore a test was conducted. Her laboratory results have since been received at 5.20pm and were confirmed negative. Her immediate family was also tested and they are also negative. She is therefore no longer considered a COVID-19 case.”

This therefore means there is only one confirmed death caused by COVID-19 in South Africa.

Mkhize said he had since been informed that the health workers who managed the patient have been debriefed and counselled.

“I am aware that the public interest around COVID-19 may end up making them feel like they did not perform their duties with utmost care. As a clinician myself, I want to reassure them that making such a diagnosis on presentation is line with our plea to them to keep a high index of suspicion so as not to miss a diagnosis of COVID-19,” he said.

He said this is common practice.

They then conduct further tests to confirm or disprove the diagnosis.

“In this instance, doctors and all health workers involved exercised clinical judgment and took extra precaution in managing this patient. We support this approach,” he said.

He assured health workers that the Department of Health and government we will do everything possible to provide the support required for them to execute their duties.

“Overwhelming as circumstances may be, we ask you to keep up the fight. This is only the beginning and your commitment assures us that we will overcome,” he said.

Country synopsis

- Total number of patients in hospitals (both public and private): 55

- Total number of patients in ICU: 4

- Total number of patients on ventilation: 3

- Total number of recoveries: 31

- Contacts of the patients that have been identified: 4 407

- Contacts of the patients that have been traced: 3 465

In the statement, Mkhize said the infection of people with underlying concomitant diseases is increasing, as illustrated by the COVID-19 patient who passed away in the Western Cape.

“We therefore urge our citizens to be vigilant, protect themselves and not unnecessarily expose themselves by making contact with a lot of people. It is important to remain in your home, create a distance between yourself and anyone, including family members that are unwell,” he said.

These are some of the underlying medical diseases that make people vulnerable:

- HIV positive people with a low CD4 count: This emphasises the importance of everyone knowing their status, get tested and immediately start treatment should they test positive.

- Chronic lung diseases, including TB, asthma and chronic obstructive pulmonary disease (COPD).

- Auto immune diseases of any kind.

- Chronic kidney diseases.

- Cancer.

- Diabetes.

Smokers and dependant alcohol consumers, as well as the elderly are also vulnerable.

Mkhize said there was an increase in the rate of internal transmissions.

“Patients without a history of travelling abroad have been detected in many provinces. The Free State province is such an example,” he said.

The majority of 61 patients infected arose from the church conference, which had five international visitors who subsequently tested positive for COVID-19. Amongst these were various local church leaders, who have since tested positive for COVID-19, thus making their own church members direct contacts. These church members have had to be screened and tested. The church leaders and members who were tested have since been put in quarantine.

The confirmed cases in the Free State province are concentrated in Mangaung and, the Minister said, requires dedicated focus of interventions.

Testing facilities and backlog in processing tests

The Minister said government is aware that there is a significant backlog, especially from some private laboratories due to pressure caused by the increasing workload.

“We are pleased that the National Health Laboratory Services has increased its testing facilities. There are five laboratories in our academic hospitals in the country. These are in Inkosi Albert Luthuli Hospital, Charlotte Maxeke, Universitas, Tygerberg and Groote Schuur, in addition to the laboratory at the NICD [National Institute for Communicable Diseases], which is the reference laboratory.

“We are now extending them to Tshwane Academic, Walter Sisulu and Port Elizabeth,” he said.

The department has seven mobile testing laboratories, whic will increase to 47 by April and spread across the country.

“By the end of April, we will be able to do 30 000 tests per day if required, and we continue to source suppliers of test kits from different suppliers so that we can meet the demand,” he said.


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