Mkhize said the majority of 61 patients infected in the Free State 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 Covid19, thus making their own church members direct contacts. These church members had to be screened and tested. The church leaders and members who were tested have since been put in quarantine.

It must be noted that these confirmed cases in the Free State province are concentrated in Mangaung and this requires dedicated focus of interventions.

The recorded 1,170 cases is an increase of 243 new cases from yesterday’s announcement,” he said, adding that the total number of tests conducted to date was 28,537.

He clarified that the 48-year-old woman, Madeleine van Wyk, who had died after a positive result for the virus, had also been suffering from a pulmonary embolism.

“This means she had an underlying disease.

“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 28-year-old female who had presented at the hospital in respiratory distress. At the time of presentation she was hypoxic. She was intubated and transferred to hospital during the early hours of this morning, 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.”

There was therefore only one confirmed death caused by Covid-19 in South Africa - Van Wyk.

“I have been informed that the health workers that managed [the 28-year-old] 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 in line with our plea to them to keep a high index of suspicion so as not to miss a diagnosis of Covid-19. This is common practice, medical doctors often make a diagnosis based on a clinical presentation and physical examination of a patient.

“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 acknowledged all the country’s doctors, nurses and health workers who were treating these patients.

“We salute them for their dedication in the service of the nation. We urge them to remain courageous and focused. We also want to assure all our health workers in the country, who remain on the frontline of this pandemic, as the department of health and government as a whole, we will do everything in our powers 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 there were currently 55 patients with Covid-19 in all hospitals. Four were in ICU. Three were on ventilators. There had been 33 recoveries.

At least 4,407 contacts for patients had been identified and 3,465 had been traced.

Clinical observations causing concern

In the minister’s words:

The infection of people with underlying concomitant diseases is increasing. This is well illustrated by the Covid-19 patient that has 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.

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

• HIV-positive people with a low CD4 count: This therefore emphasises the importance everyone to know their status, get tested and immediately start treatment should they test positive.
• Chronic lung diseases, including TB, asthma and COPD
• Autoimmune diseases of any kind
• Chronic kidney diseases
• Cancer
• Diabetes

Other population groups that are vulnerable are:

– Smokers and dependent alcohol consumers. We encourage smokers to quit smoking and for those who drink alcohol, to do so moderately.

The elderly population in our society is vulnerable. To illustrate this, in KwaZulu-Natal, one of the confirmed cases is an 81-year-old female who is now in ICU and on a ventilator. She initially presented with pneumonia and was admitted and treated as such. Because of the severity of the pneumonia, she was tested for Covid-19 and was confirmed. This elderly woman lives in an old age home. As a result, all other elderly people from this old age home are regarded as being vulnerable and are being tested. Those who will test positive will then be put in isolation.

There is 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. 

All the above factors have emphasised the need to rapidly expand testing, early detection and early treatment. We are intensifying the offensive.

The minister added that there was a significant testing 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, which is the reference laboratory. We are now extending them to Tshwane Academic, Walter Sisulu and Port Elizabeth.

“We have 7 mobile testing laboratories and in April we will have a total of 47 which will spread all over 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.”

The Citizen