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The Ministerial Advisory Committee on Covid-19 is considering new ways to measure its spread as key questions about how far it has spread continue to plague the government.
The team of 45 expert members from at least 20 international universities and institutions is advising Health Minister Zweli Mkhize on how to control the spread of the virus.
Professor Salim Abdool Karim, who chairs the committee, said in a webinar with News24 on Wednesday that information on whether the blockade had worked would only leak this week.
This is because there is a two-week delay between the start of the infection and the notification of an infection, so the data on infections currently used by the government is approximately two weeks old.
“We are working on very limited research on the coronavirus. We need to draw on our experience of other viruses and other diseases,” said Karim.
Detection of possible cases should be doubled if experts have any hope of understanding the scale of community transmissions, and experts say there are too many variables and unknowns in the Covid-19 case monitoring process to make any definitive findings. now.
The government’s strategy includes expanding its contact detection, testing and follow-up program.
Karim said that by April 18, if the number of people screened reached a million, the experts would have a sample size large enough to calculate the community’s transmission rate.
This week, Mkhize confirmed that around 460,000 people have been examined so far, adding that the evaluation resulted in around 4,000 tests.
Karim said the million figure was not reported by any data, necessarily, but that it was a good sample size.
This presents a new method for the government on how to measure the outbreak.
Apples and oranges
Karim said that he had proposed a threshold of one in 1,000 positive cases would require an extension of the blockade, but emphasized that the government took many considerations into account in its approach to the blockade, including social concerns and economic strategy.
By April 18, enough time would also have elapsed since the start of the block to calculate how effective it has been.
But a key issue Karim and the committee were dealing with was differentiating between “passive and active cases.”
Passive cases refer to those detected in the course of the spread of the disease, in other words, people who showed symptoms and presented for the test.
Passive cases are now identified as screening and testing is expanded, posing a challenge in understanding community transmission.
Karim said it would require separating the active and passive cases – “orange apples” – to make scientifically backed calculations.
The “key epidemiological question,” said retired mathematician Professor Brian Williams, was whether infected and asymptomatic people were also infectious.
Williams, who worked for the TB program of the World Health Organization (WHO) for a decade and now resides in Switzerland, added that there is a danger that there are many young people who do not show symptoms but are infected and transmit the virus. . to the older population.
Therefore, it was essential to know if these people were also able to spread the virus, he said.
An actuarial scientist, who asked to remain anonymous as he is not authorized to speak to the media, said there were questions about the criteria used to measure Covid-19 cases.
He added that the continuously published data can be misleading since many people did not understand what it meant: not only did the data reflect the number of infections from days prior to the positive results, but they also did not reflect the absolute number of deaths.
For example, he said those who were not screened for Covid-19 before his death were not included in the figures.
New York revised its death toll this week to include about 3,000 cases that had not been identified as Covid-19 cases prior to their death.
Meanwhile, United States President Donald Trump was roundly condemned on Wednesday for announcing that the United States would freeze payments to WHO, The Guardian reported.
Trump reportedly said the funds would be frozen for 60 to 90 days pending a review of the WHO warnings on Covid-19.
The WHO did not immediately respond to a request for clarity on Wednesday about whether this has implications for South Africa.
In South Africa, concern about outbreaks in medical facilities continues to increase. Twelve staff members, including seven health workers, tested positive at the Mediclinic Morningside in Johannesburg.
The Kingscare Netcare Hospital in Amanzimtoti, KwaZulu-Natal, was temporarily closed after an outbreak that was localized in a patient who developed stroke symptoms.
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