‘One-size-fits-all’ approach to Covid-19 wrong -former Eastern Cape health MEC Goqwana

A “one-size-fits-all” approach is not the way to go about handling the coronavirus pandemic.

That is the view of former Eastern Cape health MEC Dr Bevan Goqwana, who after years in the wilderness has returned to assist the provincial health department in its battle against Covid-19.

Goqwana was controversially axed in April 2006 by then premier Nosimo Balindlela after he fired his superintendent-general, whom he accused of mismanagement.

Her decision to sack Goqwana drew stinging criticism from the ANC at the time.

The then Eastern Cape ANC chair, Makhenkesi Stofile, slammed Balindlela for not informing senior members of the provincial ANC structures of the move.

Since his axing 14 years ago, Goqwana has been practising as a medical doctor in Mthatha.

His return to Bhisho last week is to shore up systems the department is putting in place to manage the virus, particularly in the rural areas where stigmas around Covid-19 are hampering efforts to curb its spread.

Since the virus entered districts like OR Tambo, the pandemic has caused widespread panic among residents.

Stigmas similar to those around HIV/Aids when it first emerged in SA have skyrocketed, the most challenging of which is the notion that Covid-19 is an automatic death sentence.

Goqwana has been studying both the country and province’s pandemic response from the sidelines and, now that he is back in the fold, hopes to assist in removing these fears and providing advice that can result in concrete solutions.

One of the points he wants to get across is that health officials should understand that not every situation is the same, and each should be treated on individual merit.

“You’ve got to understand your rural areas. You’ve got to understand your urban areas.

“Say you've got 15 people staying in four rooms. You can’t just say that a person is going to do well in [that] lockdown [situation] when somebody is infected,” Goqwana said.

“It’s not the same as somebody who’s got two children, and there’s the mother and the father. You’ve got to consider these situations.”

With winter approaching, Goqwana believes efforts to convince people in the rural areas of the facts of the virus need to be redoubled.

“People have stigmatised the virus and as a result people are scared. That needs to change because white blood cells go down with stress, so you are more vulnerable.

“I was dealing with somebody who just slept next to somebody who is positive. She was so scared, she couldn’t sleep at night, thinking that she has got it [Covid-19] from this person. Yet they were two metres apart.

“We need to reduce this anxiety. I think it’s coming from the fact that people don’t understand what this virus is and what it does.”

Funerals, in OR Tambo in particular, have been a major source of infection in the province, and Goqwana is aiming to get the department more involved in how these are managed.

“We need to get to the point that if there is going to be a funeral, some days before that funeral, a team from health will assist them [families] with sanitiser and tell them what to do when there is a problem.”

It was inevitable that winter would bring more infections, but wisdom should not be sacrificed for fear, he said, adding that people should still take the virus seriously.

Another line Goqwana is pursuing is encouraging doctors, both in the private and public sectors, to treat patients over the age of 55 at home.

“Admitting them [to hospital] is a problem because you are sending them to a lot of people. So you rather treat the elderly, especially those who have comorbidities, at home.

“We’ve got a process which goes from a GP to testing, and then to a hospital and quarantine if they are positive. If the person is negative, you give them whatever antibiotics so they can go home.

“I am trying to make sure this is going to be done by the private sector and the public sector in unity so that we can remove the stigma.”

As someone who was “born and brought up” in the Eastern Cape, Goqwana believes he is in a good position to understand the dynamics of different situations, whether they occur in the metros or rural areas.

Not that the former MEC, who occasionally serves on health portfolio committees, has entirely forgotten his political past and the events of 14 years ago.

“I was an MEC and I served there for seven years and with all the difficulties. I did what I did with a passion.

“The way I was removed ... was so bad but I decided to keep quiet because it was all about doing it for the people. There have been seven MECs after me.

“I’ve been looking at how things are happening.

“I don’t want to comment much, but because I was removed I thought ‘there was probably something wrong that I did, so let me keep quiet’. But you know, politics is politics.”

Goqwana said he would not forget, but he could forgive.

“It’s not about me, it’s about the country, it’s about the province.”

On Thursday, the World Health Organisation cautioned that the virus might linger for a long time.

“It is important to put this on the table — this virus may become just another endemic virus in our communities, and this virus may never go away,” Mike Ryan, head of the WHO emergency response team, said.

This is an opinion Goqwana seems to concur with. He said as time passed, the virus could be so mild that it’s just another infection that one can develop and recover from.

“While one is not really sure how antibodies form, there are certain people who are going to develop antibodies to it.

“When they’ve developed antibodies, it won’t be as serious as it is now. The worry is the elderly and those who have comorbidities.

“Sometimes with the viruses, they come as a parasite, and being a parasite, it can’t kill everybody because it has to survive itself. If it kills everybody it will die, so it can’t kill everybody.”

He was also convinced that the coronavirus would not be the only one to affect the world.

“Two, three years down the line you might find another virus, the existing one mutating or a new virus, especially with the climate change that is happening.

“We need our scientists to be on their toes, or try to be ahead of some of these micro-organisms.”