Hotspots to be micromanaged to curb Covid-19: Zweli Mkhize

Teams of experts will work in hotspots, concentrating on a very small catchment area  while caring for the health of people in these districts as the Covid-19 combat plan moves into a new phase.

This is according to health minister Zweli Mkhize, who on Tuesday shared the government's stance on the efficacy of the lockdown as the country prepares to move from level 4 to 3.

The teams will try to keep as many people as possible away from hospitals by getting them treated by general practitioners and nurses in the hotspot areas, he said. “We have good co-operation across the provinces. Each hotspot must have its own team of experts.”

The Cuban reinforcement team and the military brigade have been deployed in all provinces.

“We may introduce additional measures in hotspots to contain the spread of the virus. We need to make sure there are stringent measures according to each district. We are asking for vigilance and close monitoring in areas identified as hotspots. There must be containment measures for people with comorbidities.”

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A district-level alert system will help to monitor those who need to practise extra caution, the minister said.

“Emerging hotspots must be watched vigilantly. We must focus on the emergence of new infections. Field hospitals are important. They will ensure people with mild symptoms are in quarantine and prevent the spread of the infection,” he said.

Mkhize cautioned: "If combined action in hotspots does not work to contain the spread of infection, we will then consider lockdown of the area.”

While the lockdown had been effective in helping government flatten the curve, and the numbers of tests in all provinces is “quite large”, the number of hospitalised patients is highest in the Western Cape, and Mkhize predicted more hospitalisations would be seen in all the provinces.

“We have quarantine sites planned in all provinces so those with mild symptoms can be placed here,” he said. “We are now dealing with internal transmissions. We have seen a 25% increase in positive cases in the past week,” he said.

“The number of deaths is [also] showing an upward slope, with the most in the Western Cape.”

The Western Cape government has said it has plans to move to alert level 3 with a targeted hotspot plan in place to curb the spread of Covid-19.

Premier Alan Winde made this comment following President Cyril Ramaphosa's announcement on Sunday that the whole country will move to level 3, but that special measures would be taken to deal with hotspots where the disease is concentrated and where infections continue to rise.

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These hotspots included Cape Town, Tshwane, Johannesburg, Ekurhuleni, Ethekwini, Nelson Mandela Bay and Buffalo City.

Ramaphosa said hotspots were areas that have more than five infected people per 100,000 people, or where new infections are increasing at a fast pace.

Ramaphosa said in dealing with the virus in these areas, government would implement intensive interventions aimed at decreasing the number of new infections.

Winde said the province's targeted hotspot plan will utilise combined government resources to slow the spread of the virus, protect vulnerable people and save lives.

“We look forward to working with all levels of government in implementing this plan,” Winde said.

Winde said its data-led hotspot strategy aimed to change individual and community behaviour in order to slow the spread of the virus; screening a defined population in a clearly demarcated area in specific hotspot areas for Covid-19; selectively testing those who screen positive, based on limited testing capacity; and, focusing on protecting the vulnerable.

The plan also entails contact tracing those who had been in contact with positive cases as well as to quarantine or isolate positive cases, either at home or in group isolation facilities where home circumstances do not allow for it.

The province's plan also includes the introduction of effective surveillance systems in places of gathering, such as workplaces, schools, old age homes and transport hubs.

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Winde said the lockdown did not stop the virus, it only bought government time.

“Covid-19 will continue to spread, and more and more people will be infected over the coming weeks.

“To put it simply: things are going to get worse before they get better. We cannot let our foot off the pedal now. In fact, we must work harder than ever before to slow the spread of this virus,” Winde said.

Gauteng has three areas which Ramaphosa has identified as hotspots, led by Johannesburg, then Ekurhuleni and Tshwane.

In his address, Ramaphosa said the government was putting in place enhanced measures of surveillance, infection control and management.

“We will assign a full-time team of experienced personnel to each hotspot. This team will include epidemiologists, family practitioners, nurses, community health workers, public health experts and emergency medical services, to be supported by Cuban experts.

“We will link each hotspot to testing services, isolation facilities, quarantine facilities, treatment, hospital beds and contact tracing,” Ramaphosa said.

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