Why Mkhize is worried about EC copying WC ‘pattern’

On March 19, the Eastern Cape’s “patient zero” tested positive for Covid-19. Now, some 79 days later, the province has already recorded its 100th death and is the second-most infected province in SA.

Only the Western Cape’s 30,379 cases outnumber the Eastern Cape’s 5,629 – and, worryingly, it has done significantly fewer tests than Gauteng, the Western Cape and KwaZulu-Natal.

In terms of deaths, the Eastern Cape’s 101 was more than double Gauteng’s 47. Only the Western Cape has more, with 729 recorded by Saturday night.

KZN, with 2,500 fewer cases than Gauteng and the Eastern Cape, had recorded 61 deaths by Saturday.

Sunday’s figures had not been released by the time of publication.

The situation is dire, and health minister Dr Zweli Mkhize last week said he was worried that the Eastern Cape was following the same “pattern” as its western neighbour.

Already, the daily statistics provided by the health ministry show where this concern comes from. Other statistics from the National Institute for Communicable Diseases (NICD) also highlight the problem.

The Eastern Cape’s cases are doubling every two to three days, a situation the Western Cape (which is frequently growing at more than 1,000 cases a day) found itself in when it had about the same figures as the Eastern Cape does now.

Gauteng had similar case numbers to the Eastern Cape at the weekend, but it was testing significantly more people.

Also, the proportion of positive tests in the Eastern Cape is second only to the Western Cape.

Figures provided in an NICD report show that, for the period May 3-23:

• 92,056 tests were conducted in Gauteng;
• 72,267 were conducted in the Western Cape;
• 45,424 were conducted in KZN;
• 27,165 were conducted in the Eastern Cape;
• 13,801 were conducted in the Free State;
• 9,643 were conducted in Mpumalanga;
• 7,493 were conducted in Limpopo;
• 6,343 were conducted in North West;
• 3,417 were conducted in the Northern Cape;
• 2,477 tests were unallocated.

In the same period the Western Cape had 11,277 positive tests, and the Eastern Cape 1,655, while Gauteng had 1,028 and KZN 676.

In the final week of that period (May 17-23) the Western Cape had 4,397 positive tests (proportional positives of 17.5%), the Eastern Cape 486 (8.8%), Gauteng 383 (1.8%) and KZN 241 (2.1%).

This demonstrates that the Eastern Cape’s rate of infection has accelerated rapidly and, while its new case numbers have been similar to those reported by Gauteng, that province had performed more than four times as many tests in the same period.

It was a trend that continued, the NICD said in a subsequent report covering May 24-30.

“In the past week Western Cape and Gauteng provinces performed the largest numbers of tests, accounting for 61.5% of tests nationally. Western Cape (20.5%) and Eastern Cape (12.2%) provinces continued to have the highest proportions testing positive,” the report stated.

And the true number of cases could be a lot higher, with the NICD acknowledging that testing backlogs were a concern – something Mkhize has acknowledged in recent weeks.

“There has been a decrease in the volume of tests conducted over the past three weeks, which is likely owing to limited availability of testing kits,” the NICD states.

“The overall proportion testing positive continued to increase to 9.6% in week 22, with increases observed in both the public and private sectors. The increased proportion testing positive was observed across age groups, in both males and females. While the Western Cape and Eastern Cape provinces continued to have the highest proportion testing positive, the proportion testing positive increased in eight of the nine provinces over the past three weeks.

“A reduction in the proportion of public-sector tests attributed to community screening was observed over the past three weeks, likely reflecting the discontinuation of mass screening and testing approaches. Increasing turnaround times in the public-sector laboratories impacts the analysis of testing data as results for a portion of samples collected in the past week are not yet reflected in this report.”

Health minister Dr Zweli Mkhize said on Sunday evening the government was “turning its attention” to the Eastern Cape this week after visits to the Western Cape last week.

“The Eastern Cape has similar numbers to Gauteng but it has recorded the second-highest mortality numbers [behind the Western Cape] and its proximity and inter-connectedness with the Western Cape makes the province especially vulnerable.

“In addition, there is an increase in infection rate among healthcare workers both in the public and private sectors. As at June 6, the Eastern Cape had recorded 258 Covid-19-positive [healthcare workers] and 14 Covid-19 related deaths [among healthcare workers],” he said.

The Eastern Cape was “dividing up the hot spots into subdistricts to facilitate a strong community-based response”.

“Decentralisation is particularly important for rural areas, to ensure they are adequately capacitated and empowered to successfully manage the epidemic locally.”

Of particular concern was movement between the Eastern and Western Cape.

“There are many essential seasonal workers who travel to the Western Cape and back between the provinces. Both the provinces have been proactive in conducting roadside screenings. The Western Cape now has a coordinated programme of screening and assessing seasonal travellers before they leave to go home to the Eastern Cape.

“The two premiers have briefed the minister that Eastern Cape and Western Cape hold regular meetings to discuss ways to better manage the impact of interprovincial movement to the spread of Covid-19.”

On testing backlogs, the ministry said it was “clearing” these.

• In Port Elizabeth, the backlog had been reduced from 13,000 to 5,106; by Monday it should be around 4,000, and completely cleared by next week;
• In Mthatha, the backlog is 8,000, which the department expected to be cleared “in the next few weeks as well”; and
• East London “is still a challenge because there is no resident pathologist”.

While Eastern Cape premier Oscar Mabayane has steadfastly supported her, the province’s health MEC, Sindiswa Gomba, has repeatedly come under fire, with calls from the ANC Youth League in Nelson Mandela Bay and Democratic Nursing Organisation of SA for her removal and gaffs on television leading to her being derided on social media, with analysts calling her “out of her depth”, and “an embarrassment”.

Several of the province’s largest public hospitals are in apparent disarray and buckling under the pressure, with Cecilia Makiwane Hospital in Mdantsane closing three units after staff contracted the virus, Frere Hospital in East London being issued with a closure over unsafe working conditions, patients being turned away at the Livingstone and Provincial hospitals in Port Elizabeth over linen shortages, and the Motherwell Community Health Centre closing after staff refused to work without adequate PPE gear.

Nurses at Life St Dominic’s Hospital in East London claimed a shortage of beds had led the hospital’s Covid-19 patients being forced to share the hospital’s only casualty ward with patients who were there for other reasons.