Curbing outbreaks: Zweli Mkhize on what next in SA’s fight against Covid-19

Government is co-ordinating the deployment of teams to Covid-19 hotspots including epidemiologists, family practitioners, community health workers, environmental officers, social workers, psychologists and community workers to deal with the health and social challenges, says health minister Zweli Mkhize. Image: Alon Skuy/Sunday Times
Health minister Dr Zweli Mkhize says that his department has got the most out of the lockdown and that the current risk adjusted strategy is about buying time for South Africans to adjust to the new normal.

“In reality from the health perspective, we have actually got the maximum benefit from the lockdown. Now, what we need to do is to adjust all our containment measures so that we now adjust to a new normal of how we will be living. As we implement it, we are going to move on, we can’t suddenly say let us open everything.

“You are going to be forced to deal with clusters where tomorrow there are so many people infected and if you end up with that situation, you will close down those very same places all over again because you did not do the preparations. That preparatory phase is also very important, so that is the issue,” Mkhize said in an interview with the Sunday Times.

The minister and government have come under fire from some quarters over the staggered approach to reintroducing normal activities ahead of the Covid storm which is expected to land in August or September.

He said the country needed to prevent the kind of cluster outbreaks which have been seen in the Western Cape leading to a spike in infections. The province currently accounts for over half of the country’s infections, having overtaken Gauteng as the infection centre. Currently the country has 14,355 confirmed cases, the death toll stands at 261. The Western Cape has 8,404 confirmed cases, which is 58.5% of the country’s total cases.

Mkhize said that it was not true that the province was testing more than anywhere else and that the simple reason for the high numbers was the concentrated outbreaks in places with high traffic such as retail stores. Similar scenes also played themselves out in KwaZulu-Natal in private hospitals where patients and health care workers were infected.

“We have screened 10 million people and what we are seeing is that in terms of all the projections that we have, the lockdown extending it much further — in the whole country — will not necessarily delay the graph much further than we have done.”

In addition to the 10 million screenings, 376 sites have been identified for quarantine which have 30,823 beds in total. A total of 439,559 tests have been conducted.

Mkhize says that government’s approach to easing the lockdown is guided by the World Health Organisation’s recommendations for the easing of the lockdown.

In the next phase of governments approach, targeted testing will happen in hotspots as a measure to try to arrest massive outbreaks.

Multidisciplinary teams will also be deployed to regions to address the different challenges bought about by the virus.

“The teams we are deploying have epidemiologists, family practitioners, community health workers, environmental officers, social workers, psychologists. And in that group are specialists who will deal with the disease as it manifests itself.

“In that area, backing them up will be community leaders. Councillors, pastors, community NGOs, traditional healers and so on who are influential in that area who can tend to issues like food shortages and so on because they know the environment, and [the department of] social development will come in [to assist too].”

“The science at the back of the approach is that a further lockdown is not necessary in the sense of it won’t change the curve any further, but also we can’t just let go just like that. That is not going to be helpful unless you can ensure that these non-pharmaceutical interventions [are in place]. To balance that up is an administrative implementation issue, it does not offend the original science on which it was based.”

The non-pharmaceutical interventions which government has been drilling into society such as social distancing, washing of hands and wearing of masks will now have to be adopted outside the homes of South Africans where they have been practised for the last 50 days.

Schools, workplaces and public transport will all have to be redesigned to make the new norms possible.

Mkhize said he would not be goaded into throwing his weight behind one model because a number of scenarios were possible.

“The truth of the matter is that we cannot live by one model and be bound by anybody’s figures but we need to know what the possibilities are. That’s the long and short of it. The reason why there is excitement over this is that people are really looking for a reason to find fault with the government and take them to court. That’s what the problem is.”

Even as government faces a logistical nightmare of moving different areas to different levels in the coming weeks, Mkhize said that he was not being intentionally clandestine about the details.

“You must also understand that we have an outbreak to manage. So while we are managing, give us space so that we can come back and give you all the information. But we cannot stop what we are doing simply because people are now asking questions. There are some of the issues which are not urgent enough to stop what we are doing. Yes, it would be important to share information but then sometimes we get criticised and are then told that we are not being transparent on some matters.

“The truth of the matter is that, so far, we’ve been much more fortunate in the manner that the epidemic has turned out in our country. It has not been as devastating as it could have been had we followed other trajectories other countries have seen, that’s the truth.”


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