While South Africa‘s response to Covid-19 may not have been perfect, we should be thankful that our country’s leaders did not waste time and resources in a fight of politics against science, as happened in Brazil and the US, writes Dan Israel.
As a doctor, I have been grateful to be in South Africa during the Covid-19 pandemic.
Speaking to colleagues in the US, Brazil and Italy, I have heard first-hand how the pandemic engulfed hospitals and overwhelmed healthcare workers and healthcare systems in those countries.
It is no secret that pre-Covid-19, South Africa’s public health system has always been under pressure. The symbol in my mind is doctors and nurses stretched and multitasking with limited resources, even under normal circumstances. However, the planning and strategies of South Africa’s Department of Health has ensured the spread of Covid-19 has been curtailed, infections contained and the health system protected to a remarkable degree.
Since the first coronavirus case was reported in South Africa on 5 March 2020, we have thankfully had a hands-on, visible and vocal minister of health. As healthcare workers, this has been a major encouragement to us.
The formation of the National Coronavirus Command Council (NCCC) – which comprises a number of scientists, medical professionals, and government officials – all leaders in their respective fields – have, thus far, guided our government’s response to the pandemic.
Early on, Health Minister Dr Zweli Mkhize, appointed a Covid-19 Ministerial Advisory Committee (MAC) to provide him with high-level strategic advice. The MAC on Covid-19 consists of four committees: pathology and laboratory; clinical; public health; and research. Each of these committees reviews local and international research and experiences, and advises Mkhize on the management, delivery, and co-ordination of services related to the Covid-19 response.
The results of this holistic team were the quick establishment of field hospitals around the country to cope with a predicted surge of Covid-19 patients to ease the burden on saturated permanent hospitals and facilities.
The MAC wisely understood that in the South African context, the management of quarantining was paramount. For individuals who were unable to self-isolate or quarantine themselves at home in the first wave, the government provided 438 quarantine facilities across the country. This certainly significantly reduced the spread of the virus within communities.
Despite logistic and political challenges, community health workers and local clinics that service rural and township settlements were indeed equipped with personal protective equipment (PPE), testing facilities and necessary education to effectively safeguard their communities during the first wave of this pandemic. As a healthcare constituent in South Africa, we are grateful for the NCCC’s committed engagement with the MAC that resulted in these vital infrastructures.
Leaders around the world have been forced to make policy decisions, with life-and-death consequences, early on during the Covid-19 outbreak.
Even the greatest scientists in the world could not have predicted the precise trajectory of this novel pandemic. While South Africa’s response may not have been perfect, we are fortunate that our leaders – unlike in Brazil and the US – did not waste precious time and resources in a fight of politics against science, and rather prioritised containing the disease.
All of this was supported by a clear and unequivocal message of hand-washing, mask-wearing and physical distancing run on diverse communication platforms in all of South Africa’s main languages. This approach ensured that even the least socio-economically empowered could take the necessary measures to curb Covid-19’s spread. All of the co-ordinated messaging and planning – including the lockdown – hinged on one specific principle: containment.
The sometimes stringent – but disciplined – approach to managing the pandemic saw infection rates dip drastically in the first wave. In a country where we often accuse the government’s right hand of not knowing what its left hand is doing, the integration and co-ordination between the NCCC and MAC was this time refreshing – and life-saving.
Department’s proactive approach during second wave
As we look ahead to the festive season while we enter the second wave of infection – which in my opinion was inevitable – the health department’s proactive approach continues.
Nelson Mandela Bay has already been declared a hotspot, and resources are being mobilised for that city. Mkhize has already been to the Garden Route, where infection rates are rapidly rising, to assess what resources need to be sent there. He continues to mobilise resources to these challenged areas as much as possible.
President Cyril Ramaphosa has addressed the nation, warning of possible lockdowns and restrictions if we do not remain vigilant about mask-wearing, social distancing and sanitising.
While other world leaders are already touting instant miracle cures and vaccines, South Africa’s medical and political leaders have adopted a sensible approach by emphasising non-pharmaceutical interventions like mask-wearing while they explore the formidable challenges of securing appropriate vaccines for more than 50 million citizens eventually.
Although South Africa participates in the COVAX Facility which will allow us to gain rapid access to vaccines, the head of the MAC on vaccines, Professor Barry Schoub, warned the supply of vaccines would be limited and available initially to only those at high risk of exposure, such as the medically vulnerable and frontline healthcare workers.
Schoub recently said:
“This will be a gradual process and we have already seen developed countries scooping up billions of doses in advance before the trials are completed. Hopefully we can start immunising the priority groups like healthcare workers. After that we can move on to other key personnel, and then onto the elderly and those with comorbidities.”
Last week, the health department announced South Africa would expect to receive its first batch of vaccines in the second quarter of 2021, after making the first tranche of payments later this month. The consignment should cater for about 10% of the population. There is indeed significant progress.
As we enter a second wave of infections this week, we ought to remember where we have come from. The significant strides made in the public and private health sectors since the first cases of this pandemic, a mere nine months ago. South Africa’s co-ordinated approach between the health department and other arms of government to managing and fighting Covid-19 pandemic must be acknowledged and applauded.
Let us, as citizens, follow the leaders’ footsteps and commit ourselves to the safety practices they preach daily.
This is how we will play our individual parts in curtailing the second wave.
– Dr Daniel Israel is a general practitioner in Johannesburg, and a member of the Gauteng General Practitioners‘ Collaboration. He writes this in his personal capacity.
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