Brief Opening Statement for Minister Mkhize: NCCC Press Briefing

29 December 2020

Yesterday we reported 1 011 871 cumulative cases with over 7000 new cases. In this last epidemiological week we have surpassed the peak of the first wave and we had indicated that the epidemiological picture would compel us to tighten restrictions.

The majority of new cases today are from KwaZulu-Natal with 2 275 (30,5%) followed by Western Cape at 2 191 cases (29,4%), Gauteng at 1 849 cases (24,8%) and Eastern Cape at 384 cases (5,1%).

The overall positivity for the newly tested individuals is 32,9%, with Western Cape at 45,6%, followed by Limpopo at 41,0%, KwaZulu-Natal at 36,0% and Mpumalanga at 33,1%. These positivity rates are extremely high and are a major concern. Overall we need to test more and target a positivity rate of 10% or less.

11 256 patients are currently hospitalised- this is 8,3 % of our active cases. Of these 3 543 are on oxygen and 604 are on ventilators.

According to the resurgence thresholds, the majority of districts in South Africa are in Response Phase- this means greater than or equal to 20% increase in new COVID-19 cases compared to 7 days prior (based on the 7-day moving average) OR greater than or equal to a total of 30 cases per 100 000 population in the last 7 days. (There must have been a minimum total of 10 cases per 100 000 population in the last 7 days)
To determine whether a district or province is a ‘hotspot’ or in a ‘resurgence’ each of the resurgence monitoring indicators were assessed for the district or province.

These are:

  • New COVID-19 cases per day
  • Testing rate / unit population
  • Percentage positivity rate
  • Active cases (incidence risk)
  • Current COVID-19 hospital admissions
  • COVID-19 mortality
  • All-cause mortality

The Criteria for provinces or districts meeting the ‘hotspot’ or ‘resurgence’ criteria:

  • The province or district has crossed the Response threshold;
  • The resurgence indicators support the Response classification showing a similar trend (high positivity rates, increase in active cases, increase in hospitalisations, increase in mortality);
  • The trends are investigated for 7 days and determination is made as to whether the increase is a result of cluster outbreaks or localized outbreaks
  • If the district has maintained a sustained upward trend, the determination of whether the area is a ‘hotspot’ is made by an expert committee (in collaboration with the National and Provincial Departments of Health) taking into consideration the rate of community transmission and the strain on the healthcare system.
  • The ‘hotspot’ or ‘resurgence’ declaration is then be made by the Minister for Health in collaboration with his provincial counterparts.

It was through this process that the hotspots, as announced by the President yesterday, were declared.

The Provinces are now instituting their tailored resurgence plans, adapted from the surge plan that was developed together with WHO. The key focus areas of the resurgence plan are:

  • Governance and leadership
  • Medical supplies
  • Port and Environmental Health
  • Epidemiology and response
  • Facility readiness & case management
  • Information systems
  • Risk communication and community engagement
  • Occupational health and safety
  • Human resources for health

The safety of our Health Care workers remain paramount and we are concerned by the rising numbers of professionals becoming infected with COVID-19 during this second wave. We continue to engage Unions and have appraised them of the resurgence plan and outline the provincial readiness plans. It will greatly assist us to welcome, in a few days, 2 367 medical interns, 1 693 medical community service practitioners who will form part of a 7 895 strong community service workforce from all categories. This will provide relief to our exhausted frontline workers. Currently, overall availability of PPE is at 87.1%. We encourage unions to access the dashboard and and use the Stock Visibility System to assist us with stock surveillance and movement and continue to be active participants in OHS committees as was jointly resolved over the course of the pandemic

We are also cognizant of the non-COVID related services that need to continue.The alcohol ban will greatly assist to reduce the trauma burden on our facilities over the festive season and save lives. We are still rolling out our catch up programmes to ensure that other essential health services continue to be delivered and remind the public that our facilities remain open for non-COVID related consultations with triage mechanisms to ensure that patients are not exposed to COVID-19 while visiting our facilities. We do not want a situation where we bring COVID-19 under control, only to find that other major public health burdens become exacerbated by neglect.

We remind citizens to ensure they access the following essential services:

  • Immunizations for children
  • Antenatal Care for expectant mothers
  • Screening and testing for other communicable diseases such as malaria, HIV, and TB
  • Screening and testing for non-communicable diseases such as hypertension, diabetes prostate, Cervical and breast cancer
  • Voluntary male circumcision