Dr Zweli Mkhize. Image: Povo News

A total of 328 health workers have tested positive
for COVID-19 since the beginning of the outbreak in South Africa with an
elderly doctor in Limpopo dying after being in contact with a patient who tested
positive. This was revealed by Health Minister Zweli Mkhize in his latest media
briefing on the spread of the virus in South Africa and the impact of the six
weeks of hard lockdown on the containment of the disease. Most of the infected
health workers are in the private sector with a total of 195 while 133 tested
positive in the public sector. Nurses are the worst affected  with 123 cases confirmed in the private sector
and 50 in the public sector. So far 44 doctors have tested positive – 19 in the
private and 25 in the public sector. The others are allied health workers and
health workers deployed in communities.

Applauding  health workers for their role in keeping COVID-related
deaths in hospitals low, Dr Mkize said the total of 93 deaths now recorded in
South Africa is 1.9% of the number of confirmed cases in the country compared
to up to 14% in Western European countries. Of the 4996 cases reported until
yesterday (28 April), 2073 have recovered while 395 have been admitted to

He urged healthcare workers who are
unemployed or in retirement to come forward if they want to assist in treating
patients, assuring local doctors and nurses that the more than 200 Cuban doctors
who arrived in South Africa on Monday will not be taking anyone’s post or
threaten local employment but are here to reinforce human resources in the
communities. Among the Cubans are 105 family physicians, 11 public health specialists
and 18 epidemiologists.

The deployment of the Cubans has elicited a
mix response from the healthcare sector and the public with SAMA criticizing government
for not engaging with it before they were brought to the country. In a
statement yesterday, SAMA chair Dr Angelique Coetzee said the principle of not
engaging with the biggest representative body of doctors in the country is
flawed and wrong.

She said that in light of the current poor
economic environment in the country, the money spent on bringing the Cuban Brigade
to South Africa would have been better spent on first employing local doctors who
have the necessary skills and experience to drive this process, especially in
rural areas.

There are many unemployed doctors in South
Africa and many community service medical officers have still not been placed.
In addition, many private practitioners have indicated their willingness to
assist, she noted, adding that there are many public and private health
specialists, family physicians and epidemiologists who would have heeded the
president’s call for assistance, Dr Coetzee pointed out.

“SAMA, through its various societies would
have been able to source local expertise before this was sought overseas and
the cost of employing the expertise may have been mitigated. Retired doctors
can be brought back into the service delivery system – even for a short time.
They can also mentor younger doctors who lack the necessary experience and
skills. Only when we have exhausted all our internal human resources should a
consultative process between SAMA, the Department of Health and the Presidency
been initiated to bring the Cuban specialists to South Africa,”  Dr Coetzee said, adding that SAMA will request
a meeting with the Health Minister to express its unhappiness on the processes
that were followed.

Referring to criticism over early
projection models that pictured a much worse scenario than is currently
experienced and prompted the hard lockdown, Dr Mkhize said it has averted a
rapid explosion of cases and pushed back a peak in infections (now expected in
September/ October) to allow the health sector to prepare for a possible influx
into hospitals.

“The issue is when we started with the
lockdown, we wanted to slow down the viral infection. To suddenly open without
putting in place the necessary mechanisms for limiting the spread… if you just
go back to normal, we are actually going to go to an early explosion, which
means you can have a rebound of infections quite quickly,” he said.

However, he stressed that the lockdown has
not stopped the spread completely and that the further extension of the lockdown
in its current form would not have a substantial benefit in delaying the peak
infection curve.

According to Mkhize, the biggest challenge for
South Africa in preventing a surge in deaths is its high disease burden of
hypertension, diabetes, HIV and obesity which is prompting a unique response as
other countries don’t have the huge number of comorbidities. Most of the people
who died in South Africa had hypertension, diabetes and obesity and were older
than 63 years.

Prof Cheryl Cohen from the Centre of
Respiratory Diseases and Meningitis at the National Institute for Communicable
Diseases told News24 that it is accepted that the confirmed number of cases in
South Africa was underreported and that a high percentage of possible asymptomatic
cases could lead to a rapid increase in the spread later.