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Coronavirus in South Africa: The lull before the tsunami?

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The country has seen an unexpected slow-down in the daily rate of infections.

During the past fortnight South Africa has seen a dramatic, and unexpected slow-down in the daily rate of coronavirus infections.

Health experts are warning that it is far too early to see this as a significant development, and worry that it could even trigger a dangerous sense of complacency.

President Cyril Ramaphosa has now suggested that the two weeks of lockdown is responsible. He has extended the nationwide restrictiions, scheduled to end in one week’s time, to the end of the month.

But – as the country and the continent continue to brace for the potentially devastating impact of the pandemic – doctors are struggling to explain what’s going on.

The beds are ready. Wards have been cleared. Non-emergency operations rescheduled. Ambulances kitted out. Medical teams have been rehearsing non-stop for weeks. Managers have spent long hours in online meetings drawing up, and tweaking their emergency plans. 

But so far, and against most predictions, South Africa’s hospitals remain quiet, the anticipated “tsunami” of infections that many experts here have been waiting for has yet to materialise.

“It’s a bit strange. Eerie. No-one is sure what to make of it,” said Dr Evan Shoul, an infectious disease specialist in the main city, Johannesburg.

“We’re a bit perplexed,” said Dr Tom Boyles, another infectious disease doctor at Johannesburg’s Helen Joseph Hospital, one of the biggest public hospitals in the city.

“We’ve been calling it the calm before the storm for about three weeks. We’re getting everything set up here. And it just hasn’t arrived. It’s weird.”

Aggressive tracing of contacts

It is nearly five weeks since the first confirmed Covid-19 case in South Africa, and until 28 March, the daily graph tracking the number of new infections followed a familiar, accelerating, upward curve.

But on that Saturday, the curve suddenly broke sharply – from 243 new cases in one day, to just 17. Since then, the daily average has settled at around 50 new cases.

Could it be that South Africa’s early, and strict lockdown, and its aggressive tracing work, are actually working? Or is this just a small lull?

On Thursday President Ramaphosa said it was “too early to make a definite analysis”, but he said that since the lockdown had been introduced the daily increase in infections had dropped from 42% to “around 4%”.

“I think the more people we test, the more we’ll reveal whether it’s an aberration, or it’s real. The numbers are not yet there,” cautioned Precious Matotso, a public health official who is monitoring South Africa’s pandemic on behalf of the World Health Organization (WHO).

Complacency fears

There is a general acknowledgement here, from the health minister to frontline hospital staff, that it is dangerously early to try to reach any firm conclusions about the spread of the virus.

“It’s difficult to predict which road we’re going to take – a high, middle or low [rate of infection]. We don’t have widespread testing.

“There might be early signs that are positive, but my fear is that people start becoming complacent, based on limited data,” said Stavros Nicolaou, a healthcare executive now coordinating elements of the private sector’s response.

The sense of a vacuum caused by this extended lull – the potential “calm before a devastating storm,” as Health Minister Zweli Mkhize described it last week – is, inevitably, being filled by speculation.

The widespread assumption has been that the virus – introduced to South Africa, and many other African countries largely by wealthier travellers and foreign visitors – would inevitably move into poorer, crowded neighbourhoods and spread fast.

Nervous anticipation

According to experts, that remains the most likely next stage of the outbreak, and there have already been several confirmed infections in a number of townships.

But doctors here and in some neighbouring countries have noted that public hospitals have seen not yet any hint of an increase in admissions for respiratory infections – the most likely indication that, despite limited testing, the virus is spreading fast.

One theory is that South Africans might have extra protection against the virus because of a variety of possible medical factors – ranging from the compulsory anti-tuberculosis BCG vaccine that almost all citizens here are given at birth, to the potential impact of anti-retroviral HIV medication, to the possible role of different enzymes in different population groups.

But these ideas have not been verified.

“These stories have been around for a while. I’d be amazed if it was BCG. These are theories. They’re probably not true,” said Dr Boyles.

“It’s an interesting hypothesis” but nothing more than that, said Prof Salim Karim, South Africa’s leading HIV expert, of the BCG jab. He chided “instant experts” for promoting unverified solutions on social media.

Coronavirus in South Africa: The lull before the tsunami?

Confirmed coronavirus cases in South Africa

“I don’t think anyone on the planet has got the answers,” said Mr Nicolaou.

“We’re still planning as if the tsunami is coming. The feeling is still very much one of great nervous anticipation,” said Dr Shoul.

And so South Africa waits – wondering whether it is experiencing a minor pause before what one doctor here called “an intergalactic spike,” or something more significant.

The more important question may be whether these quiet weeks are being put to good use.

There have been particular concerns that the state health system has been slow to implement an aggressive testing regime and is currently too dependent on private clinics.

Internal health department correspondence, seen by the BBC, points to growing concerns about mismanagement and dysfunction within the state system, particularly regarding the slow rate of testing.

But those concerns are balanced by growing confidence in the government’s “evidence-based” approach to the pandemic, and by encouraging signs of increasingly constructive and formal cooperation between the state and the private sector. BBC

Source: https://vietnamnet.vn/en/society/coronavirus-in-south-africa-the-lull-before-the-tsunami-632636.html

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Residents booked for violating pandemic prevention rules on Ho Chi Minh City’s downtown pedestrian street

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Many people have been booked for violating pandemic prevention and control measures as they hang out with their friends along Nguyen Hue Pedestrian Street in Ho Chi Minh City.

Residents flocked to the Nguyen Hue promenade in downtown District 1 on Thursday evening to have a walk, get some fresh air, and chat with friends, according to the observation of Tien Phong (Youth) newspaper reporters.

Many of them parked their motorbikes on the sidewalk to have a chat and grab a bite, but did not follow pandemic response measures including wearing face masks in public and keeping a safe distance.

At around 7:30 pm, a group of district-level police officers patrolled the street and booked dozens of people for wrong parking and violating pandemic prevention and control regulations.

Several violators did not cooperate at first but eventually had to accept administrative fines after the officers provided the evidence of their offenses.

In one of the cases, L.V.D., 25, was booked for failure to wear a face mask in public places and illegal parking.

As D. denied his wrongdoings, an officer showed the video footage of him pulling the face mask down to his chin while talking to his friend.

The offender had no other choice but to sign the violation record, facing fines worth VND1-3 million (US$44-132) for failure to wear face masks in public and VND200,000-300,000 ($8-13) for illegal parking.

Residents are booked for parking their motorbikes on the roadway along Nguyen Hue Walking Street in Ho Chi Minh City, October 21, 2021. Photo: D.T. / Tien Phong

Residents are booked for parking their motorbikes on the roadway along Nguyen Hue Walking Street in Ho Chi Minh City, October 21, 2021. Photo: D.T. / Tien Phong

According to Major Dinh Tien Dung, deputy head of District 1’s traffic and order police unit, many people did not put on face masks or wore them improperly.

They only put on one when they saw police officers approaching, Dung continued.

“We decided to use cameras to film their violations from afar so that they won’t be able to deny their wrongdoings,” he said.

A young man pulls down his face mask while walking on Nguyen Hue Street in Ho Chi Minh City, October 21, 2021 in this supplied photo.

A young man pulls down his face mask while walking on Nguyen Hue Pedestrian Street in Ho Chi Minh City, October 21, 2021 in this supplied photo.

Major Dung added that his unit had booked more than 200 of such violations on Nguyen Hue Pedestrian Street since the beginning of the week.

Ho Chi Minh City has been the hardest-hit locality since the fourth outbreak began on April 27, with over 422,200 local infections.

The city had imposed social distancing measures at various levels since May 31 before loosening multiple restrictions on October 1, because most of its adult population had been vaccinated with at least one dose.

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Source: https://tuoitrenews.vn/news/society/20211022/residents-booked-for-violating-pandemic-prevention-rules-on-ho-chi-minh-citys-downtown-pedestrian-street/63726.html

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Ministry asks localities to increase inter-provincial passenger transport

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Coaches at Gia Lâm station in Hà Nội’s Long Biên District. —VNA/ Photo 

HÀ NỘI — The Ministry of Transport has issued a document asking People’s Committees of cities and provinces to coordinate on the implementation of temporary guidelines on transport activities.

The measures are to ensure safe and flexible adaptation to and effective control of the COVID-19 pandemic.

The Government has issued Resolution No.128/NQ-CP on temporary regulations on safe and flexible adaptation to and effective control of COVID-19. To implement the resolution, the Health Ministry has promulgated temporary medical guidance and the Transport Ministry has also released temporary guidelines on transport activities in the five areas of land, inland waterway, maritime, railway and aviation. 

Therefore, to ensure smooth and concerted transport activities, People’s Committees of cities and provinces were asked to direct local agencies and units to follow the ministry’s guidelines, and instruct departments of transport to increase passenger volume on fixed intra-provincial and inter-provincial routes licensed by the provincial authorities.

The ministry also suggested localities resume other routes depending on the local level of pandemic risk, while striving to maintain from 10 per cent to a maximum 50 per cent of licensed trips per month in line with requirements in the temporary guidelines.

In a report reviewing passenger transport activities on fixed routes during one week of resumption from October 13-18, the ministry said authorities of 48 provinces and cities had allowed the resumption of inter-provincial routes, while in 15 other localities, the transport departments had submitted plans to resume routes to the municipal/provincial authorities. —

Source: https://vietnamnews.vn/society/1063729/ministry-asks-localities-to-increase-inter-provincial-passenger-transport.html

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Ho Chi Minh City doctors excise over 100 tumors from woman’s abdomen

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Doctors at the Ho Chi Minh City Oncology Hospital on Thursday removed more than 100 tumors weighing about five kilograms from the abdomen of a 50-year-old woman from the Mekong Delta province of Tien Giang. 

Dr. Nguyen Van Tien, head of the surgery department at the hospital, said that the patient suffered a swollen, painful abdomen upon her admission.

She had noticed unusual signs about two years ago, but deferred seeking medical care for her abdominal pain over complicated COVID-19 developments in Ho Chi Minh City. 

It was not until the coronavirus pandemic was basically put under control in the southern city that the patient visited the Ho Chi Minh City Oncology Hospital.

After a consultation meeting, doctors diagnosed the patient with uterine sarcoma, a disease in which malignant cells form in the muscles of the uterus or other tissues that support the uterus, so they decided to perform a surgery on the woman to remove the tumors.

Surgeons took out a total of more than 100 tumors attached to the patient’s uterus, intestinal loops, junctions, grooves of the small intestine, colon, and renal fossa.

The tumors, which weighed about five kilograms in total, compressed and pushed the positions of many internal organs.

Dr. Tien recommended that people have their health checked periodically, especially when there are abnormal signs in their bodies, so that doctors can detect risks early and provide timely treatment or intervention.

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Source: https://tuoitrenews.vn/news/society/20211022/ho-chi-minh-city-doctors-excise-over-100-tumors-from-womans-abdomen/63725.html

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