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Coronavirus morning update: President urged to give regular updates, and what’s in demand in SA shops

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Your latest coronavirus news: The DA leader says the president should be making a weekly address, and also have a question-and-answer sessions with the media; and lockdown has led to some interesting retail trends – with several other products that are currently in hot demand across supermarkets.

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WATCH | 12 May: 11 350 cases of coronavirus in SA, 580 health workers have tested positive

South Africa’s positive Covid-19 cases totalled 11 350 on Tuesday, with the Western Cape recording 484 of the 698 new cases, according to Health Minister Zweli Mkhize.

WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 11 350.

According to the latest update, no new deaths were reported. So far a total of 206 deaths have been recorded.

Just short of 370 000 tests have been conducted, with more than 13 600 new tests.

Of note is that the Eastern Cape has now overtaken KwaZulu-Natal with the third highest cases in the country – with 1 504.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

DA leader John Steenhuisen has questioned why President Cyril Ramaphosa has not addressed the nation about government’s response to the Covid-19 pandemic in nearly three weeks.

The interim opposition party leader has called for transparency from the president, saying the first step would be weekly national addresses, as well as question-and-answer sessions with the media.

“Since his announcement of a move to Level 4 of the lockdown, he has been missing in action and has left it to a handful of ministers to communicate the questionable decisions of the National [Coronavirus] Command Council.

“We call on the President to address the nation regularly – at least once a week – and that these briefings should include the opportunity to answer questions from the media. We also call on him to make public all Covid-19 data, along with the NICD [National Institute for Communicable Diseases] modelling he is using to justify the continued lockdown,” he said.

READ MORE | Come out and address us, Mr President – John Steenhuisen

Schools’ state of readiness to reopen during the Level 4 lockdown hangs in the balance yet again as teacher unions continue to raise what they call “gaps” in an updated report received from the Department of Basic Education.

On Monday, the department held a series of meetings with various stakeholders in the sector to consider schools’ state of readiness.

After Basic Education Minister Angie Motshekga’s announcement two weeks ago, principals and school management teams (SMTs) across the country were scheduled to resume duties on 11 May and teachers on 18 May to prepare for the return of pupils on the proposed date of 1 June. 

This, however, did not happen because some provinces, such as the Eastern Cape, were still not ready to start the process, while Gauteng and the Western Cape reportedly indicated that they were.

READ MORE | ‘We can’t have every province doing its own thing’ – teacher unions on school reopening

South Africa’s lockdown has led to some interesting retail trends – like a spike in the sale of non-alcoholic beverages, and pineapples – but there have been several other products that are currently in hot demand across supermarkets.

Shoprite and Checkers supermarkets saw a “major spike” in the sale of bleach and other household cleaning products – which the group attributes to an increased interest in hygiene, and additionally more time to do some home spring cleaning.

“Products such as Albex, Jik, Domestos and Handy Andy selling exceptionally well,” a spokesperson for the company says.

This is a trend mirrored in Pick n Pay’s analysis of shopping trends in the build up to the lockdown. According to the group’s annual results presentation, released on Tuesday, bleach was one of the most commonly stockpiled items – the sales of which grew by 138%.

READ MORE | These are the hottest products in demand in SA stores – including hair dye and bleach

Members of the Portfolio Committee on Justice and Correctional Services is concerned about the backlog the Covid-19 pandemic will cause in South Africa’s high courts.

The Office of the Chief Justice met with the committee on Tuesday.

Several MPs enquired how the pandemic would affect the administering of justice, particularly if it created backlogs in cases before the high courts, which is administered by the Office of the Chief Justice.

“How are they ensuring access to justice for the public?” DA MP Glynnis Breytenbach asked.

READ MORE | MPs concerned Covid-19 will cause backlog in courts

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Tuesday night, positive cases worldwide were edging closer to 4.24 million, while deaths were more than 290 000.

The United States had the most cases in the world – almost 1.36 million, as well as the most deaths – close to 82 000.

READ MORE | All the confirmed cases worldwide

Latest news:

The city of Wuhan on Monday ordered all its 11 million residents to be tested for the coronavirus on Monday after discovering six new cases over the weekend.

Five people from the Sanmin residential compound in the city’s East West Lake district tested positive on Sunday. They were all linked to an 89-year-old man who tested positive on Saturday.

The six new cases ended a 35-day run of zero new infections in the city. Before this, the last time Wuhan reported a new case was on April 3.

Wuhan also ended its 76-day lockdown on April 8. Since then, the flow of people into the major city has restarted, with public transport, restaurants, and parks operating as normal.

On Monday, the epidemic prevention and control headquarters of Wuhan issued an emergency notice requiring district authorities to submit plans for mass testing on Tuesday, according to The Washington Post and The New York Times.

READ MORE | Wuhan orders all its 11 million residents be tested for the coronavirus after 6 new cases found

A 113-year-old woman, believed to be the oldest person living in Spain, has beat the coronavirus at retirement home where several other residents died from the pandemic, the residence said on Tuesday.

Maria Branyas, who was born in the US, was infected with the virus in April at the Santa Maria del Tura care home in the eastern city of Olot where she has lived for the past 20 years and fought the infection in isolation in her room.

“She survived the disease and is doing fine,” a spokesperson for the residence told AFP, adding Branyas had only displayed mild symptoms of the disease.

“She feels good now, she took a test last week and the result was negative,” the spokesperson said without giving further details.

Branyas, a mother of three, was isolated in her room for weeks, with only a single employee decked in protective gear allowed in to check on her, according to Catalan regional television TV3 which broadcast images of the centenarian.

READ MORE | 113-year-old Spanish woman survives coronavirus

LATEST RESEARCH

A large study involving several thousands of patients may reveal why men seem more vulnerable to Covid-19 than women.

The study was published in the European Heart Journal on 10 May 2020 and was featured in a news release. It essentially revealed that men have higher concentrations of an enzyme called ACE2 in their blood.

In a previous Health24 article, we explained why SARS-Cov-2 is so contagious. It boils down to the proteins in the spikes of the virus that gives it its name – coronavirus – which is derived from the Latin “corona”, meaning crown.

These proteins in the spikes successfully bind to a receptor on human cells, called the angiotensin-converting enzyme 2 (ACE2). Once the virus binds to cells, it starts to multiply inside the host, which ultimately makes us sick.

And because men have a higher concentration of this enzyme, it is no surprise that they are far more likely to bear the brunt of Covid-19 than women.

READ MORE | Why are men more susceptible to Covid-19? An enzyme could be to blame

A new study from the Keck School of Medicine of USX suggests that temporarily suppressing the body’s immune system early on during Covid-19 might help a patient avoid the worst outcome.

According to their research that was published in the Journal of Medical Virology, the body’s two main lines of defence, the innate and adaptive immune responses cause the immune system to go into overdrive in some patients, which may lead to fatal consequences.

What is the difference between innate and adaptive immune response?

When the body gets threatened by an infection, there are two lines of defence. The first line of defence, the innate immune response, kicks in right after the body gets infected by pathogens like viruses or bacteria.

The innate immune response targets the specific pathogen and tries to kill it and any cells damaged by it.

The second line of defence, the adaptive immune response, only kicks in days later if there are still any signs of the virus in the body. This response uses mechanisms such as T and B cells to help fight the virus.

Your immune system responds differently to various viruses and bacteria. In the case of flu, the infection moves swiftly and the immune system kills almost all of the targeted cells within days.

But, in the case of Covid-19, the disease progresses much more slowly. When the immune system realises there is imminent danger, the second line of defence, the adaptive reaction, may kick in long before the sick cells are killed, interfering with the innate immune response’s ability to properly attack the intruder.

READ MORE | Can suppressing the immune system early in Covid-19 prevent severe symptoms?

As the race for a vaccine against SARS-CoV-2 is on and clinical trials are being sped up, scientists are also spending time to find out if existing medicines could be the next best treatment for Covid-19.

An international team of scientists argues that repurposing an existing medicine is likely to offer a quicker solution than vaccine development. Their research backing their argument was published in the British Journal of Pharmacology, and explained in a press release from Cambridge University.

A team of researchers representing the International Union of Basic and Clinical Pharmacology stated that there will be no magical cure to treat the disease. According to the researchers, a multi-pronged approach is needed to find new, effective medicines, as a vaccine may take over a year to develop.

As scientists unpack the effect of SARS-CoV-2 on the body, we now know that some of the severe symptoms we see in other people are the result of the immune system fighting back, causing damage to tissue and vital organs.

Once the virus enters our bodies, if we have no immunity, it breaks into our cells and replicates throughout the body.

The researchers believe that there are certain areas a successful drug should cover. Professor Anthony Davenport from the University of Cambridge, one of the authors, explains: “Any drug to treat Covid-19 will need to focus on the three key stages of infection: preventing the virus entering our cells in the first place, stopping it replicating if it gets inside the cells, and reducing the damage that occurs to our tissues, in this case, the lungs and heart.”

READ MORE | Covid-19: A repurposed drug might offer quicker results than a vaccine

As US health officials start to learn how the new coronavirus affects children, a new study details the cases of 48 young patients who wound up in the intensive care units at 14 different hospitals after they were infected with Covid-19.

What common threads did the researchers find? An overwhelming majority – 83% – of these young patients suffered from an underlying health condition. Nearly 40% of those children needed a ventilator, and two died.

No child in the study had the new coronavirus-linked inflammatory syndrome that can cause life-threatening heart problems in children. Instead, the 48 patients showed the severe respiratory distress that has hit so many American adults so hard.

“The idea that Covid-19 is sparing of young people is just false,” said study co-author Lawrence Kleinman. He is chief of the department of paediatrics’ division of population health, quality and implementation science at Rutgers University, in New Jersey.

“While children are more likely to get very sick if they have other chronic conditions, including obesity, it is important to note that children without chronic illness are also at risk. Parents need to continue to take the virus seriously,” Kleinman said in a Rutgers news release.

The findings appear to confirm two things: Only a tiny fraction of children will be hit hard by Covid-19, but when it happens the prognosis is very grim.

READ MORE | Covid-19 is still rare in kids, but far from harmless – study

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

 
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Iceland suggests reopening schools is safe

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Some countries are refusing to open their schools for fear of a prompting a second wave of coronavirus infections. But their policies would appear to be flatly contradicted by evidence from Iceland. There, a company called deCODE Genetics, in association with the country’s directorate of health and the national university hospital, has analysed the results of coronavirus tests on 36,500 people. The tests identified 1801 cases of people suffering from the disease – and ten deaths. Each case was carefully tracked. In not a single case could the researchers find evidence of a child passing on the disease to their parents. The company’s CEO, Kari Stefansson, revealed the findings in an interview carried on the Science Museum website. He suggests the fact that few children suffer any symptoms, and are less likely to cough, is an important factor.

The Icelandic study reinforces the results of a review of evidence last week by the Royal College of Paediatricians and Child Health, which said it couldn’t find a single documented case of a child under 10 passing Covid-19 to an adult. In one case, a nine-year-old boy returning from a skiing holiday in the Alps was found to be infected with SARS-CoV-2, the virus which causes Covid-19, as well as influenza and the common cold. He didn’t pass SARS-CoV-2 to anyone, in spite of coming into contact with 170 children. He did, however, pass the flu and cold to his siblings; but not SARS-CoV-2.

It ought to be pretty strong evidence that opening schools is safe, and is among the first moves which should be taken to exit from lockdown. But don’t bet against the unions squashing plans to open before September at the earliest.

 
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FBI Warns of China Targeting US Groups Conducting COVID-19-Related Research

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FBI Warns of China Targeting US Groups Conducting COVID-19-Related Research

 
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SARS-CoV-2 epidemic

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Abstract

France has been heavily affected by the SARS-CoV-2 epidemic and went into lockdown on the 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find 3.6% of infected individuals are hospitalized and 0.7% die, ranging from 0.001% in those <20 years of age (ya) to 10.1% in those >80ya. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project 2.8 million (range: 1.8–4.7) people, or 4.4% (range: 2.8–7.2) of the population, will have been infected. Population immunity appears insufficient to avoid a second wave if all control measures are released at the end of the lockdown.

The worldwide pandemic of SARS-CoV-2, the coronavirus which causes COVID-19, has resulted in unprecedented responses, with many affected nations confining residents to their homes. Much like the rest of Europe, France has been hit hard by the epidemic and went into lockdown on the 17 March 2020. It was hoped that this would result in a sharp decline in ongoing spread, as was observed when China locked down following the initial emergence of the virus (1, 2). Following the expected reduction in cases, the French government has announced it will ease restrictions on the 11 May 2020. To exit from the lockdown without escalating infections, we need to understand the underlying level of population immunity and infection, identify those most at risk for severe disease and the impact of current control efforts.

Daily reported numbers of hospitalizations and deaths only provide limited insight into the state of the epidemic. Many people will either develop no symptoms or symptoms so mild they will not be detected through healthcare-based surveillance. The concentration of hospitalized cases in older individuals has led to hypotheses that there may be widespread “silent” transmission in younger individuals (3). If the majority of the population is infected, viral transmission would slow, potentially reducing the need for the stringent intervention measures currently employed.

We present a suite of modeling analyses to characterize the dynamics of SARS-CoV-2 transmission in France and the impact of the lockdown on these dynamics. We elucidate the risk of SARS-CoV-2 infection and severe outcomes by age and sex and estimate the current proportion of the national and regional populations that have been infected and might be at least temporarily immune (4). These models support healthcare planning of the French government by capturing hospital bed capacity requirements.

As of 7 May 2020, there were 95,210 incident hospitalizations due to SARS-CoV-2 reported in France and 16,386 deaths in hospitals, with the east of the country and the capital, Paris, particularly affected (Fig. 1, A and B). The mean age of hospitalized patients was 68ya and the mean age of the deceased was 79ya with 50.0% of hospitalizations occurring in individuals >70ya and 81.6% of deaths within that age bracket; 56.2% of hospitalizations and 60.3% of deaths were male (Fig. 1, C to E). To reconstruct the dynamics of all infections, including mild ones, we jointly analyze French hospital data with the results of a detailed outbreak investigation aboard the Diamond Princess cruise ship where all passengers were subsequently tested (719 infections, 14 deaths currently). By coupling the passive surveillance data from French hospitals with the active surveillance performed aboard the Diamond Princess, we disentangle the risk of being hospitalized in those infected from the underlying probability of infection (5, 6).

Fig. 1 COVID-19 hospitalizations and deaths in France.(A) Cumulative number of general ward and ICU hospitalizations, ICU admissions and deaths from SARS-CoV-2 in France. The green line indicates the time when the lockdown was put in place in France. (B) Distribution of deaths in France. Number of (C) hospitalizations, (D) ICU and (E) deaths by age group and sex in France.

We find that 3.6% of infected individuals are hospitalized (95% CrI: 2.1–5.6), ranging from 0.2% (95% CrI: 0.1–0.2) in females under <20ya to 45.9% (95% CrI: 27.2–70.9) in males >80ya (Fig. 2Aand table S1). Once hospitalized, on average 19.0% (95% CrI: 18.7–19.4%) patients enter ICU after a mean delay of 1.5 days (fig. S1). We observe an increasing probability of entering ICU with age—however, this drops for those >70ya (Fig. 2B and table S2). Overall, 18.1% (95% CrI: 17.8–18.4) of hospitalized individuals go on to die (Fig. 2C). The overall probability of death among those infected (the Infection Fatality Ratio, IFR) is 0.7% (95% CrI: 0.4–1.0), ranging from 0.001% in those under 20ya to 10.1% (95% CrI: 6.0–15.6) in those >80ya (Fig. 2D and table S2). Our estimate of overall IFR is similar to other recent studies that found values of between 0.5 and 0.7% for the Chinese epidemic (6–8). We find men have a consistently higher risk than women of hospitalization (RR 1.25, 95% CrI: 1.22–1.29), ICU admission once hospitalized (RR: 1.61, 95% CrI: 1.56–1.67) and death following hospitalization (RR: 1.47, 95% CrI: 1.42–1.53) (fig. S2).

Fig. 2 Probabilities of hospitalization, ICU admittance and death.(A) Probability of hospitalization among those infected as a function of age and sex. (B) Probability of ICU admission among those hospitalized as a function of age and sex. (C) Probability of death among those hospitalized as a function of age and sex. (D) Probability of death among those infected as a function of age and sex. For each panel, the black line and grey shaded region represents the overall mean across all ages. The boxplots represent the 2.5, 25, 50, 75 and 97.5 percentiles of the posterior distributions.

We identify two clear subpopulations in those cases that are hospitalized: individuals that die quickly upon hospital admission (15% of fatal cases, mean time to death of 0.67 days) and individuals who die after longer time periods (85% of fatal cases, mean time to death of 13.2 days) (fig. S3). The proportion of fatal cases who die rapidly remains approximately constant across age-groups (fig. S4 and table S3). Potential explanations for different subgroups of fatal cases include heterogeneous patterns of healthcare seeking, access to care, underlying comorbidities, such as metabolic disease and other inflammatory conditions. A role for immunopathogenesis has also been proposed (9–12).

We next fit national and regional transmission models to ICU admission, hospital admission, and bed occupancy (both ICU and general wards) (Fig. 3, A to D, fig. S5, and tables S4 to S6), allowing for reduced age-specific daily contact patterns following the lockdown and changing patterns of ICU admission over time (fig. S17). We find that the basic reproductive number R0 prior to the implementation of the lockdown was 2.90 (95% CrI: 2.80–2.99). The lockdown resulted in a 77% (95% CI: 76–78) reduction in transmission, with the reproduction number R dropping to 0.67 (95% CrI: 0.65–0.68). We forecast that by the 11 May 2020, 2.8 million (range: 1.8–4.7, when accounting for uncertainty in the probability of hospitalization given infection) people will have been infected, representing 4.4% (range: 2.8–7.2) of the French population (Fig. 3E). This proportion will be 9.9% (range: 6.6–15.7) in Ile-de-France, which includes Paris, and 9.1% (range: 6.0–14.6) in Grand Est, the two most affected regions of the country (Fig. 3F and fig. S5). Assuming a basic reproductive number of R0 = 3.0, it would require around 65% of the population to be immune for the epidemic to be controlled by immunity alone. Our results therefore strongly suggest that, without a vaccine, herd immunity on its own will be insufficient to avoid a second wave at the end of the lockdown. Efficient control measures need to be maintained beyond the 11 May.

Fig. 3 Time course of the SARS-CoV-2 epidemic to 11 May 2020.(A) Daily admissions in ICU in metropolitan France. (B) Number of ICU beds occupied in metropolitan France. (C) Daily hospital admissions in metropolitan France. (D) Number of general ward beds occupied in metropolitan France (E) Daily new infections in metropolitan France (logarithmic scale). (F) Predicted proportion of the population infected by 11 May 2020 for each of the 13 regions in metropolitan France. (G) Predicted proportion of the population infected in metropolitan France. The black circles in panels (A), (B), (C) and (D) represent hospitalization data used for the calibration and the open circles hospitalization data that were not used for calibration. The dotted lines in panels (E) and (G) represent the 95% uncertainty range stemming from the uncertainty in the probability of hospitalization following infection.

Our model can help inform the ongoing and future response to COVID-19. National ICU daily admissions have gone from 700 at the end of March to 66 on 7 May. Hospital admissions have declined from 3600 to 357 over the same time period, with consistent declines observed throughout France (fig. S5). By 11 May we project 3900 (range: 2600–6300) daily infections across the country, down from between 150,000–390,000 immediately prior to the lockdown. At a regional level, we estimate that 58% of infections will be in Ile-de-France and Grand Est combined. We find that the time people spend in ICU appears to differ across the country, which may be due to differences in health care practices (table S5).

Using our modeling framework, we are able to reproduce the observed number of hospitalizations by age and sex in France and the number of observed deaths aboard the Diamond Princess (fig. S6). As a validation, our approach is also able to correctly identify parameters in simulated datasets where the true values are known (fig. S7). As cruise ship passengers may represent a different, healthier population than average French citizens, we run a sensitivity analysis where Diamond Princess passengers are 25% less likely to die than French citizens (Fig. 4 and fig. S8). We also run sensitivity analyses with longer delays between symptom onset and hospital admission, missed infections aboard the Diamond Princess, equal attack rates across all ages, reduced infectivity in younger individuals, a contact matrix with unchanged structure before/during the lockdown and one with very high isolation of elderly individuals during the lockdown. These different scenarios result in mean IFRs from 0.5 to 0.9%, the proportion of the population infected by the 11 May 2020 ranging from 1.7–8.9%, the number of daily infections at this date ranging from 1700 to 9600 and a range of reproductive numbers post lockdown of 0.62–0.73 (Fig. 4, figs. S8 to S15, and tables S7 to S12).

Fig. 4 Sensitivity analyses considering different modeling assumptions.(A) Infection fatality rate (%). (B) Estimated reproduction numbers before (R0) and during lockdown (Rlockdown). (C) Predicted daily new infections on 11 May. (D) Predicted proportion of the population infected by 11 May. The different scenarios correspond to: Children less inf. – Individuals <20ya are half as infectious as adults; No Change CM – the structure of the contact matrix is not modified by the lockdown; CM SDE – Contact matrix after lockdown with very high social distancing of the elderly; Constant AR – Attack rates are constant across age groups; Higher IFR – French people 25% more likely to die than Diamond Princess passengers; Higher AR DP – 25% of the infections were undetected on the Diamond Princess cruise ship; Delay Distrib – Single hospitalization to death delay distribution; Higher delay to hosp – 8 days on average between symptoms onset and hospitalization for patients who will require an ICU admission and 9 days on average between symptoms onset and hospitalization for the patients who will not. For estimates of IFR and reproduction numbers before and during lockdown, we report 95% credible intervals. For estimates of daily new infections and proportion of the population infected by 11 May, we report the 95% uncertainty range stemming from the uncertainty in the probability of hospitalization given infection.

A seroprevalence of 3% (range: 0–3%) has been estimated among blood donors in Hauts-de-France, which is consistent with our model predictions (range: 1–3%) for this population if we account for a 10-day delay for seroconversion (13, 14). Future additional serological data will help further refine estimates of the proportion of the population infected.

While we focus on deaths occurring in hospitals, there are also non-hospitalized COVID-19 deaths, including >9000 in retirement homes in France (15). We explicitly removed retirement home population from our analyses as transmission dynamics may be different in these closed populations. This means our estimates of immunity in the general population are unaffected by deaths in retirement homes, however, in the event of large numbers of non-hospitalized deaths in the wider community, we would underestimate the proportion of the population infected. Analyses of excess death will be important to explore these issues.

This study shows the massive impact the French lockdown had on SARS-CoV-2 transmission. Our modeling approach has allowed us to estimate underlying probabilities of infection, hospitalization and death, which is essential for the interpretation of COVID-19 surveillance data. The forecasts we provide can inform lockdown exit strategies. Our estimates of a low level of immunity against SARS-CoV-2 indicates that efficient control measures that limit transmission risk will have to be maintained beyond the 11 May 2020 to avoid a rebound of the epidemic.

Supplementary Materials

science.sciencemag.org/cgi/content/full/science.abc3517/DC1

Materials and Methods

Supplementary Text

Figs. S1 to S17

Tables S1 to S12

References (17–32)

MDAR Reproducibility Checklist

This is an open-access article distributed under the terms of the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
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