Does the body build immunity to Covid-19 once infected? 

Because of the rapid progression of Covid-19, it is still too soon to tell. However, the limited evidence so far suggests that people do develop immunity. 

How long is the virus active/transferable for in the air or on surfaces?

Covid-19 can survive for varying lengths of time depending on the surface. Business Insider checked with Dr Andres Romero, an infectious disease specialist, in this article. It’s important to note that this is not Covid-19 specific but what is known of viruses generally. 

What is the mortality rate for healthy victims (not elderly and who do not have compromised immune systems)?

As of 19 March, South Africa has a zero mortality rate. It’s shifting every day as new cases are recorded, but globally, it’s at about 1%, but the exact figure will remain uncertain as the pandemic is still spreading around the world. It’s important to note that if this percentage appears low it will still translate to thousands of people. It is also significantly impacted by the country’s capacity to treat people. 

What happens in the case of school lockdowns when parents need to stay at home to look after their children? Unpaid leave? How will this work with people who need to go to work to earn their salary but have no option of at-home care for their children?

Government is considering a UIF tax reprieve as well as special leave provisions. You can read more about it here. 

How do Covid-19 infection rates compare with that of normal flu?

For further reading on this, read Kevin Davie’s article from February on the flu. Daily Maverick also published Virus literacy for beginners which lays out the differences. 

Is anything being done to address the high risk of infection among the immuno-compromised i.e. those with HIV/TB etc. 

This is why social distancing is imperative. HIV activists released a joint statement drawing attention to a number of issues that need addressing. You can read their statement here. The Southern African HIV Clinicians Society has also released an important statement advising health workers to promote HIV testing and treatment now more than ever. 

Are medical facilities working on a vaccine for Covid-19? If so, is there any indication as to when this will be ready?

Yes, the whole world is looking for a vaccine. Clinical trials are under way. Editor of Maverick Citizen, Mark Heywood, spoke to Professor Lynn Morris from the National Institute of Communicable Diseases on this topic. You can read his interview with her here. The estimates are that an effective and safe vaccine is about 12 to 18 months away. Adele Baleta from Spotlight also wrote about the urgent but long race for a vaccine.

Has the transport system put any systems in place to limit spread of the virus i.e. hand sanitisers, and are they disinfecting buses, trains, planes etc.?

As part of the State of National Disaster, there should be sanitiser and enhanced infection control on all public transport. If you don’t see this, let us know. For more information on what the government is doing on transport-specific Covid-19 measures you can see here. 

What is the treatment advice if you are positive and in self-quarantine? What medication does one take and what should we be doing to ensure a swift recovery?

We can’t give treatment advice, sadly. The recommendation is to contact your doctor. You can also see extensive detail from the World Health Organisation website here. There are no proven treatments. There is a lot of fake news, untested and quack remedies out there from steaming your nostrils, overdosing on Vitamin C to blowing hot air into your mouth with a hairdryer. These are dangerous. There are no proven treatments and the only means to manage Covid-19 is to manage some of the symptoms.

Should I be tested if I feel unwell and it feels like the common cold or flu?

Call your doctor and see if your symptoms match the ‘case definition’ for Covid-19 before having a test. This case definition is shifting and all doctors would be well-versed in what to do.

How is SA ensuring that we have an accurate number of cases, especially given healthcare facilities in rural areas?

Since the first documented cases in China in January, the National Institute of Communicable Diseases has instituted emergency measures to ensure that it’s tracking and tracing methods are of a global standard. In an interview in the Africa Report, the regional representative for the WHO in the Africa region said it is unlikely that the relatively low infection rates across the continent are the result of underreporting. He said that the WHO’s experience of managing Ebola and other infectious diseases showed that cases would show up in the health system. It is however accepted that some cases will be missed. The challenge is that we do not know how many. 

What is being done to limit the spread of the virus in poorer communities?

By declaring a National State of Disaster, President Cyril Ramaphosa has scaled up the country’s response to a level below a national emergency. You can learn about the difference between a National State of Disaster and a National Emergency in Marianne Merten’s article published on Thursday. A national comprehensive response is being implemented which includes a shutdown of most borders, travel bans on viral hot-spots and a mass education initiative.  To flatten the curve of infection, South Africa has to ensure that coronavirus infections are not massified. There is now supposed to be enhanced high-temperature screening at taxi ranks, train stations and elsewhere. If you do not see this, please let us know, preferably with a photograph ([email protected]). 

For those with no medical aid or funds to undergo testing, are all government hospitals equipped for Covid-19 testing or only specific ones? Will the government cover testing for all citizens at no cost?

There is a list of hospitals that have been assigned to deal with testing. You are encouraged to call the Department of Health hotline (0800 029 999) where you will be assigned the closest hospital. Anyone who goes to a state hospital will have their test for free. In an interview on Wednesday 18 March 2018, acting DG of Health Anban Pillay said the government believed that the private sector should zero-rate what they are charging for tests. This means they should make it non-profit by charging about R300 per test which is the cost of the kit and the testing. Current private testing is between R1,100 and R1,300. Shani Redi’s article relays what medical aids are willing to cover. 

Once exposed to the virus, how long does it take to become a vector for the virus, even if you are asymptomatic? If you have no symptoms, are you contagious? 

The WHO has said that the risk of catching Covid-19 from someone with no symptoms is very low; however, it is essential to understand that this is because the droplets from coughing are the main mechanism by which the virus travels. If someone infected coughs, touches their face or nose and then touches you or a surface, Covid-19 will spread. So yes, if you have no symptoms you are still contagious. 

What is the likely progression of the pandemic?

The true answer is that nobody knows. There are some estimates but no epidemiological models for Covid-19 have been published by reputable epidemiologists. 

On Tuesday 17 March, 2020, the MEC for Health in Gauteng, Dr Bandile Masuku, noted that the mortality rate, until this date, has been low and that the recovery rate is high. It is still difficult to predict. Countries like Hong Kong and Singapore have managed down the projected infection rates using different methods. After weeks of severe outbreak China was able to limit the phase and impact of the coronavirus through stringent quarantine and lockdown.  

Health Minister Zweli Mkhize has said South Africa’s aim is to flatten the curve of infection although he is expecting a spike in cases before it begins to come down. 

In an interview, the acting DG of the Health Department, Anban Pillay, said the outbreak is likely to extend into June or July, according to the government’s early modelling. This is because South Africa is following conventional practices of extended screening and testing and prevention rather than so-called “herd immunity” which is letting the infection peak to create immunity.

How do we treat the drying of our hands after washing them? Can the virus be transmitted via hand towels or air dryers? 

The WHO advises that hands should be dried with clean paper towels or with a warm air dryer. They point out that air dryers are not effective in killing Covid-19 alone – you must wash your hands thoroughly with soap and water or use an alcohol based sanitizer. 

What are the chances of the government giving financial help to small businesses that are negatively affected by the virus? Is this feasible in SA?

Finance Minister Tito Mboweni has said that South Africa will tap into disaster relief funds to assist the stimulus package that is currently being inked.   But, it is unlikely to be on a scale of Europe or the US as South Africa is currently running a massive deficit and debt to GDP levels are at historically high levels in the democratic era. You can read more here. 

If you are a SME business owner, please take a few minutes to fill out this survey. 

How are other countries with public health facilities on a par with SA’s planning to manage the pandemic?

Important to look at how Korea, Hong Kong and Singapore have managed their pandemics. In those countries, shutdowns and social distancing happened when infection rates were negligible. In addition, they followed the mantra of “test, test, test”. 

By taking these measures,  the expected crunch on the health system did not happen.  In Spain, the private testing networks as well as private hospitals have been nationalised to extend the facilities available.

This is likely to be the next challenge in South Africa where public high care and intensive care facilities are much lower than those in the private sector. Read Rebecca Davis’ analysis on South Africa’s response in comparison to international best practices. It is a moment which calls for solidarity. 

Will insurance cover the cost of cancelled flights and accommodation?

 It is still unclear as to whether insurance will cover cancelled flights but many airlines are now offering free of charge cancellations or flight changes. Business Insider has compiled a list of those airlines. 

What, if any, are the environmental benefits to the outbreak of Covid-19 (grounded flights, CO2 emissions)?  

Our Burning Planet journalist, Tiara Walters, has written this piece showing the impact that the new ban on the consumption of wild animals will have on the planet. Getaway magazine has reported that the canals in Venice are clear for the first time in years and that there has been a dramatic reduction in pollution in some areas. You can see the full article here. 

Is this primarily a health crisis or financial crisis? Which sector will it have the greatest impact on? 

It is both: an all-round humanitarian crisis. Editor of Business Maverick, Tim Cohen, has an analysis on the financial impacts of Covid-19 here. 

How do you detect Covid-19 in babies?  

The Covid-19 symptoms in babies are milder than adults. For more details on Covid-19 in children, please refer to this article by Spotlight. 

How does testing happen in a way that doesn’t cause transmission? If I am referred for a test by the doctor on the telephone, where do I go, and will the test venue not be a source of transmission of the virus to all who go there for testing? What will happen at doctors’ waiting rooms to segregate those with respiratory symptoms and thus possible Covid-19 infection from people coming to consult a doctor for other non-related issues? 

Isolation areas and strict infection control are crucial within doctor’s rooms and hospitals. For more information on testing, read Rebecca Davis’ article here. 

Why is there a stronger global response to this pandemic than there has been for SARS, Ebola and other more lethal diseases and viruses?  

The reasons are complex: this is a pandemic, which means that Covid-19 is impacting on the entire world. Ebola was mostly in poorer nations and did not impact on higher-income countries. SARS was mostly in Asia. Covid-19 has impacted the entire world and is being “imported” to countries via travellers. It is therefore crucial that there is a co-ordinated response by governments around the world, led by the WHO. As an example, if Europe and the US do not manage to contain the spread it will impact even further on a country such as South Africa as citizens with Covid-19, returning home, will continue to infect families and communities. The data shows that the best practice is the same and it explains why some Asian nations with experience of the SARS coronavirus developed systems that have kept infection rates relatively low. 

What may feel like a more intense global response and heightened global anxiety is potentially the impact of social media – word travels much faster and so it feels more intense. Also, the growth of China is a big factor. Now a behemoth, the impact of China in the world is clear, not only in the spread of the virus (its nodal point was in Wuhan and it moved out very quickly but US President Donald Trump’s statement that it is a “Chinese virus” is extremely ignorant) but also in the impact on the global economy.

Has anyone recovered from Covid-19 in SA? 

There’s the occasion for some hope. The first patient who tested positive is home and doing well. He is being swabbed and tested and may then be declared coronavirus-free. As of 19 March, none of the 116 people who tested positive have been admitted to ICU wards and only two of those are in hospital for observation. The rest are at home on quarantine. Those most at risk are the elderly, cancer patients, diabetics and people with respiratory illnesses.

Is the fear surrounding the virus warranted?

Yes, it is widely regarded as the most pressing medical emergency of the century. DM

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