The Western Cape is ready to roll-out booster programme as soon as EVDS enables it”

The Western Cape Government welcomes the South African Health Product Regulatory Authority’s (SAHPRA) approval of a third ‘booster’ vaccination for adults in South Africa, at least 6 months after the second dose.

We have been planning for this programme, and we can confirm today that we are ready to go as soon as the EVDS is updated accordingly, and the first cohort of people in this province reaches the 6-month period since their 2nd doses.

Getting this booster will be important for those residents who are at higher risk of severe illness, as we now rapidly approach our fourth wave.

As we have done throughout this pandemic, we will ensure that the public gets all the information they need on this programme. SAHPRA’s approval process is rigorous and strict and we have full confidence in its safety and efficacy.

As I am sure there are many people who urgently want to get this booster shot, I ask you to please wait for us to make the announcement that the programme has opened. This is because the EVDS – which is run nationally – must first enable us  to process the third doses for all those presenting at the sites. We thank you for your understanding and patience, and we will be pushing the National Government to act with speed so that this happens as soon as humanly possible.

“COVID-19 cases rising rapidly. Hospitalisations are not rising as quickly. It is however too soon to tell as to whether this trend will continue.”

The Western Cape is fast approaching its fourth wave, with new infections increasing at a rapid rate.

We will officially enter our fourth wave, when our 7-day-moving average of new daily infections reaches 30% of the previous peak. At the current trajectory, this is imminent.

At this stage, while there has been an increase in hospitalisations, it has not shown the same rapid rate in increase, as the new infections.

However, it is too soon to tell as to whether this trend will continue because the new infections are mostly amongst younger residents, who generally have milder disease.

What we do know is that top scientists are of the expert view that vaccinations will continue to provide protection against severe illness and death, and that is why our vaccination programme in the province has never been more important.

Our health platform data indicates the following:

• We are now seeing steep increases in the number of daily new cases with on average 665 new diagnoses per day. We will reach the fourth wave when this hits around 1100 cases per day, on a 7-day rolling average.
• The proportion of tests coming back positive has increased to an average of 20%.
• Admissions are showing signs of an early increase with 19 admissions per day. Deaths remain low with <2 deaths per day.

• Overall, there is a 587% week on week increase in cases in the Metro, and 326% week on week increase in Rural, albeit off lower bases.
• All sub-districts in the Metro are seeing increases in cases.
• All rural districts are also seeing increases in cases except in Central Karoo.
• There is a clear private sector predominance of those being infected.
• The reproduction number reached a high of 2.5. It is higher than what we saw early on in second and third waves.

In terms of projections for the week ahead, the South African COVID-19 Modelling Consortium expects this steep increase in COVID-19 cases to continue next week, with numbers rising to an average of 3156 a day in the Western Cape. This would be as high as the third wave peak. Their projections for this week were largely correct.

“Spread of Omicron globally demonstrates the irrationality of travel bans on Southern Africa”

Over 80% of PCR specimens in the last week in the Western Cape have the proxy marker of the Omicron COVID-19 variant. This indicates that the rapid increase in cases being experienced is linked to this new variant, as is the case in other provinces in South Africa.

Globally, as of 7 December 2021, there have been 1368 sequenced cases in 49 countries, with established community transmission in several countries. In some cases, there is no traceable link to travel to Southern Africa.

This again demonstrates the great irrationality of enforcing job-killing travel bans on our region. This variant is going to spread globally and is already doing so. This decision is therefore discriminatory and must come to an end.

I again appeal to those who have imposed bans on Southern Africa: follow the science. Listen to the WHO. Focus on tried and tested measures, such as PCR testing of all travelers 72hours before travel, which has worked globally throughout the pandemic.

It is not too late to claw back some of the job losses that these hugely damaging decisions have caused. But the global community must act quickly.

“The Western Cape has adopted a resurgence plan to ensure we are prepared for the fourth wave:

Throughout the pandemic, the Western Cape Government has adopted a data-led evidence-based approach to saving lives. We have been agile and innovative, and we have always learnt from our experiences, applying these lessons to our plans to deal with future waves.

This will continue as we now respond to the imminent fourth wave through our 6-point plan.

We aim to:

1. Change community behaviour to prevent infection, through sustainable and affordable interventions based on current evidence.
2. Ensure ongoing surveillance, particularly with hospitalisations. While we will be vigilant of the growth of cases, our primary focus will be on health service pressure so that we save lives.
3. Support and maintain our mass vaccination campaign, because it remains the most important intervention that we have to protect our health system.
4. Tritate our health platform to ensure we have the capacity needed to respond. This will be done through pre-determined triggers, that will enable us to bring field hospital and other capacity online when it is needed. 
5. Maintain comprehensive health service, with a particular focus on mitigating the impact that de-escalation may have on chronic disease care.
6. Safeguard the well-being of healthcare workers, through vaccination as well as healing and mental health programmes.

We will ensure that we are as responsive as possible so that we continue to provide care to every person who needs it, when they need it.

“The Western Cape health platform has adequate capacity, with COVID-19 and PUI cases only making up 6% of all patients”

Through our sophisticated Bed-Bureau Management System, the Western Cape is able to closely monitor bed usage across the province.  This enables us to use a trigger approach to bring capacity online as it is needed.

Our data shows us that:

• The Metro hospitals have an average bed occupancy rate of 89%; George drainage area hospitals at 63%; Paarl drainage area hospitals at 72% & Worcester drainage area hospitals at 77%.
• Critical care bed occupancy rate for designated COVID beds for the province is at 17%.
• COVID & PUI cases currently make up 6% of all available acute general hospital capacity in both Metro and Rural Regional Hospital drainage areas.
• The Brackengate Hospital of Hope currently has 9 patients  (2.7% bed occupancy rate), Sonstraal currently has 0 patients; Freesia & Ward 99 have 0 patients. Mitchell Plain Hospital of Hope has 0 patients.
• The Metro mass fatality centre has closed.
   

In terms of new hospitalisations, we are currently seeing an increase of admissions from 7 admissions per day (7 day moving average) at the lowest inter-wave period, to 19 admissions (7 day moving average) per day currently.

In terms of the profile of these admissions, they are largely part of a younger adult cohort. This may be because of the proportion of vaccinated people in this population is much lower when compared to older groups. Another reason could be because the virus is predominantly spreading amongst younger people at this early stage of the resurgence.

In terms of severity of those being admitted, it is still too early to comment. This is made particularly challenging at this early stage as the younger cohort historically have had milder disease.

Our epidemiologists are closely monitoring this data and we will provide an update to you at next week’s weekly briefing.

“The Western Cape’s field hospital network is on standby to be used at short notice”

Since the first wave, the Western Cape has invested in infrastructure to ensure we have the bed capacity needed to care for all those who need our help.

We can therefore announce the following triggered escalation approach:

• Brackengate intermediate care facility is now in the process of being fully commissioned.
• Once we reach 50 % capacity at Brackengate we will commission the Mitchells Plain Hospital of Hope (capacity of 200  beds). This will take place ward by ward, titrated against COVID admissions. Ward size ranges from 30-45 beds per ward.
• One ward at Mitchells Plain Hospital of Hope will be commissioned by 13 December 2021 for adolescents who fit the clinical criteria for admission.
• Sonstraal and Harry Comay intermediate care facilities will be commissioned as required depending upon the COVID load.
   

“Vaccinate. Save Lives.”

The COVID-19 vaccine is doing what it is meant to: preventing severe illness that may lead to death. In other words: vaccines are saving lives.

With the fourth wave imminent, and the growth of cases being experienced in almost every single community of our province, every single person should get vaccinated as soon as possible. The risk of not doing so now is just too great.

Our top priority as a province is to reach those at highest risk of severe illness: those residents who are over 50, or people who have comorbidities.

How are we doing? As of 7 December:

• In the 60+ age cohort, 66% are fully vaccinated, and 5% are partially vaccinated. This means that 71% of all people over 60 have had at least one dose of the vaccine.
• In the 50 to 59 age cohort, 57% are fully vaccinated, and 5% are partially vaccinated. This means that 62% of all people aged 50 to 59 have had at least one dose of the vaccine.
   

If we breakdown the data for all those people over 50 who are fully vaccinated, we can see that the Overberg district is doing the best, followed by the Garden Route. The Central Karoo is lagging all other districts by some margin.

The breakdown is as follows:

• Overberg: 75.3%
• Garden Route: 66.5%
• Cape Winelands: 59.4%
• West Coast: 59.1%
• City of Cape Town: 58.5%
• Central Karoo: 44.3%

Using the data available to us, we are adopting a targeted approach to increase vaccinations amongst the 50+ in areas where there is a low take up.  This is being done through pop-up vaccination sites, social mobilization with key partners in communities, and through innovations such as the Vaxi Taxi.

We want to ensure that getting vaccinated is as easy and convenient as possible and we will continue to find new ways to innovate to ensure this objective.

“52 647 healthcare workers in the Western Cape have so far received their booster vaccination as part of Sisonke”

Healthcare workers are an essential part of our COVID-19 response and ensuring that they have the protection they need to save lives is important to us.

The Sisonke 2 programme is currently rolling out Phase 3b of its programme, to healthcare workers who consent to get the booster dose.

The implementation of this programme commenced on 10 November, and so far, 52 647 healthcare workers in the Western Cape have received an additional J&J dose.

“The 4 things we need you to do to stay safe, save lives, and to save jobs this December”

As we approach our fourth wave, we all need to be on heightened alert to ensure that we keep ourselves and our families safe.

There are 4 key things we need you to remember, so that we do so, and so that we save lives and jobs in the Western Cape.

They are:

• Vaccinate.
• Wear a mask.
• Ensure good ventilation with lots of fresh air.
• If you gather, keep it short, small and outside

If we all follow these basic steps, and follow the golden rules of good hygiene, including staying home when sick, we can slow the spread and protect our loved ones and our economy.

We all have a role to play, and now is the time to play it.