W Cape no Wuhan
If other provinces trace, screen and test with the same rigour, we should see a different picture.
Only the gullible believe the neglectful Gauteng provincial health department, which killed 143 Esidimeni patients, is doing a better job than the Western Cape in combatting Covid-19. There are indeed more Covid-19 cases and deaths recorded in the Western Cape than any other province. But tracing, screening and testing are more efficient and focused.
Jibes about “Wuhan Cape” are misplaced. Competence in this climate should be prized, not mocked.
Gauteng carries out more tests but produces fewer positive results. For example, in the week ended 10 May, Gauteng carried out 20 603 tests, yielding 203 positives (1%), while the Western Cape tested 16 020, with 1 937 positives (12.1%).
That’s because testing in Gauteng is less focused. Test kits are expensive and in short supply. They must be used to maximum effect.
In Professor Salim Karim’s Covid-19 presentation last month, there were images of small fires being extinguished. This concept drives what Western Cape Premier Alan Winde calls rigorous screening and testing.
The method is, “based on our active case-finding approach, where we purposely follow the ‘bush fires’ – pockets of infections within communities – to ensure that every person who has been infected is identified quickly. It allows us to isolate patients, trace their contacts, and provide healthcare”.
Less rigour is applied in Gauteng. That’s why more tests yield less. Some provinces are even worse.
Another differentiator is the lack of clarity about whether people die “of” or “with” Covid-19.
Many deaths attributed to Covid-19 have other causes. In a recent analysis of 71 cases recorded as Covid deaths in the Western Cape, “only 6% had Covid only, 94% had another disease, 65% had two or more co-morbidities” (Helen Zille tweet, 12 May).
Until we know if and how all provinces are recording co-morbidities it is difficult to draw conclusions. However, if other provinces are not rigorously tracing and following up contacts, they won’t record as many Covid-19 deaths. Their samples won’t be as skewed towards Covid as those in the Western Cape. So, you’ll have people elsewhere dying of for example tuberculosis but not being tested for Covid-19, which won’t appear on a death certificate.
It has also been suggested that because the Cape is a popular tourist destination, the coronavirus arrived there before it was detected in Johannesburg. And the virus had already spread in the Western Cape before lockdown.
However, Johannesburg attracts more foreign tourists than does Cape Town. In 2019, Statistics SA recorded 488 375 foreign travellers passing through OR Tambo International Airport, more than double the 200 609 who used Cape Town International. And most of the skiers who brought the virus back to South Africa from Italy in March, were from Gauteng. Those people were traced, but were all their contacts followed with the same precision as seen the Western Cape?
If other provinces trace, screen and test with the same rigour, we should see a different picture. At this rate it’s more likely that thousands of cases will go undetected, and the province with the best-practice testing will remain stigmatised.