The Herald (South Africa)

NMU rises to challenge of fighting Covid-19

- LUNGILE PEPETA, AZWINNDINI MURONGA and BAREND VAN WYK * Prof Pepeta is dean of the faculty of health sciences at NMU, Prof Muronga is dean of the faculty of sciences, and Prof Van Wyk is dean of the faculty of EBET.

Our faculties and academics at Nelson Mandela University have combined forces with hospitals, businesses and communitie­s in the Nelson Mandela Bay metro to help fight Covid-19 at a time when society needs us most.

The biggest battle now is to break the chain of transmissi­on. Masks, hand-washing and sanitisers are the first and most critical line of defence.

A team of chemists from InnoVenton — the chemical technology research institute in NMU’s faculty of science — is daily producing hundreds of litres of 70% alcohol sanitisers in our laboratori­es for distributi­on to our communitie­s.

Our provincial hospitals are critically short of protective gear, and all gear from our laboratori­es not in use, including face masks, goggles, lab gowns and gloves, is being donated to these health-care workers.

A team from our faculty of humanities’ department­s of visual arts and media communicat­ion is engaging our metro’s garment industry and communitie­s in a strategy to produce face masks and protective clothing.

Our microbiolo­gists are on standby to advise the hospital in their capacity as experts in virology and how to respond to the spread of the pandemic.

When the lockdown was announced, local manufactur­ers engaged with our faculty of engineerin­g, the built environmen­t and technology (EBET) to share what resources are available and to find out how to assist with the provincial effort.

Doctors were consulted regarding the most pressing needs and doctors at Livingston­e Hospital expressed a dire need for face shields.

Two senior engineers at eNtsa, Riaan Opperman and Akshay Lakhani, co-opted doctoral graduate and 3D printing specialist Sean Poole to print face shields, hundreds of which have been supplied to the public and private sector.

Given the shortage of ventilator­s in the province, engineers at eNtsa are working with local manufactur­ers such as Hansens to investigat­e the production of ventilator­s. The eNtsa team is also evaluating innovative ideas involving scuba equipment and working with a consortium of companies and Walter Sisulu University on the reverse engineerin­g and manufactur­ing of the Nuffield 200 ventilator system.

Anaestheti­st Dr Lorenzo Boretti, at Livingston­e Hospital, requested an intubation box to protect staff and patients when performing endotrache­al intubation during sedation and operating procedures.

Students in the faculty of EBET’s advanced engineerin­g design group, together with local companies CustomWork­s and Shibah Engineerin­g, came up with an intubation box designed to reduce aerosolise­d droplets generated by patients during intubation, stopping the droplets from becoming airborne and putting staff at risk.

To assist with the capturing of patient data, tracing and tracking of Covid-19 positive patients and mortalitie­s, the faculty of EBET’s centre for community technologi­es (CCT) is partnering with the ICT industry, the Eastern Cape department of health and the Nelson Mandela Bay Emergency Response team to develop and customise smart digital solutions for case identifica­tion.

CCT director Professor Darelle van Greunen and her team have created several ICT solutions for Covid-19 management, including a unique cloud-based patient identifier that can trace patients through the system at all levels.

This also assists in tracing people who may have been in contact with infected patients and facilitate­s the capturing of co-morbiditie­s.

To boost Covid-19 testing, the Eastern Cape disaster management teams have identified high-risk areas and the National Health Laboratory Services has provided six large mobile testing units which have been deployed across the province with more than 3,000 PCR testing kits, and more being sent to them as they go. Results are available in 24 hours.

NMU has a large mobile clinic called Zanempilo (“bringing health”) which brings medical services to communitie­s without access to these in the Nelson Mandela Bay metro, staffed by our health sciences profession­als and students.

Zanempilo will serve as the seventh mobile testing unit.

The mobile units will significan­tly increase the testing throughout the province, including the deep rural areas.

By April 5, only 538 tests had been done in the province, predominan­tly in urban areas; 25 were positive, 338 were negative and 170 were pending.

We fear the low number of positives is not an accurate reflection, given the vast rural areas such as the former Transkei.

The PCR tests are comprehens­ive, not the rapid tests, which can give false results.

Many of us carry various strains of the coronaviru­s as other forms of influenza, such as swine flu, SARS and MERS, and because we have been exposed to them and other coronaviru­ses, we carry the coronaviru­s antigen, and the IgG and IgM antibodies.

The rapid test picks these up and can then give a positive result for Covid-19 when the person is negative.

If high numbers of people are incorrectl­y diagnosed as positive, this puts strain on medical facilities, and dilutes care for patients with Covid-19.

Furthermor­e, antibodies against Covid-19 take a while to develop. This leads to false negative rapid tests.

Planning ahead, we have been identifyin­g potential field hospital spaces together with local and provincial government, including sports grounds on our campuses.

Our new medical school facility on the Missionval­e Campus

could also be repurposed into a field hospital. Along with seven other medical schools at SA universiti­es, we will be participat­ing in the World Health Organisati­on’s global Solidarity Trial.

These are clinical trials on the antiviral combinatio­ns being used to treat people for Covid-19, including combinatio­ns of ARVs, the anti-malaria drug hydroxychl­oroquine and other antiviral drugs.

Covid-19 has also highlighte­d the need for SA to manufactur­e life-saving drugs.

None of the advanced pharmaceut­ical intermedia­tes (APIs) or drug substances for HIV, TB and malaria are made locally, which makes them incredibly expensive, and there are concerns there could be a decrease in supply.

Professor Paul Watts, holder of the SARChI chair in microfluid­ic bio/chemical processing at NMU, explains their research group has done a huge amount of research into new ways of manufactur­ing generic drugs in SA for Aids, TB, malaria, cancer and influenza. Watts says if the ARV/ hydroxychl­oroquine/ antiviral drug combinatio­ns prove to be an effective treatment for Covid-19, they could produce these with their new flow process technology.

It has taken his team 20 years of collaborat­ion with UK researcher­s to develop this technology for SA, and they would be able to manufactur­e the drugs 20%-30% cheaper than the imports.

The majority of SA’s APIs are imported and, over the past 10 years, Watts says SA has spent about R120bn buying in Aids, TB and malaria APIs from India and China.

The local manufactur­e of key generic drugs for major diseases and viral pandemics in SA and Africa could give more people access to the drugs.

Time is not on our side, and as a metro and province, we are going to need to considerab­ly gear up our collaborat­ive effort and emergency response.

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