Covid-19: Western Cape to only test those at highest risk and most vulnerable

The Western Cape Government has taken the decision to only test those who are at the highest and most at risk of dying from Covid-19, within the public sector in the Cape Town Metropolitan area.

“This will allow us to get test results back from these vulnerable groups quickly so that we can ensure speedy interventions to save lives. This is our top priority,” Western Cape Premier Alan Winde said.

This decision follows confirmation that the backlog of tests from the Western Cape at the National Health Laboratory Service grew to 27 000, an increase of 9 000 since May 26 when the backlog for the region was reported to be 18 000. Winde stated that the government is aware that other provinces are experiencing similar backlogs.

This means that someone who is seriously ill in hospital, or a health worker, or someone who is at high risk of dying from Covid-19, may have to wait between 7 and 12 days for their results.

“We have previously petitioned both President Cyril Ramaphosa and Minister (Zweli) Mkhize to address this backlog, and I am appreciative of the efforts that they are taking to do so. I also understand the lack of test kits can be explained by global demand and subsequent limited supply to South Africa,” Winde said.

Winde points out that until such a stage when extra testing capacity is made available, this decision is the only remaining solution available to ensure early detection in those individuals who the government knows are at risk of dying from Covid-19. This will also ensure greater protection for healthcare workers, who need to care for those who are sick.

Premier Alan Winde, earlier today, thanked frontline workers for all they do during this time.

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“Indeed, if we can get a test back within 24 to 48 hours, we can ensure early treatment and if need be, hospitalisation, of those people who we know will deteriorate rapidly as the infection progresses. For some of our residents, it might be the difference between living and dying.

“I fully understand that every single person who starts developing symptoms wants to get tested so that they know if they Covid-19. This gives you a level of calm and certainty. I assure you that this decision was not taken lightly and entailed careful consideration of the very serious testing challenges we face in South Africa,” Winde said.

Winde further asked the public for patience and understanding as they act decisively to save the lives the most vulnerable.

The following frequently asked questions have been answered:

Who will be tested by the Western Cape Government?

• You are admitted to hospital with Covid-19 symptoms;

• You are over 55 and have Covid-19 symptoms;

• You are of any age, have Covid-19 symptoms, and have one or more of these conditions:

– Diabetes, hypertension or heart disease on treatment,

– Cancer on treatment,

– Tuberculosis on treatment,

– HIV with poor adherence to ARVs,

– Chronic lung disease on treatment (e.g. Asthma, Emphysema, Chronic Bronchitis);

• You are a healthcare worker and you have Covid-19 symptoms; or

• You live in a care or old age home and have Covid-19 symptoms.

What evidence is this based upon?

• Both local and international data shows 90% of people who are infected with Covid-19 will not require hospitalisation.

• The data indicates 10% of people who are infected will need healthcare treatment, with some of these patients requiring critical care.

• Approximately 2% of known/confirmed cases have died.

• Of those who die, 96% had one or more underlying health conditions.

• Residents over the age of 55 are at higher risk.

• The testing backlog in the Western Cape alone is 27 000. It could be as high as 100 000 for the country.

• Some residents are waiting between 7 and 12 days for their test results.

What do I do if I start feeling sick and I am not in one of the high-risk groups?

• If you start developing symptoms, and you are not in one of these high-risk groups, you will not be tested by the Western Cape Government. You should assume you have Covid-19 and isolate to prevent the virus from spreading to others. You should isolate for 14 days from the onset of symptoms.

• This means you must not leave your home, and you must limit contact with other people. This will stop the spread of the virus and protect vulnerable people from being infected.

• For information on homecare and self-isolation, you can look at the following detailed information here:

• You can also contact our dedicated hotline on 021 928 9102 for advice.

What do you do if you find it difficult to breathe?

• In about 10% of cases, healthcare will be needed. If you have any difficulty breathing, you must seek urgent healthcare immediately.

• Please seek medical assistance at your closest emergency facility or call an ambulance.

What happens if I live outside of the City of Cape Town?

The rest of the Province does not have such established and high rates of community transmission of Covid-19. The rural districts will continue to screen for Covid-19 cases in communities. All people screening positive for symptoms will be referred for testing (not limited only to vulnerable groups).

Does this testing strategy apply in the private sector?

No this applies to the public sector. Currently, the private sector does not adhere to the same criteria.

What is comorbidity?

Comorbidity is the presence of one or more additional diseases or medical conditions occurring with a primary medical condition.

People with existing co-morbidities are more at risk of being severely ill if they contract Covid-19.

The top three comorbidities per age group:

• 20 – 39 years (30% diabetes, 25% HIV, 20% Hypertension)

• 40 – 49 years (51% diabetes, 33% HIV, 28% Hypertension)

• 50 – 59 years (70% Diabetes, 63% Hypertension, 27% HIV)

• 60 – 69 years (74% Hypertension, 58% Diabetes, 8% HIV)

• 70 years and older (58% Hypertension, 46% Diabetes, 29% Chronic Kidney Disease)

High-risk comorbidities include:

• Diabetes

• Hypertension

• Heart disease

• Cancer

• HIV

• Tuberculosis

• Chronic lung disease

What steps has the Western Cape Government taken to increase testing capacity?

• We are using private labs via the National Health Laboratory Service when they have spare capacity. However, there is also a growing demand in the private sector given the increased number of cases in the country.

• We are pursuing an additional contractual relationship with private laboratories.

• We have also started exploring testing capacity at the University laboratories with the support of the Solidarity Fund.

• We are in regular communication with the National Government on the need for testing kits to be brought into the country.

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