South Africa had 85 positive cases as of 18 March, up from 62 cases the previous day and local transmission is a reality (8 cases). Most of the cases occurred in provinces in which MSF has ongoing operations – there are 45 cases in Gauteng Province (location of MSF Section Office; Tshwane migrant health project); 16 in KwaZulu-Natal (location of Eshowe HIV/TB project); and Western Cape (location of country coordination office; Khayelitsha HIV/TB project).
As such, MSF teams have linked with official crisis response role players at City, sub-district, provincial and national levels. Department of Health has officially accepted MSF support on the COVID-19 response as MSF is the main partner identified as an emergency care organization.
Specific supportive actions have been requested and some immediate support activities have commenced. Overall concerns on the forecasted impact in a country with the highest HIV/TB prevalence and overstretched public health facilities remains a challenge and we are advising the government how best to decant facilities.
In the Western Cape, where MSF is working with the Western Cape Department of Health and City of Cape Town Health, one MSF doctor, one MSF nurse, and two MSF counsellors are supporting the newest Provincial Coronavirus Hotline daily, helping to clarify myths, answer mobility questions, assessing symptoms, provide comfort, and more. The support roster is managed by the Southern Africa Medical Unit currently and its members/doctors are supporting.
Three MSF nurses have been oriented in contact tracing and prioritized to support community tracing activities. Authorities have specifically requested support in regard to Personal Protective Equipment (PPE), staffing, and the printing of Information, Education and Communication materials. These requests are being evaluated as bilateral meetings are planned for this week.
In KwaZulu-Natal Province, MSF met with provincial and sub-district authorities and it was determined that four MSF nurses will be deployed to the City of Durban to support contact tracing efforts there and that MSF will support contact tracing at a district level when the need arises - currently, one positive case has been reported for the District, and confirmation is pending. PPE though is a challenge and we are waiting to receive pending materials within this week so MSF nurses can support the government safely.
The Department of Health considers MSF a principal partner in the emergency response and has asked MSF to conduct clinician trainings at the District level, to assist with the establishment and staffing of Helpdesks in District facilities, and to assist with the establishment of a temporary isolation structure, as the District has only six isolation beds for confirmed cases, four isolation beds for suspected cases, and one ICU bed.
In Gauteng Province, two MSF nurses and two drivers from the Tshwane and Rustenburg teams have supported home-based contact tracing activities in the Johannesburg area. The Rustenburg team is in support of Tshwane for now, as there have been no confirmed cases in North West Province to date. Community health promotion activities have already started as of yesterday and HUB rules adapted regarding hygiene and IC measures.
Even with the repurposing of some staff due to the COVID19 response, the usual activities are running fairly well for now. Nevertheless, certain activities that are deemed not to be a priority are being stopped/delayed. For example, enrollment in the ARTIST/RADIANT trial is on hold until further notice and all other studies, including endTB, are being debated as well with decisions to come this week.
Find out more about MSF's response to COVID-19 response globally.