One On One

Q & A – NICD

The novel coronavirus has been declared a pandemic and South Africa has since declared it a national disaster. About 150 cases have been confirmed in the country and its rapid spread has become a cause for concern to many people. The Free State Weekly’s Martin Makoni asked Professor Cheryl Cohen from the National Institute for Communicable Diseases what it means for a disease to be declared a pandemic and what people can do about it. Makoni also asked Cohen how the coronavirus differed from others and what it might take to find a cure or vaccine. Excerpts:

The corona virus has been declared a pandemic, what does it mean and should people do about it?

A pandemic is declared once sustained community transmission or outbreaks occur in different regions of the world or continents. The declaration from the WHO that Covid-19 is a pandemic allows for governments and heads of state to activate preparedness plans and undertake emergency procedures to help contain the spread of the virus and protect the public. Members of the public should remain aware of any restrictions or protocols that the government has placed on the country and abide by such rules.

How different is the Covid-19 from other coronaviruses to make it so deadly?

Although SARS-CoV-2 stems from the same family as the SARS outbreak of 2003 and MERS outbreak of 2012, this virus differs in terms of its transmission and the seriousness of disease caused. One reason why COVID-19 is spreading rapidly now is because it is a new virus and so there is no immunity in the human population. Currently the mainstay of managing positive cases is symptomatic management.

Please explain in detail the process of contamination and what the corona virus does to the body to make a person sick?

The corona virus is transmitted mainly via respiratory droplets. This means when affected individuals cough or sneeze, these droplets get dispersed and unaffected individuals inhale these particles and become infected. The virus may also remain on surfaces that have been coughed or sneezed on or touched by an affected individuals contaminated hands, thereby contaminating the surface. Therefore, it is important to practice adequate hand hygiene, good cough and sneeze etiquette as well as good environmental disinfecting practices. COVID-19 affects the respiratory system of the body. Mild cases have cold and flu symptoms like fever and cough. In more severe cases the lungs may be affected which affects a person’s ability to breathe.

How true is it that an attack by the corona virus could potentially damage the male reproductive system permanently? Which organs are at risk generally?

As little is still known about the novel coronavirus one cannot postulate which organs may or may not be affected. There is however, no scientific evidence from any validated resources that make mention of Covid-19 and the male reproductive system. As Covid-19 is mainly a respiratory illness, the lungs are the main organ at risk. The main complication being a secondary lung infection or bacterial pneumonia. This is mostly important in the immunocompromised or elderly population.

There are fears that the coronavirus spread might intensify in SA when winter sets in, how true is this?

As with the influenza virus, it has been proven that the novel coronavirus does not survive well in warmer temperatures. There is however no information on whether the virus will spread more in winter months.

Under what conditions does the Covid-19 thrive and what should people do to ensure the virus does not spread?

SARS-CoV-2 has been described to remain on surfaces for varying times and preferably under cool to cold conditions. Precautions to avoid spread include adequate hand hygiene i.e. making use of at least 60 percent alcohol based disinfectant or washing your hands for at least 20 seconds with soap and water, making sure you cough or sneeze into your elbow or tissue and avoiding crowded areas or gatherings if you start displaying symptoms.

China has seen some marked drop in new cases in recent weeks, thanks to its effective shutdown in the epicentre and the surrounding areas, how practical is that approach in South Africa given that a large part of the population lives in informal settlements?

China has enforced a rather draconian method to contain the spread of the virus. This method is not achievable in many other countries around the world. This method of containment would not be practical for South Africa. We are a country with overcrowding in many places which makes social-distancing difficult. We are also limited in resources to which a country like China has, which hinders the development of appropriate infrastructure. Altogether, South Africans need to have each other’s health interest at heart and take the necessary precautions advised to limit the spread to the best we can.

How dangerous is the exchange of money in relation to the spread of the corona virus and what can people do about it?

It has been proven that the novel coronavirus has the ability to remain on a variety of surfaces, including money, for a period of time ranging from hours to days. This however, should not impact whether or not we interact with these surfaces (or money). Rather we should remain aware of the virus’s capabilities to survive and take necessary precautions when handling money or touching multiple surfaces. Don’t touch your face (eye, nose or mouth) or handle food after handling money. Wash or disinfect your hands regularly to limit potential spread.

What sort of hygiene would you recommend for people using public transport to minimise the spread?

Due to the high volumes of individuals using public transport, it is vitally important these individuals practice strict hygiene practices. These would include: carrying a compact or travel size bottle of alcohol disinfectant, coughing or sneezing into your elbow or tissue and not into the general environment, limiting hand shaking or contact where possible and even notifying other commuters of any incorrect practices. Windows should be kept open on public transport. Sick people should stay home and try to limit use of public transport. We need to be aware of each other’s actions which could affect others and speak out in our fight to contain the virus.

South Africa has many people living on the streets and sometimes under very cold and wet conditions, how much risk do they face and how can this be addressed?

Unfortunately, South Africa has many citizens who are struck by poverty or homelessness. This makes them especially vulnerable to contracting an illness and more so Covid-19 during this time of the pandemic. They may be unable to combat the infection well due to inadequate nutrition. They are also limited in their accessibility to health care as they are often unable to get transport to a healthcare facility. This is not an issue resolvable by the NICD. The question should be more accurately directed to the relevant South African department.

There is presently no cure or vaccine for the corona virus and reports say it could take up to two years to find one, what’s involved in finding a cure or vaccine?

The development process of a vaccine or cure is a lengthy one. A lot of research needs to be done, trials by pharmaceutical companies in animals and humans conducted and eventually approval by regulatory agencies before it is permitted for public use.