• An ‘immunity passport would indicate that the bearer is immune to Covid-!9
• There are, however, worries that the concept is unworkable and potentially dangerous to privacy and liberty
• Medical science can’t even say whether a person who has recovered from Covid-19 is indeed immune from the disease

A grieving widower played by Matt Damon flashes a shiny coded wristband for security guards to scan in the 2011 movie “Contagion”.

After a quick beep and a green light, Damon is allowed into a store to buy a prom dress for his daughter.

That wristband was an “immunity passport” – a certification of his character’s immunity to the movie’s deadly virus.

With fiction quickly becoming reality, immunity passports are now being touted as a means to reopen the world following Covid-19 lockdowns. But experts worry that a host of practical and ethical problems make the concept unworkable and potentially dangerous to privacy and liberty.

Private sector moving rapidly

Governments and private businesses are currently developing similar programmes that would allow people who have proven immunity against Covid-19 to move freely about, without hewing to physical distancing guidelines or public health measures.

For example, Chile is issuing three-month “medical release certificates” to people who have recovered from Covid-19, and Britain has announced plans to issue “antibody certificates” to those who test positive for coronavirus antibodies.

The private sector is moving even more rapidly toward adopting immunity passports, said Natalie Kofler, a lecturer with Harvard Medical School’s Center for Bioethics.

“You have these private companies developing these immunity passport apps,” Kofler said. “You have them partnering with other private businesses to help them use these immunity passports as ways to limit access either for customers or employees.”

But there are fundamental problems with these immunity passports, in terms of how they would work and how they would be used, Kofler and other experts say.

Do antibodies equal immunity?

At this point, medical science can’t even say whether a person who has recovered from Covid-19 is indeed immune from the disease, or if the presence of coronavirus antibodies in your bloodstream conveys any level of immunity, said Gigi Kwik Gronvall, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

For example, people might need a certain level of coronavirus antibodies in their blood to be immune, Gronvall said. Immunity might not even depend on antibodies at all. Instead, other factors like the immune system’s innate memory might be the only thing that would prevent reinfection.

Worse, the accuracy rate of current antibody tests is so iffy that a person without immunity might actually get a false positive, getting a passport they shouldn’t have and increasing their risk of catching and spreading the virus, Kofler said.

Guidelines issued last week by the US Centers for Disease Control and Prevention state that given their lack of accuracy, antibody test results “should not be used to make decisions about grouping persons residing in or being admitted to congregate settings, such as schools, dormitories, or correctional facilities”, or to “make decisions about returning persons to the workplace”.

“While I do think that there is a degree of immunity that individuals who have recovered from Covid possess, it will be very hard to operationalise an immunity passport,” agreed Dr Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

“There are many questions about immunity, including its duration, its durability, and how to measure it that makes it difficult to rely completely on. That said, I do believe those with antibodies – as assessed by a highly specific test – do have some protection for a period of time from reinfection,” Adalja said.

Hundreds of millions of tests

Even if antibody tests say something meaningful, there’s not nearly enough access to testing to conduct an immunity passport program in a fair manner, said Françoise Baylis, a professor of ethics at Dalhousie University in Nova Scotia, Canada.

Nations would need at least double as many test kits available as there are citizens in their country, to conduct an equitable programme, she said.

“In theory, you test everybody once, but not everybody is going to test as having been exposed to the virus and having recovered from Covid-19,” Baylis said. “So you’ve got to at least offer people a second chance, right? That gets you to two tests. People might fail this on the second attempt as well, so you’re going to have to be constantly able to test your population.”

There are 38 million people in Canada, but that country has said it would only be able to conduct one million antibody tests within the next two years, Baylis noted.

“What happens to the other 37 million Canadians?” she asked.

The United States would need even more tests – 660 million tests at minimum, to offer at least two opportunities for each of the country’s 330 million residents.

Only a small percentage infected

Additionally, too few people have been infected with Covid-19 at this point to make immunity passports a linchpin for reopening the economy in the United States or elsewhere.

Only 2% to 3% of the global population has recovered from the coronavirus, Kofler noted.

“A business isn’t going to want only 1% to 2% of their customers able to enter their store,” Kofler said. “You’re not going to be able to run a business if only 1% to 2% of your employees are able to work freely.”

Baylis noted that even in Covid-19 hotspots, only 15% to 30% of people have recovered from infection.

“You don’t reopen the economy with 30% of your population,” Baylis said.

Beyond those practical concerns, there also are ethical roadblocks to instituting an immunity passport programme, experts said.

Privacy is one problem

A physical passport worn by a recipient would “make it very easy to tell across the street if somebody has a wristband that signifies them as immune or not immune”, said Dakota Gruener, executive director of the ID2020 Alliance, a global public/private alliance focused on the development of digital ID programmes.

Gruener said many also are uncomfortable with the notion of centralised databases maintained by government organisations that would be “pinged” every time someone is asked to prove their Covid-19 immunity.

Gruener favours a decentralised system, where a person would carry their immunity passport around with them on their smartphone.

“Your data remains your own, stored locally on your own device,” Gruener said.

But what if you don’t have a smartphone because you can’t afford one? What if you can’t afford to be tested in the first place? Economic concerns like these would put people who earn less money at a disadvantage, Baylis said.

‘Stop and frisk’ policies

Experts also are concerned that authorities would use immunity passports as one more means of harassing blacks and other minorities, promoting “stop-and-frisk” policies.

“We see this as one more reason to stop somebody who’s freely walking about to be able to demand, ‘Do you have the right certification to be out in public?'” Baylis said.

These sort of concerns are being bulldozed by companies eager to get folks back to work, Gruener said, and officials and ethicists need to work with private firms to make sure these problems are addressed.

But Baylis countered that any efforts by private companies to develop immunity passports should be halted, rather than accommodated.

“It’s wrong to allow the private sector to answer that question for us and then to think that society, by its governance, just has to respond by putting parameters that would somehow satisfy certain kinds of ethical or social concerns,” Baylis said.

“The first question is whether we should be doing this,” Baylis said. “Only when you answer that question in the affirmative do you then move on to the second series of questions about how we do this ethically.”

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WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 30 967, after 1 727 new cases were reported.

According to the latest update, 643 deaths have been recorded in the country.

There have been 16 116 recoveries.

So far, 701 883 tests have been conducted, with 21 708 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

Taxis and buses will be allowed to operate throughout the day with no time restrictions, but with limited passengers from Monday.

Transport Minister Fikile Mbalula has announced minibus-taxis will remain at 70% loading capacity, while buses, e-hailing transport, metered taxis and shuttles as well as chauffer and charter services will stay at 50%.

He said public transport vehicles were only permitted to ferry people who were allowed to travel between provinces in terms of the regulations.

Mbalula added such travel was restricted to people undertaking work responsibilities or performing a service permitted under Level 3, provided they were in possession of the requisite permit.

READ MORE | Lockdown Level 3: Curfews to be lifted for public transport

Limited domestic air travel will be allowed under Level 3 of lockdown, phased in for business purposes, Transport Minister Fikile Mbalula said on Saturday.

While this could be good news for businesses that have to date been hamstrung by travel restrictions, it also raises questions of feasibility for airlines themselves, which are already facing crippling losses in the face of the coronavirus pandemic.

Speaking during a briefing on updated transport regulations, Mbalula said the number of flights allowed each day will be restricted and based on the reason for travel, as well as the availability of port health services.

In Phase 1, only so-called “golden triangle” airports will be phasing in business travel. OR Tambo International Airport and Lanseria Airport will be open in Gauteng, as well as King Shaka International Airport in KwaZulu-Natal and Cape Town international Airport in the Western Cape.

READ MORE | Level 3 gives airlines a lifeline – but it’s a short one

Game parks and private game farms may open their gates to visitors again from Monday, when Alert Level 3 kicks in, tourism minister Mmamoloko Kubayi-Ngubane announced on Saturday night.

Kubayi-Ngubane was describing upcoming regulations for her sector under Level 3, which had not yet been published 29 hours before they are due to come into effect.

“Public and private game farms have been opened for self-drive excursions,” she said, stressing that no group tours will be allowed, and visitors will have to use their own vehicles.

Visitors may not cross provincial boundaries to reach game parks for such drives. Under Level 3, provincial borders are technically closed to those who can not show a need to travel on essential business.

READ MORE | Game parks and hikes are legal again from Monday – but no overnight stays and only in-province

Experts have warned against using coronavirus “disinfection” tunnels that some people think will stop the spread of the virus.

Instead, they have suggested that strict personal hygiene, washing hands, wearing masks and keeping a 1.5m distance from others to prevent the spread of the virus.

“Human spraying is harmful with almost no benefit,” said Professor Salim Abdool Karim, who is the chairperson of the Ministerial Advisory Committee on Covid-19.

He said spraying hands properly with a sanitiser was the way to prevent the spread of the virus.

READ MORE | Coronavirus: Experts slam coronavirus ‘disinfection’ tunnels

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Saturday night, positive cases worldwide were more than 6 million, while deaths were more than 367 000.

The United States had the most cases in the world – more than 1.76 million, as well as the most deaths – more than 103 500.

READ MORE | All the confirmed cases worldwide

Latest news:

The European Union on Saturday called on the United States to “reconsider” the decision to sever ties with the World Health Organisation over its handling of the coronavirus pandemic.

President Donald Trump said on Friday he was severing US ties with the WHO, accusing it of failing to do enough to combat the initial spread of the virus.

The United States was the largest contributor to the WHO budget, providing at least $400 million in annual funding.

“The WHO needs to continue being able to lead the international response to pandemics, current and future,” Commission president Ursula von der Leyen and foreign affairs chief Josep Borrell said in a joint statement.

“For this, the participation and support of all is required and very much needed.”

READ MORE | EU urges US to think again on WHO split

LATEST RESEARCH

Ten percent of Covid-19 patients with diabetes die within a week of entering the hospital and 20% need a ventilator to breathe by that point, a new French study found.

Researchers analysed data on more than 1 300 Covid-19 patients with diabetes, average age 70, who were hospitalised in France during March. Of those, 89% had type 2 diabetes, 3% had type 1, and the rest had other types of diabetes.

The study found that one in five patients had been placed on a ventilator in intensive care within seven days of entering the hospital; one in 10 had died; and 18% had been discharged.

“The risk factors for severe Covid-19 [in patients with diabetes] are identical to those found in the general population: age and BMI [weight],” said researchers led by diabetes specialists Dr Bertrand Cariou and Dr Samy Hadjadj, from University Hospital Nantes.

READ MORE | 1 in 10 older patients with diabetes, hospitalised with Covid-19, dies – according to a new study

A new study finds that prescriptions rose sharply for two drugs that President Donald Trump claimed could help prevent or treat Covid-19.

This happened despite the fact that multiple studies found the medicines might only bring harm to patients with coronavirus illness.

The study, conducted by researchers at Harvard-affiliated Brigham and Women’s Hospital in Boston, found that prescriptions for the two drugs – hydroxychloroquine and chloroquine – rose by a staggering 2 000% during the week of 15 March to 21 March.

Early in the pandemic, Trump repeatedly touted hydroxychloroquine and chloroquine as a potential means of preventing or treating coronavirus illness.

READ MORE | Prescriptions for discredited Covid drugs surged 2 000% after Trump’s support

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

^{Image credit: Getty Images}

There’s good news for women: Getting a mammogram regularly can cut their odds of advanced and sometimes fatal breast cancers, a new study says.

European researchers tracked data from nearly 550 000 women in Sweden who were eligible for mammography screening.

The team compared rates of advanced and breast cancers that were fatal within 10 years after diagnosis for women who got mammograms and those who didn’t.

The result: Compared to the women who didn’t get mammograms, those who did had a 25% lower rate of advanced breast cancer and a 41% lower rate of breast cancers that went on to be deadly within 10 years.

Cuts the risk of dying

The study was published earlier in May in the journal Cancer.

“This study shows that participation in breast cancer screening substantially reduces the risk of having fatal breast cancer,” study co-author Stephen Duffy, of Queen Mary University of London, said in a journal news release.

Earlier studies had suggested a real health benefit to mammograms, but some experts thought that benefit may have been due to improvements in breast cancer care, not the advent of mammography. However, Duffy and his colleagues believe their study got around that potential confounder.

Because the study participants were tracked for both mammography screening and breast cancer treatment over the same period of time, the results are “not affected by potential changes in treatment of breast cancer over time”, Duffy noted.

So, the research suggests that mammography cuts the risk of dying from breast cancer above and beyond what can be achieved with current therapies, emphasised study co-author Dr Laszlo Tabar, of Falun Central Hospital in Sweden.

“Some may believe that recent improvements in breast cancer treatment make early detection less important,” he said in the news release, but “our study shows that nothing can replace finding breast cancer early.”

Guidelines relaxed

Two US breast cancer experts agreed that the message for women is clear.

“Screening catches cancers earlier and decreases the incidences of advanced cancers and deaths – get your mammogram,” said Dr Alice Police. She is regional director of breast surgery at the Northwell Health Cancer Institute in Sleepy Hollow, New Year.

Police noted that in recent years, some guidelines have been relaxed regarding the timing of mammograms. For example, in 2016, the influential US Preventive Services Task Force upped the age for first mammogram for women from a prior recommended age of 40 to 50 years of age, for women at average risk. Women in their 40s should talk to their doctor about their use of mammography screening, and the decision “should be an individual one”, the expert panel said.

But Police believes the new study “proves [again] that screening is important to reduce the rates of advanced and fatal breast cancers and should start at age 40”.

Dr Kristin Byrne is chief of breast imaging at Lenox Hill Hospital in New York City. She said “the conclusions of the study are very clear and reaffirms the significant importance of screening mammography in detecting a breast cancer when it is small and it has not spread to the lymph nodes or elsewhere.

“This is why it is so important for women 40 and over to have yearly screening mammograms as long as they are in good health,” Byrne stressed. “Women at high risk may need to start [even] younger and should discuss it with their doctors.”

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Two new studies offer hope for an effective coronavirus vaccine – and for the notion that prior infection also confers immunity.

Both studies were conducted in rhesus macaque monkeys, so testing in humans is required for more definitive proof. But in one study, monkeys developed immunity against the new SARS-CoV-2 coronavirus after receiving experimental vaccines.

“Our findings increase optimism that the development of Covid-19 vaccines will be possible,” said lead researcher Dr Dan Barouch. He directs the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.

As part of the new research, macaques were given experimental coronavirus vaccines that expressed six different forms of the SARS-CoV-2 spike protein, a structure on the virus’ surface that it uses to bind with and invade human cells.

High levels of antibodies

The vaccines provide DNA that enables host cells to make the spike protein so that they can then generate antibody responses to it. In this way, the immune system is trained to recognise coronavirus and quickly respond to it if it appears.

The vaccines were given to 25 adult macaques in initial vaccinations and also in follow-up boost immunisations. Another 10 monkeys got a sham vaccine.

All of the macaques were infected with the new coronavirus six weeks after vaccination, and those that had received the real vaccines produced levels of antibodies in their blood that were high enough to neutralise the virus within two weeks.

In fact, eight of the 25 vaccinated monkeys showed no detectable virus at any point following exposure to SARS-CoV-2, and the other vaccinated animals showed only low viral loads, the researchers reported in the 20 March issue of the journal Science.

In all cases, as the production of immune system antibodies rose, viral load declined. That suggests that there’s a direct correlation between the two – an important factor to consider as vaccine development goes forward, the researchers said.

In another important finding, a second study conducted by the same team found that monkeys who were infected with the new coronavirus developed immunity.

Protection against re-exposure

In that research, nine adult macaques were infected with the virus, but then cleared it from their bodies when they were re-exposed to it 35 days later. All nine also had few or no symptoms after re-exposure and had immune responses that appeared to protect them against a second infection.

Further research is needed to find out how long this natural immunity lasts, the study authors noted.

Still, “In these two studies, we demonstrate in rhesus macaques that prototype vaccines protected against SARS-CoV-2 infection and that SARS-CoV-2 infection protected against re-exposure,” Barouch said in a Beth Israel news release.

However, he stressed that research conducted in animals sometimes fails to pan out in people, so, “further research will be needed to address the important questions about the length of protection, as well as the optimal vaccine platforms for a SARS-CoV-2 vaccine for humans”.

^{Image credit: Getty Images}

WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 20 125.

According to the latest update, 397 deaths have been recorded in the country.

There have been 10 104 recoveries.

So far, more than 543 000 tests have been conducted, with just short of 17 600 new tests.

READ MORE | All the confirmed cases of coronavirus in SA

Latest news:

Cooperative Governance Minister Nkosazana Dlamini-Zuma has told the National Coronavirus Command Council (NCCC) that the sale of tobacco and alcohol should continue to be banned until the country reaches Level 1 of the lockdown.

News24 was reliably told that Dlamini-Zuma was supported by Home Affairs Minister Aaron Motsoaledi when she told the NCCC this week that she believed it would be too much of a health risk to allow the sale of cigarettes and alcohol on 1 June when the country is expected to go to Level 3 of the nationwide lockdown.

This prompted a debate in the meeting, chaired by President Cyril Ramaphosa, with no resolution on the matter.

A high-ranking insider with intimate knowledge of the meeting said Dlamini-Zuma had come prepared with academic papers that argued against the sale of tobacco and alcohol during the Covid-19 pandemic, citing health risks.

READ MORE | Lockdown: Dlamini-Zuma pushes for tobacco, alcohol ban to continue until Level 1

Internationally recognised epidemiologist and infectious diseases specialist Professor Salim Abdool Karim has weighed in on the debate about schools reopening in the midst of the Covid-19 pandemic.

He said the country should expect small outbreaks in schools – although they would be handled and dealt with accordingly.

Karim stated this during an interview with broadcast channel eNCA, where he said there was no good reason for children not to return to school if there were health protocols – such as hand sanitisation and social distancing – in place to curb the spread of the virus.

He added scientific evidence showed children seemed to be infected at a much lower rate than adults and were less susceptible to the virus.

READ MORE | Small Covid-19 outbreaks must be expected in schools, says Karim

Almost 230 000 people have been charged for contravening lockdown regulations since they were enforced on 26 March, Police Minister Bheki Cele has revealed.

Cele, who briefed the media on Friday, said the number of people charged for breaking the regulations had almost doubled as the country started moving into Level 4 of the lockdown.

“At one point towards the end of April when we were still on Level 5, we had about 107 000 cases opened with 118 000 people charged for contravention of the lockdown regulations. In just over a month, this number has more than doubled and is almost at 230 000 for contraventions,” he added.

Cele said the provinces with the highest number of arrests almost mirrored the provincial infection statistics, with the Western Cape recording the most arrests and highest number of confirmed cases of Covid-19, followed by the Eastern Cape, KwaZulu-Natal and Gauteng.

READ MORE | Almost 230 000 people charged for contravening lockdown regulations

The Western Cape is starting to see increased pressure on its hospital systems ahead of the coronavirus peak, but it has not yet reached peak capacity, the Premier’s office said on Friday.

It warned however that, while it was ready to meet current critical care needs, at the peak, “even in the best-case scenario, we will still fall short of ICU beds”.

“The public sector has an existing capacity of 2 162 acute beds, and an 1 428 additional care beds will be provided by temporary ‘field hospitals’ in the Western Cape, including the 850 additional beds at the Cape Town International Convention Centre, 330 beds at a temporary hospital facility in Brackengate, 68 at the Khayelitsha Thusong Centre, 150 at the Cape Winelands Sonstraal Hospital, and 30 additional beds at Tygerberg Hospital,” said Premier Alan Winde’s spokesperson Bianca Capazorio.

She said the 850-beds planned for the CTICC remained on schedule to be completed by the first week of June, and that work was “progressing well”.

The temporary hospital at the convention centre will cater for patients presenting with milder clinical signs, and who are in need of hospitalisation and treatment, including administration of oxygen, but not to those with severe clinical signs requiring intensive care treatment.

The CTICC agreed to waive the hiring costs of the venue, welcoming the opportunity “to be part of the solution”.

READ MORE | Winde confirms pressure on hospital system increased, despite not yet hitting peak capacity

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Early on Saturday morning, positive cases worldwide were 5.18 million, while deaths were more than 336 000.

The United States had the most cases in the world – closing in on 1.6 million, as well as the most deaths – almost 96 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Brazil has emerged as a coronavirus hotspot, and President Jair Bolsonaro seems to be taking a page out of US President’s Donald Trump’s playbook to tackle the growing number of cases.

Over the past several days the country’s daily spikes of cases have grown. On Tuesday, the country recorded 1 179 fatalities. On Wednesday, Brazil has the largest spike of cases in 24 hours with close to 20 000 cases, about a fifth of the overall record 106 000 new global cases the World Health Organisation recorded.

The country holds the third-highest number of cases behind the US and Russia, with over 310 000 infections and more than 20 000 deaths.

Vox reported that Bolsonaro mishandled the outbreak from the start by “continuously downplaying the seriousness of the virus, vocally opposed state governors’ decisions to impose lockdown measures, personally attended anti-lockdown protests, and pushed for businesses to reopen despite the growing outbreak.”

READ MORE | Brazil’s death toll is over 20 000 – and its president’s response mirrors Trump’s playbook

LATEST RESEARCH

Hydroxychloroquine, a drug used to treat lupus and rheumatological disorder, has received a massive amount of publicity this year. The reason? Its role in the Covid-19 pandemic.

The drug made headlines after being proposed as a preventative measure (prophylaxis) against Covid-19, as reported in the New York Times.

While hydroxychloroquine has generally fewer side-effects than its cousin chloroquine, which was also researched as a possible Covid-19 treatment, it was generally declared as ineffective against the novel coronavirus, based on several studies.

But, besides the fact that the hydroxychloroquine hype may cause those who really need the medicine for lupus not being able to find it, the drug can also have irreversible side effects, as discussed in the journal Nature.

READ MORE | Covid-19: Amid caution over use of hydroxychloroquine, experts warn of possible irreversible blindness

As schools in South Africa are set to reopen for Grades 7 and 12, there is a debate whether children are less at risk from Covid-19 than adults and those with underlying conditions.

While the general consensus has been that children are not as severely affected by Covid-19 as the elderly, more severe cases in children have been recorded throughout the world.

A new report from paediatric anaesthesiologists, infectious disease specialists and paediatricians at the Children’s Hospital at Montefiore and Albert Einstein College of Medicine describes some of the most significant clinical characteristics of children hospitalised with severe Covid-19.

This report was published in the Journal of Pediatrics and compared the cases of 46 Covid-19 patients aged between one month and 21 years. These patients were either admitted to the general unit or the Pediatric Critical Care Unit (PCCU) at Montefiore.

READ MORE | Why do some children get sicker from Covid-19 than others?

The Covid-19 crisis is sweeping across the planet, becoming “the greatest disruptor the world has seen in generations”, according to a statement by the International Union Against Tuberculosis and Lung Disease (Union). But as the infection rate continues to surge, it should not result in other serious diseases, such as tuberculosis (TB), being neglected, a Union panel discussion on TB and Covid-19 on Wednesday concluded.

As of 21 May, South Africa has 369 confirmed Covid-19 deaths. Projections indicate that this figure could rise to more than 40 000 by November this year. However, according to the latest statistics by the World Health Organization (WHO), TB caused around 63 000 deaths in South Africa in 2018 (figures for 2019 are not yet available).

Following the recent release of modelling on the impacts of the initial Covid-19 response on TB – commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University – key leaders in the Union panel discussed what the results of this modelling study mean, and how governments can all work together to prevent the potential 1.4 million TB deaths worldwide, caused by the Covid-19 pandemic.

A major factor indicated in the study was an estimation that, globally, a three-month lockdown and a protracted 10-month restoration could lead to an additional 6.3 million people falling ill with TB and an additional 1.4 million TB deaths over the next five years. As a result, the world would face a setback of around five to eight years in the fight against TB.

READ MORE | Fighting TB in the time of Covid-19: how 1.4 million deaths can be prevented

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

READ MORE: Coronavirus 101 

^{Image credit: Getty Images}