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Health24.com | Coronavirus in SA: All the confirmed cases

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18 March: 116 confirmed cases (31 new cases)

* The total includes 14 local transmissions: eight in Gauteng, three in KwaZulu-Natal, and two in the Western Cape, one in Mpumalanga

This is a developing story, Health24 will update as we receive information via official channels.

LIVE: All the latest coronavirus news in SA and the world

KWAZULU-NATAL (19 – 3 local transmissions)

  • A 59-year-old male who travelled to Austria and Italy.
  • A 54-year-old male who travelled to Italy.
  • A 55-year-old male who travelled to Italy.
  • A 59-year-old female with no international travel history.
  • A 5-year-old male with no international travel history.
  • A 3-year-old male with no international travel history.
  • A 48-year-old male who travelled to Dubai.
  • A 34-year-old male who had travelled to the UK.
  • A 47-year-old male who had travelled to Switzerland.
  • A 79-year-old male reported having travelled to Greece and Italy.
  • A 52-year-old male travelled to Switzerland.
  • A 38-year-old male from Durban who lives in Turkey, was visiting family in South Africa. He had travelled to the UK and returned to SA on 7 March.
  • A 40-year-old male who travelled to Portugal. He returned on 7 March.
  • A 45-year-old male who had recently travelled to Italy.
  • A 38-year old male who also had recently travelled to Italy.
  • A couple who had also travelled to Italy.
  • The wife of the first diagnosed patient, she had also travelled to Italy.
  • A 38-year-old male who travelled to Italy and returned 1 March. He was the country’s first confirmed positive case.

GAUTENG (61 – 8 local transmissions)

18 March:

  • A 20-year-old male with no international travel history.
  • A 3-year-old male with no international travel history.
  • A 21-year-old female with no international travel history.
  • A 71-year-old female with no international travel history.
  • A 25-year-old male who travelled to the UK.
  • A 45-year-old male who travelled to Austria.
  • A 52-year-old male who travelled to Austria and Italy.
  • A 49-year-old female who travelled to Austria and Italy.
  • A 35-year-old male who travelled to the UK and Netherlands.
  • A 34-year-old female who travelled to the UK.
  • A 30-year-old female who travelled to Switzerland and Austria.
  • A 36-year-old female who travelled to Switzerland and Austria.
  • A 30-year-old female who travelled to Italy.
  • A 35-year-old male who travelled to Italy.
  • A 34-year-old male who travelled to Italy.
  • A 37-year-old male who travelled to Finland and France.
  • A 21-year-old female with no travel history.
  • A 34-year-old male with no international travel history.
  • A 26-year-old female with no international travel history.
  • A 32-year-old female with no international travel history.
  • A 45-year-old male who had travelled to Belgium, UK, France and the US.
  • A 37-year-old male who had travelled to the UK.
  • A 54-year-old female who had travelled to the USA.
  • A 52-year-old male who had travelled to the UK.
  • A 25-year-old male who travelled to the UK.
  • A 52-year-old female who had travelled to Italy.
  • A 59-year-old male who travelled to the UK and Dubai.
  • A 57-year-old male who travelled to the USA.
  • A 60-year-old male who travelled to the USA.
  • A 37-year-old female who travelled to Italy and Dubai.
  • A 33-year-old who had travelled to Spain.
  • A 60-year-old female who had travelled to Austria.
  • A 30-year-old male who had travelled to India.
  • A 39-year-old who had travelled to the United States.
  • A 43-year-old female who had travelled the United States.
  • A 50-year-old male who had travelled to France and the UK.
  • A 37-year-old male who had travelled to United States, Dubai and Mexico.
  • A 60-year-old male who had travelled to Iran.
  • A 36-year-old male who had travelled to the UK.
  • A 54-year-old male who had travelled to Switzerland.
  • A 27-year-old male who had travelled to the UK.
  • A 21-year-old female who had travelled to Germany.
  • A 53-year-old female who had travelled to Germany.
  • A 29-year-old male who had travelled to Switzerland.
  • A 76-year-old male who had travelled to the UK and the US.
  • A 72-year-old female who had travelled to the UK and the US.
  • A 47-year-old male who had travelled to the UK and the US.
  • A 52-year-old male who had travelled to Germany.
  • A 38-year-old male who had travelled to the Netherlands and Germany.
  • A 62-year-old male who had travelled to the Netherlands.
  • A 19-year-old female who had travelled to France and Italy.
  • A 39-year-old female who travelled to Switzerland and Austria.
  • A 50-year-old male who travelled to Austria.
  • A 21-year-old female who travelled to Italy.
  • A 57-year-old male who travelled to Switzerland.
  • A 43-year-old male who had travelled to New York via Dubai and returned to SA on 8 March.
  • A 33-year-old female who travelled to Italy and returned on 1 March.
  • A 34-year-old male who travelled to Germany and returned on 9 March.
  • A 33-year-old female who travelled to Germany and returned on 9 March.
  • A 57-year-old male who travelled to Austria and Italy. He returned to South Africa on 9 March.
  • A 39-year-old woman who travelled to Italy – she was part of the same travel group as the first diagnosed patient.

WESTERN CAPE (31 – 2 local transmission)

  • A 68-year-old male with no international travel history.
  • A 2-year-old male who travelled to New Zealand.
  • A 51-year-old male who travelled to Egypt and Dubai.
  • A 35-year-old female who travelled to Switzerland and Dubai.
  • A 27-year-old female who travelled to Switzerland and Dubai.
  • A 60-year-old male who travelled to Portugal and the UK.
  • A 51-year-old male who travelled to the UK.
  • A 54-year-old female who travelled to Portugal and the UK.
  • A 51-year-old male who travelled to the UK.
  • A 26-year-old female who travelled to the UK.
  • A 2-year-old male with no international travel.
  • A 3-year-old male who travelled to the UK.
  • A 58-year-old male who travelled to the UK and Austria.
  • A 62-year-old female who travelled to the UK and Ethiopia.
  • A 71-year-old female who travelled to the UK.
  • A 39-year-old male who had travelled to Canada.
  • A 15-year-old male who had travelled to France.
  • A 35-year-old female who had travelled to Germany and Austria.
  • A 42-year-old female who had travelled to Spain, Switzerland and the UK.
  • A 50-year-old male who had travelled to the Netherlands.
  • A 33-year-old male who had travelled to Switzerland.
  • A 35-year-old male who had travelled to Austria.
  • A 27-year-old male who had travelled to Brazil.
  • A 33-year-old female who had travelled to France.
  • A 49-year-old male who had travelled to France and Italy.
  • A 14-year-old female who had travelled to the US and Dubai.
  • A 73-year-old male who had travelled to the UK.
  • A 32-year-old male who had travelled to the UK.
  • A 46-year-old male who travelled to Italy.
  • A 50-year-old male who travelled to Switzerland and Austria.
  • A 36-year-old male who travelled to multiple countries, including Germany, Austria, Switzerland and Turkey. He returned to South Africa on 9 March.

MPUMALANGA (4 – 1 local transmission):

  • A 56-year-old female with no international travel history.
  • A 64-year-old male who travelled to Italy.
  • A 55-year-old-male who had travelled to France.
  • A 27-year-old female who had travelled to the United States and returned on 7 March.

LIMPOPO (1):

  • A 29-year-old male who had travelled to France and the Netherlands.

READ MORE: Coronavirus 101

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Health24.com | Coronavirus: Basic protective measures

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As recommended by the World Health Organization:

Wash your hands regularly and thoroughly

  • Wash your hands frequently and thoroughly with soap and water or an alcohol-based hand rub.
  • Why do this? Soap and water or an alcohol-based rub kills viruses that may be on your hands.

Practise and maintain social distancing

  • Keep at least one metre of distance between yourself and a person who is coughing or sneezing.
  • Why do this? The virus spreads when liquid droplets are expelled through the air – when someone coughs or sneezes. In the event that you are too close, you could breathe in the droplets, which may contain the Covid-19 virus, if the person coughing or sneezing is infected.

Avoid touching your eyes, nose and mouth

  • Why do this? Your hands touch many surfaces and can potentially pick up the virus. Once your hands are contaminated, the virus can be transferred through your eyes, nose or mouth where it enters your body.

Practice respiratory hygiene

  • Don’t cough or sneeze into your hands. Cover your mouth and nose with your bent elbow or a tissue when you cough or sneeze. Don’t forget to throw away the tissue immediately.
  • Why do this? Droplets expelled when sneezing or coughing spread viruses.

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Health24.com | Coronavirus: What are the criteria for a suspected case?

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Criteria for a person under investigation (PUI), according to the National Institute for Communicable diseases:

  • A person with acute respiratory illness with the sudden onset of at least one of the following symptoms: cough, sore throat, shortness of breath or fever [≥ 38°C (measured) or history of fever (subjective)] irrespective of admission status 

AND

If the PUI, in the 14 days prior to experiencing symptoms, met at least one of the following epidemiological criteria:

  • Was in close CONTACT with a CONFIRMED or PROBABLE case of coronavirus infection;

OR

  • If the person has  a history of travel to areas with local transmission of the virus;

OR

  • Worked in, or attended a health care facility where patients with coronavirus infections were being treated

OR

  • Admitted with severe pneumonia of unknown cause

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Health24.com | Coronavirus in SA: President says first local transmission is concerning

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President Cyril Ramaphosa on Sunday said he was worried about the first confirmed local transmission of coronavirus in the country.

In his address to the nation, the president also confirmed that total number of confirmed cases in the country were now at 61.

“Initially, it was people who had travelled out of the country, especially from Italy, who had positively tested for the virus.

“It is concerning that we are now dealing with internal transmission of the virus”, he said.

President Ramaphosa also said that on the back of the number of cases rising to 61, the expectation is that the total is expected to rise in the coming days and weeks.

No country is immune

Addressing the nation, he referred to the situation as “a matter of great national importance”.

“The world is facing a medical emergency far graver than what we have experienced in over a century,” he said, as he started his speech.

“Given the scale and the speed at which the virus is spreading, it is now clear that no country is immune from the disease or will be spared its severe impact.

“Never before in the history of our democracy has our country been confronted with such a severe situation,” he added.

Wits case awaiting NICD confirmation

In his address, the president also mentioned a Wits University student who had tested positive for the virus.

Earlier on Sunday, News24 reported the Department of Health as saying that the National Institute for Communicable Diseases (NICD) was conducting a “confirmatory test” on the specimen of a Wits University student who had tested positive for the Covid-19 virus.

On Sunday, the tertiary institution said the medical student had tested positive for the virus, despite not showing any symptoms of the virus.

The university’s senior executive made the announcement in an email circulated to staff and students on Sunday. 

The student had been in self-isolation since Wednesday – a precaution taken by the university while they waited on his test results.

The student was tested last week, and results came back positive on Sunday afternoon.

The department said the test had been conducted by a private laboratory.

Classes cancelled

“As previously announced by the Minister of Health, on receiving positive results from a private laboratory, the NICD will conduct a retest in order to confirm and validate the results before they are released,” the statement read.

The department added that it would make a formal announcement once the NICD’s results were available.

The Wits senior executive team said the student was “asymptomatic and attended classes last Monday and Tuesday, without knowledge that the student had contracted the virus”.

The university’s statement added that the institution had since taken an immediate decision to cancel all contact classes for the Graduate Medical Programme 1 (MMBBCh 3 classes). The programme will continue online.

The university has also instructed students in the programme to immediately go into self-isolation for 14 days.

“The Faculty is personally reaching out to each of the 350 students who could be affected. They will receive the full support of the Faculty, including the requisite monitoring and testing,” the executive team said.

Dean of Students Jerome September would be making arrangements for students in residences who required self-isolation.

READ | Coronavirus in SA: President confirms first local transmission in the country

READ | Coronavirus in SA: All the confirmed cases

READ | Kids still get the coronavirus – even if symptoms are mostly mild

READ | Coronavirus 101: Here’s what you need to know

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Compiled by Bevan Lakay

Health24.com | Even a little activity keeps ageing brains from shrinking

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Take a walk, weed your garden, go for a swim or dance – it could keep your brain from shrinking as you age, a new study suggests.

Being physically active may keep your brain four years younger than the rest of you, which might help prevent or slow the progression of dementias like Alzheimer’s disease, researchers say.

“We recently published a paper using information of both current and past physical activity and found they both are associated with lower risk of developing Alzheimer’s disease,” said lead researcher Dr Yian Gu, an assistant professor of neurological sciences at Columbia University in New York City. “The current study is a step further to show that physical activity is also protective against brain volume loss.”

Gu cautioned, however, that the new study doesn’t prove that exercise preserves brain size, only that the two appear to be linked.

Varying levels of physical exercise

For the study, Gu and her colleagues used MRI scans to collect data on the brain size of more than 1 550 people, average age 75.

None had dementia, but nearly 300 had mildly impaired thinking and 28% had the APOE gene, which appears to increase the risk of Alzheimer’s disease.

Participants reported varying levels of physical activity. Researchers found that those who were the most active had bigger brains than those who were inactive.

The most active logged either seven hours of low-intensity physical activity, four hours of moderate activity or two hours of high-intensity physical activity a week.

After taking into account age, sex, education, race/ethnicity and APOE gene status, the researchers found that the average brain size of the most active was 883 cubic centimetres, compared to 871 for those who were inactive.

That difference of 12 cubic centimetres, or 1.4%, is equivalent to nearly four years of brain ageing, Gu and her colleagues said.

Physical activity benefits brain

A limitation of the study is that it relied on participants’ ability to remember how much and how often they were active. Researchers said their reports could be inaccurate, skewing the results.

Nevertheless, another expert stressed that keeping active could only add benefits for seniors.

“It’s plausible, and not unique to this study, that physical exercise is good for your brain,” said Dr Marc Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, New York, who reviewed the findings.

Although it’s not clear how physical activity benefits the brain, Gordon suspects that it might come from keeping blood vessels healthy and lowering blood pressure and diabetes risk. “There are a lot of factors that could play a role,” he said.

“I encourage my patients to be physically active,” Gordon added. “Keep socially active and keep mentally active.”

The findings are scheduled to be presented at a meeting of the American Academy of Neurology, in Toronto. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

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Health24.com | Taking more antibiotics may up odds for hospitalisation

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If your doctors keep giving you prescriptions for antibiotics, you might be at increased risk of hospitalisation for a serious infection, a new report suggests.

For the study, researchers analysed data from two million patients in England and Wales. These patients had received prescriptions for antibiotics between 2000 and 2016 to treat common infections such as upper respiratory tract, urinary tract, ear and chest infections.

Those who had nine or more antibiotic prescriptions for common infections in the previous three years were more than twice as likely to be hospitalised with another infection within three or more months, the findings showed.

The risk was 1.77 times higher among those who had five to eight prescriptions, 1.33 times higher among those who had three to four prescriptions and 1.23 times higher among those who had two prescriptions, the University of Manchester researchers found.

Good bacteria in the gut

Doctors may “prescribe numerous courses of antibiotics over several years, which according to our study increases the risk of a more serious infection. That in turn, we show, is linked to hospital admissions,” study author Tjeerd van Staa said in a university news release.

“We don’t know why this is, but overuse of antibiotics might kill the good bacteria in the gut (microbiota) and make us more susceptible to infections, for example,” he said.

It’s clear doctors lack the tools to prescribe antibiotics effectively for common infections, especially when patients already have previously used antibiotics, van Staa said.

“Prescribing antibiotics for a common infection – even though it’s not certain whether it’s viral, where antibiotics are not indicated, or bacterial, where they are – might be easier when there is little time,” he suggested.

Also, in large practices, doctors may be less likely to know their patients and less tuned in to their history and circumstances to make informed decisions, van Staa said.

The study doesn’t show a direct cause-and-effect relationship between prescription practices and hospitalisations. And more research is needed to understand the association, the researchers noted.

The study was published online in the journal BMC Medicine.

READ | 1 in 4 gets unnecessary antibiotics at children’s hospitals

READ | Where ‘superbugs’ lurk in your home – and how to stop them

READ | Superbugs: Here’s why you should opt for organic chicken

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Health24.com | Researchers identify potential coronavirus vaccine target

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The number of coronavirus cases worldwide has surpassed 120 000 and stringent measures are being taken in countries such as Italy to try and contain infections.

Researchers are actively looking for ways to prevent new infections by targeting the new virus, which is officially named SARS-Cov-2, but referred to as the Covid-19 virus to prevent unnecessary confusion and panic.

This new strain of coronavirus, first identified in December 2019, is similar to the coronavirus strains that caused the SARS and MERS outbreaks a number of years ago. 

Two new studies were recently published in the journal Cell, explaining why the Covid-19 virus is spreading so easily and how it adheres to cells.

According to the research, the Covid-19 virus uses the same way to enter cells as SARS-Cov did in 2003, leading scientists to look at ways to disrupt the process – with the help of enzyme inhibitors and antibodies.

How exactly does a coronavirus infect your cells?

We are told that you get infected with the new coronavirus into your system and can become potentially sick with Covid-19 by inhaling droplets coughed out by sick people, but exactly how you can get sick is a bit more complicated.

The new virus can be defined as an enveloped RNA virus. This means that an envelope plays a strong role in helping the virus survive when it attaches to its host, and that this envelope was encoded by the last cell it infected.

When these viruses infect a cell, it happens in two stages:

  • Firstly, the new coronavirus connects with a receptor on its target cell.
  • Secondly, the virus “sheds” its envelope to fuse with the cell it attaches to. This makes the virus strong and helps it to survive.

By understanding how exactly the cells react, researchers are more easily able to come up with a way to halt the process.

“Unravelling which cellular factors are used by SARS-CoV-2 (the Covid-19 virus) for entry might provide insights into viral transmission and reveal therapeutic targets,” according to the authors of one of the new papers in Cell.

How a vaccine is developed

The researchers also studied whether there are any human antibodies that could help prevent the entry of the new coronavirus into cells.

According to a news report, they found that antibodies against the virus that caused the SARS outbreak in 2003 could potentially reduce the infection of this new virus. This was only achieved in a laboratory environment, but holds great promise.

“Although confirmation with infectious virus is pending, our results indicate that neutralising antibody responses raised against SARS-Cov (the 2003 SARS virus) could offer some protection against the latest SARS-CoV-2 (the Covid-19 virus) infection, which may have implications for outbreak control,” the team revealed in the paper.

And this is not the only research to use potential antibodies in a vaccine. Another team from the University of Washington in Seattle provided more evidence that the virus enters target cells via an enzyme could ACE2, according to another paper published in Cell.

The roll of this ACE2 enzyme was discussed in a previous Health24 article on why the new virus spreads so easily. 

Light at the end of the tunnel

It’s important to reiterate that while research looks promising, more testing and clinical trials are still required. 

READ | Why exactly does the coronavirus spread so easily among people?

READ | What is the difference between Covid-19 and coronavirus?

READ | Yes, washing our hands really can help curb the spread of coronavirus

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Compiled by Marelize Wilke

Health24.com | Trying to get over a breakup? Social media will only make it worse – even if you block or unfollow your ex

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Getting over a breakup doesn’t happen overnight, but staying connected to social media is not going to bring you closer to the peace and healing you’re seeking. That’s according to new research from the University of Colorado Boulder that explored how breaking up is tougher to do in the online age.

“Before social media, breakups still sucked, but it was much easier to get distance from the person,” said Anthony Pinter, a doctoral student in the information science department and lead author of the study.

“It can make it almost impossible to move on if you are constantly being bombarded with reminders in different places online.”

Think about it. You forgot to unfriend your ex, and wake up to them posting they’re “in a new relationship”. Or, perhaps you see his sister under the platform’s “People You May Know” whimsical feature. It could feel like there’s no escaping. 

And when Facebook launches a timeline memory of the two of you enjoying a date night (that you’ll now always remember)? That timeline exploding into little highlights of happy moments in your relationship certainly won’t help you to let go of the past.

No escape

Participants who had experienced an upsetting encounter online involving a breakup within the past 18 months were recruited and interviewed for over an hour.

Among 19 participants who underwent in-depth interviews, it was found that even when they took every step to remove their exes from their online lives, social media reminded them – several times a day – putting them in an emotional tailspin. Not fun, especially once you’ve started to come to terms with the fact that the relationship is over and started to heal from the pain of the breakup.

And in even more dispiriting news: “A lot of people make the assumption that they can just unfriend their ex or unfollow them and they are not going to have to deal with this anymore,” said Pinter. In fact, their research shows quite the opposite. 

News Feed is ‘the devil’

If you’re on Facebook then you will be familiar with News Feed, the primary interface that opens when one launches Facebook. This interface, respondents said, is a major source of distress, as it delivers news of ex-lovers, like announcing that they’re in a new relationship.

In the case of one participant, his social media profile worked against him during his breakup when he noticed his roommate had already “liked” his ex’s post announcing their new relationship, saying that he was the last to know about it.

Seeing their exes leaving comments in shared spaces, such as groups or mutual friends’ pictures, was also a common complaint by participants.

“In real life, you get to decide who gets the cat and who gets the couch, but online it’s a lot harder to determine who gets this picture or who gets this group,” said Pinter.

But, wait, what about Facebook’s 2015 ‘Take A Break’ feature that promised to stop reminding you about your unwelcome memories? 

Well, that feature only works if Facebook knew you were in a relationship. When you switch to “single”, you’re then asked if you want activities that are linked to your ex to be hidden. But if you don’t use the Relationship Status tool, those reminders will keep coming.

“Am I never going to be free of all this crap online?” asked one exasperated participant.

All this distress seems justified to the research team conducting the study, aimed at identifying and offering solutions for “algorithmic insensitivity”.

Simply put, the authors would like such unpleasant encounters be minimised, and platform designers pay more attention to the “social periphery” – all those people, groups, photos and events that spring up around a connection between two users.

Their research stems from a larger National Science Foundation grant award called Humanizing Algorithms.

“The algorithms are really good at seeing patterns in clicks, likes and when things are posted, but there is a whole lot of nuance in how we interact with people socially that they haven’t been designed to pick up,” said Assistant Professor Jed Brubaker at UCB and researcher of the study, Jed Brubaker.

Healing rationally

Life can be unimaginable without social media, but if you truly want to rid your online life from reminders of a break up, the researchers recommend unfriending or blocking, and untagging your ex in all photos and videos. The Take a Break feature might work, but remember that it may not be foolproof.

Your best bet? “Take a break from social media for a while until you are in a better place,” said Pinter.

If you aren’t feeling like you’re floating in inner peace, then for the process of acceptance, forgiveness and moving on to happen, we agree with Pinter – getting off social media entirely will help you to cleanse your life of any negative energy. This doesn’t mean you have to hole up in your home.

Instead, spend quality time with your loved ones, do some travelling if you have the means, and take charge of your life. Getting over the breakup isn’t going to happen overnight, but focusing on yourself and the things that bring you happiness is an effective way to get you through the situation.

Image: Erik Lucatero, Unsplash

Health24.com | Why nurses may need suicide-prevention screening

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Nurses are at elevated risk for suicide, but the issue gets little attention, researchers report.

Their study of 2005–2016 US government data found the suicide rate among female nurses was significantly higher (10 per 100 000) than that of the general female population (7 per 100 000). The rate among male nurses (33 per 100 000) was also higher than in the general male population (27 per 100 000).

Opioids and benzodiazepines

The findings show “that male and female nurses are at a higher risk for suicide, confirming our previous studies,” said study senior author Judy Davidson, a research scientist at the University of California, San Diego.

“Female nurses have been at greater risk since 2005 and males since 2011. Unexpectedly, the data does not reflect a rise in suicide, but rather that nurse suicide has been unaddressed for years,” Davidson said in a university news release.

Drugs – namely opioids and benzodiazepines – were the most commonly used method of suicide in females. This indicates “a need to further support nurses with pain management and mental health issues,” said study co-author Dr Sidney Zisook, a psychiatry professor at UC San Diego School of Medicine.

“The use of firearms was most common in male nurses, and rising in female nurses. Given these results, suicide prevention programmes are needed,” Zisook said in the release.

The study was published online in the journal WORLDviews on Evidence Based-Nursing.

Time to take urgent action

Another paper in the same issue outlined the effectiveness of a health care provider suicide prevention programme called the Healer Education Assessment and Referral (HEAR) program, which has been tested at UC San Diego.

The programme provides education about suicide risk factors and offers screening. It is listed as a best practice in suicide prevention by the American Medical Association.

“It is time to take urgent action to protect our nursing workforce. The HEAR program is ready for replication at the national level to address this newly recognised risk among nurses,” said Davidson, co-chair of an American Nurses Association task force on nurse suicide.

Talk-based therapy to build resiliency would complement the programme, she added.

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