The Western Cape has prepared its healthcare system for the peak, and must move to Level 3 in conjunction with targeted hotspot strategy
On Saturday, I attended the President’s Coordinating Council which served as a consultation platform to discuss the proposed ‘alert levels’ for various parts of the country.
During that presentation, I set out how the Western Cape had adopted a targeted hotspot strategy that goes beyond just district level. Using epidemiological data, we can focus the entire impact of our government on geographical areas where the virus is spreading in order to slow it down and protect vulnerable people.
This is not business-as-usual. I take this pandemic seriously and I don’t believe we can just return to normal. Major interventions are needed in these hotspots so that we can save lives. This strategy, however, allows for more of the economy to open while doing so, thereby preventing a severe humanitarian crisis from unfolding at the same time.
This is not a zero-sum game. We can care for sick people and save lives now, and we can do it in a way that saves lives in the future too.
We must remember that the scientific reason for the Lockdown has been to allow us time to prepare for the peak of the pandemic. Covid-19 cannot be stopped, and many people will be infected over the coming weeks. The key measure that must be used to determine levels is whether we are prepared to provide care to every person who needs it at the time they need it.
Based on the following evidence, and in conjunction with targeted interventions through our hotspot strategy, we believe the entire Western Cape can move to level 3:
- R725.5 million has been committed towards Covid-19 related expenditure across the Western Cape Government.
- We have established a dedicated Coronavirus Provincial Hotline for residents to call, that has received a total of 28500 calls since 16 March 2020. On average it receives 500 calls a day.
- The conversion of the CTICC into a temporary hospital facility that will provide some 850 additional beds at the peak of the pandemic is well underway.
- In total, this facility will include 4 wards - a mixed staffing model of temporary appointments, temporary re-deployment of staff, agency staff (medical -, infectious disease -, emergency - and internal medicine specialists and volunteers will be applied at the facility).
- It is estimated that 200 admissions and 200 discharges will be managed per day during the peak.
- We will open additional temporary hospitals along the R300 in the Metro, in Khayelitsha and in the Cape Winelands that collectively provide an additional 616 beds.
- This is in addition to the Western Cape’s 2 162 (includes 658 through expansion) general care beds and 150 ICU beds that exist in Central and Regional Hospitals across the province.
- We have opened 18 testing and triage centres (12 are already operational) to provide additional support at these facilities.
- We have 3888 Community Health Workers operating across our province, with a further 464 due to start work soon
- We have increased the number of tests from 7 975 on 1 April to 94 275 on 18 May. This is an increase of 1182%. This represents a testing ratio of 1347.27 per 100 000, the highest in the country.
- Using our targeted hotspot approach, we have screened 473 348 people, and referred 12 095 people for testing.
- We launched an online screening tool which has assisted in screening 62 200 people.
- We have recruited 1 645 volunteers to support our healthcare workers when this peak arrives.
- We have ordered R350 487 835.00 worth of PPE so that our healthcare workers have the protection they need to care for every sick person. We aim to procure R550 million worth of PPE over the course of the pandemic.
- In the public sector we have provided 86 129 flu vaccinations thus far – 65 670 vaccinations to vulnerable groups of people and 20 459 vaccinations to healthcare workers.
- Since the pandemic, we have de-escalated non-essential operations at our healthcare facilities in the Western Cape, which has freed up existing ward capacity in these hospitals (Central and Regional – in relation to the 2 162 general beds and 150 ICU beds) to care for Covid-19.
- We have 432 ventilators and have ordered an additional 100 ventilators to be used at the peak and use our current piped medical gas for high-flow oxygen treatment.
- We have 19 Quarantine and Isolation facilities available offering 2365 beds.
- We are activating an additional 9 facilities which will realise an additional 2292 beds.
- We have launched the Red Dot Transport Service, that through 100 minibus taxis, will transport healthcare workers home when their shift ends at 19h00, given the limitation on the public transport system to operate after 19h00.
- The Red Dot Transport Service will also safely transport those who test positive for Covid-19 to facilities if they cannot isolate safely at home and others to quarantine facilities should they need it.
To support business and workers, and to ensure that more of the economy can open in a safe manner:
- We launched the Covid-19 Content Centre for business which supports businesses by answering their questions on everything they need to ensure business continuity during Covid-19, from understanding the regulations to opening safely, from accessing funding to learning from best practice. Businesses in need of assistance can visit www.supportbusiness.co.za or email firstname.lastname@example.org
- We have assisted in preparing business for adapting to the “new normal” by preparing Covid-19 health guidelines for business. These guidelines not only provide information on how businesses can prevent the spread of Covid-19 in the workplace, but also what to do if an employee displays symptoms or tests positive for Covid-19. The guidelines can be found on our Covid-19 website
- We have produced a range of information material for employers and their staff to utilise in the workplace such as posters, checklists and decals, that remind people of health guidelines to stop the spread of Covid-19. These can also be downloaded on the Covid-19 website: coronavirus.westerncape.gov.za/resources
- To assist businesses to procure the necessary PPE required to protect employees, together with the City of Cape Town and Wesgro, and in partnership with FNB/RMB, we launched a dedicated online PPE marketplace that provides a single place for small and large PPE manufacturers to promote their product ranges, and for businesses to secure masks and other PPE. The PPE marketplace can be found at www.supportbusiness.co.za/marketplace
- We launched an online form where members of the public can submit any complaints against businesses not complying with Covid-19 health and safety guidelines. If you believe that a business is not following the health guidelines in place to stop the spread of Covid-19, you can report it using this online form: coronavirus.westerncape.gov.za/covid-19-business-safety-complaint-form
- We have launched JUMP a smartphone app for entrepreneurs. Previously just a mobile website, the JUMP app for entrepreneurs was developed to assist existing and potential business owners in the Western Cape to get all the resources they need to start, scale and grow their companies. In its new iteration, the smartphone app also included a FundingAssist feature which gives business owners looking for funding, the opportunity to assess their unique business finance needs, receive recommendations on the appropriate funders and products available, and assist them with their funding readiness and application process. For more info visit bizjump.co.za
- We launched the #GoDigitalWC weekly webinar series which brings leading experts in digital technology and business transformation to present ideas and advice for SMMEs on how they can adapt and innovate during the Coronavirus crisis.
- We have made available a large number of free digital skills training courses online through the I-CAN Learn platform, and have encouraged anyone interested in learning new digital skills to visit the I-CAN Learn website
- We also called for digital and technology experts to volunteer for the Tech Volunteer programme which aimed to match experts with businesses who need digital expertise. One week after the call for volunteers when out, we then called for businesses to register to receive digital and technology advisory support from the tech experts who had volunteered for the programme. We're currently in the process of matching businesses in need with the relevant tech experts.
- To help businesses to navigate and access the many support funds available to them, together with Wesgro and the City of Cape Town, we launched the Covid-19 support finder. This online tool asks five easy questions, ranks the answers against pre-determined criteria, and provides a list of funds that your business may qualify for. The process takes under a minute. Find out more at www.supportbusiness.co.za/covid-19-support-finder
- We have procured 100 000 cloth masks, distributed to agri-workers across the Western Cape. We have also facilitated a donation of 1000 litres of hand-sanitiser produced by the repurposed Distell’s Monis Production Plant.
- We have in particular distributed 35 198 face masks to agri-workers in the Witzenberg region. The partnership with Distell has enabled us to allocate 150 litres hand sanitiser to the Cape Winelands District Municipality.
- We have approved protocols for the transport of essential seasonal workers in the agriculture sector from the Western Cape to other provinces. The guidelines stipulate which documentation should accompany every essential worker and the health and safety requirements for owners and drivers of minibus taxis. It stresses that under no circumstances should season workers who tested positive for Covid-19 be allowed to travel from the Western Cape to neighbouring provinces or regions.
- We have created communication material for agricultural communities and assisted in amplifying messages in rural communities through radio.
- We have met with key stakeholders in the agricultural sector, including Agri Western Cape, Hortgro, VinPro, the African Farmers Association of South Africa, SATI and the Prestige Workers Forum to ensure a joint-up approach to fighting the pandemic.
Ensuring that people can get to work and other destinations safety is critical during the pandemic.
- In addition to the Red Dot Transport Service for healthcare workers, we have also launched a new USSD “quick code” system that enable public transport users to send free feedback using their cell phones. This is giving users a voice in the fight to prevent the spread of Covid-19 on public transport.
- Since the lockdown started, the Department has been engaging in public and transport operator education in partnership with bus operators and taxi associations. This has established an effective system for monitoring Covid-19 hygiene in public transport interchanges.
- The new USSD system enable the Department to keep improving its response by gathering information from public transport users to establish whether public transport operators to comply with regulations and best practice by distributing masks, gloves and sanitiser. To date, 355 responses have been completed.
- PPE has been distributed to public transport operators, as well as support provided to others to access a supply of PPE.
- A donation of 10 000 litres of hand sanitizer was facilitated from Distell to the MBT industry, along with a further 500 500ml units of hand sanitizer from SA Taxi Finance and from DMC Source to the MBT industry.
Creating public awareness of key behaviour changes needed to fight the pandemic has been a key pillar of our response:
- We have a dedicated online website, which is being zero-rated. Nearly 1 million users have visited the page.
- We have run ads on social distancing, good hygiene, and what to do when sick, in over 3500 radio slots on over 29 regional and community radio stations. This has been done in all 3 languages of the Western Cape.
- We have run Facebook ads on all key behaviour change messages and have reached over 3 million individual users.
- We developed an online dashboard that provides transparent data on the number of Covid-19 cases, recoveries, deaths and number of tests. This data is going to be shared down to ward level.
- Over 1,8 million pamphlets have been delivered across the Western Cape. In Dunoon alone, some 12 000 pamphlets were distributed by our Department of Human Settlements.
- We have established a Faith Based Organisation network to ensure that we are able to share information with these organisations.
We have a Provincial Disaster Management Joint Operations Centre activated in terms of the Disaster Management Act:
- It operates 24/7 a day, focussing on prevention and mitigation of Covid-19 pandemic in the Western Cape.
- It has assisted in repatriating more than 6000 foreigners form Cape Town
- It has managed the dedicated Provincial Hotline since mid-March assisting residents who believe they might have Covid-19.
- It has mapped critical infrastructure, including Health Facilities, Isolation and Quarantine Sites, Feeding Points etc.
- It has assisted in the planning for quarantining and isolation.
- It is responsible for the coordinating preparations for major escalation scenarios that might occur during a disaster.
The Western Cape Government has supported Municipalities through this difficult time:
- By ensuring that the delivery of basic services in all municipalities are continuing interrupted.
- By ensuring that front line and essential workers are operational so that these services continue.
- By improving basic water supply in high density informal settlements.
- All district municipalities have embarked on programmes to clean public open spaces.
- A Local Government Support Grant, of R16,2 million was distributed to municipalities, aimed at augmenting and supporting the current humanitarian initiatives.
- Support has been provided to homeless people in municipalities across the Western Cape Government.
Making sure that people are safe and that the virus is slowed is critical. All law enforcement has been under the joint command of the South African Police Service and the SANDF, including Metro Police:
- In hotspot areas we are working with all enforcement role-payers to ensure compliance.
- This has included integrated roadblocks, vehicles checks, and deployments.
- 500 LEAP officers have been deployed to the SAPS Clusters, and they were involved in over 1300 operations during this reporting period.
- We have also taken a stand against Police Brutality and inefficiencies, to ensure proper accountability during this time.
- We are working with the City of Cape Town and all district and local municipalities to deploy accredited Neighbourhood Watch members as disaster risk management volunteers to assist in tasks such as queue management. Additionally, trained peace officers and Chrysalis Academy graduates have been deployed, subject to their availability.
During a Public Health Emergency, ensuring proper environmental and waste protocols are adopted and enforced is critical:
- We have developed a Protocol to deal with waste from households with COVID 19 cases that includes measures to ensure greater protection of waste workers and households from infected waste.
- All municipal waste workers are provided with appropriate personal protective equipment.
- The province has four licensed health care risk waste treatment plants including two incinerators where this waste is taken to. In addition, there are 71 operational waste disposal facilities across the province, of which 1 is a high hazardous waste disposal facility.
- The Pandemic is having a severe economic impact on the waste industry, especially on the informal waste industry and waste pickers. A relief program for waste pickers, in the form of food vouchers has been rolled out to help with support of National Government.
- We have issued three Practice Notes to our stakeholders in the Spatial Planning and Land Use Management Sector and also in the Environmental Sector, to assist both in the Municipal domain and in the Private Sector. This should facilitate processes for Planning and Environmental applications, that in time will enable property development and construction activities post the lockdown period.
We understand that vulnerable communities are most at risk during this pandemic:
- We have identified high density and risk informal settlement areas and have commenced planning to assist these areas. This includes Dunoon, Kosovo and IThemba informal areas.
- We have identified land and existing pipeline projects in close proximity to hotspot areas in order to plan and fast track assistance for communities of hotspot areas.
- We have assisted municipalities and Department of Water and Sanitation to identify areas of water shortages across the province.
- We have delivered a total of 615 water tanks in the Western Cape thus far.
- In addition, 14 Water Tankers are in use.
- The City of Cape Town has at its own cost purchased 93 tanks and installed all of them as of 30 April 2020.
Our first initial projections, based on research being conducted by our Department of Economic Development and Tourism, indicate that:
- Over 200 000 jobs are going to be lost in the Western Cape alone due to the lockdown and “Alert Level 4” restrictions, even with the gradual lifting of restrictions over time.
- The situation will be even worse if we stay on Alert Level 4, and businesses are forced to stay closed.
In addition, our call-centre went from receiving 400 calls on average a day to 14 000 calls a day as the humanitarian impact of the Lockdown is felt.
The Hard Lockdown has threatened the well-being and livelihoods of millions of people. This is a real and imminent threat to the health of our people. In response we have done the following:
- Over 1,2 million meals have been provided to children across the Western Cape through our emergency school feeding programme
- Thus far 134 515 food parcels and nearly 200 000 daily cooked meals have been provided to beneficiaries in the province by a combination of civil society organisations, faith-based organisations, private donors, SASSA, the Solidarity Fund, the Provincial and National Departments of Social Development, the Western Cape Education Department, municipalities and businesses.
- Municipalities across the Western Cape have provided humanitarian relief to its most vulnerable residents.
- We provide support to homeless people in shelters through our funded partners. The Department of Social Development funds 27 shelters with 1 499 bed spaces. This budget provides for three daily meals, social workers and social auxiliary workers.
- The Department is also working with NGO’s, to provide extra mattresses, food, and care packs to the poor. For the lockdown period, an additional family shelter was established to provide accommodation for up to 120 family members.
- We are currently funding 20 shelters for survivors of Gender-Based Violence
- We have provided additional Personnel Protective Equipment (PPE) to 110 Old Age Homes.
Our humanitarian support will become unsustainable over time on our current budgets as more and more people lose their jobs. We simply cannot ignore the impact of this on the health of people, especially vulnerable people, into the future.
This is precisely why, that given our robust healthcare system preparation and that we will continue to rigorously intervene in hotspots, we must open more of our economy over time. Not allowing this to happen will threaten lives in the future, and this cannot be ignored by any level of government.
I want to again reiterate that this cannot be done alone. We need the help of every single person in our team effort to slow the spread, and “flatten the curve”. When you keep yourself safe, through practicing good hygiene, keeping your distance, and wearing a mask properly, you help keep vulnerable people who are at higher risk safe too. Your actions can save lives, and we need every person to continue to be our partner in this Covid-19 response.