UWC Publications - COVID-19

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Clinical condition, resuscitation and medical-psychological care of severe COVID-19 patients(part 1)
(Elsevier, 2021) Maoz, Zeev; Huet, Isabelle; Sudres, Jean-Luc; Bouchard, Jean-Pierre
This interview covers the clinical and psychological condition of patients afflicted with severe COVID-19 and their pulmonary rehabilitation process. For these patients, symptoms are medically urgent and lifethreatening. The sequelae of this viral attack and immune response to it are significant, and often persist for months after discharge from intensive care. To understand the medical and psychological state of these patients, a description is given of the organs affected, the oxygen cycle in the body and the medical care procedures that are used to help patients with dysfunctional respiratory systems. The link between physical and psychological progress is described. Physical weakness results from pulmonary sequelae and deconditioning, and is often experienced by patients as mental fatigue similar to psychological depression. This may draw the patient into a downward spiral, with multiple health aspects deteriorating, independently of the resolution of initial problems. Conversely, a positive physical or psychological evolution may lead to the evolution of the other. Thus, reversing the negative trend for just one system component can delay, completely arrest the spiralling down, or transform it into an upward spiral, improving the patient’s condition. In addition, for people undergoing severe COVID-19, the return to normal life could be destabilizing and memories that arise from their crisis state may trigger PostTraumatic Stress Disorder (PTSD). Health and psychosocial professionals hold an important role both in post-hospital care and in secondary prevention, i.e. prevention of relapse and re-hospitalization. Physical rehabilitation work must take these psychological factors into account, in the same way that any psychological follow-up is supposed to consider physiological factors.
Clinical observation and management of COVID-19 patients
(Taylor and Francis, 2020) Taishen, Li
Three leading infectious disease experts in China were invited to share their bedside observations in the management of COVID-19 patients. Professor Taisheng Li was sent to Wuhan to provide frontline medical care. He depicts the clinical course of SARS-CoV-2 infection. Furthermore, he observes the significant abnormality of coagulation function and proposes that the early intravenous immunoglobulin and low molecular weight heparin anticoagulation therapy are very important. Professor Hongzhou Lu, a leader in China to try various anti-viral drugs, expresses concern on the quality of the ongoing clinical trials as most trials are small in scale and repetitive in nature, and emphasizes the importance of the quick publication of clinical trial results. Regarding the traditional Chinese medicine, Professor Lu suggests to develop a creative evaluation system because of the complicated chemical compositions. Professor Wenhong Zhang is responsible for Shanghai’s overall clinical management of the COVID-19 cases. He introduces the team approach to manage COVID-19 patients. For severe or critically ill patients, in addition to the respiratory supportive treatment, timely multiorgan evaluation and treatment is very crucial. The medical decisions and interventions are carefully tailored to the unique characteristics of each patient.
Conceptualising COVID-19’s impacts on household food security
(Springer, 2020) Devereux, Stephen; Béné, Christophe; Hoddinott, John
COVID-19 undermines food security both directly, by disrupting food systems, and indirectly, through the impacts of lockdowns on household incomes and physical access to food. COVID-19 and responses to the pandemic could undermine food production, processing and marketing, but the most concerning impacts are on the demand-side – economic and physical access to food. This paper identifies three complementary frameworks that can contribute to understanding these effects, which are expected to persist into the post-pandemic phase, after lockdowns are lifted. FAO’s ‘four pillars’– availability, access, stability and utilisation – and the ‘food systems’ approach both provide holistic frameworks for analysing food security. Sen’s ‘entitlement’ approach is useful for disaggregating demand-side effects on household production-, labour-, trade- and transfer-based entitlements to food. Drawing on the strengths of each of these frameworks can enhance the understanding of the pandemic’s impacts on food security, while also pinpointing areas for governments and other actors to intervene in the food system, to protect the food security of households left vulnerable by COVID-19 and public responses.
Coronavirus disease 2019 (covid-19) response in Zimbabwe: A call for urgent scale-up of testing to meet national capacity
(Oxford University Press, 2021) Dzinamarira, Tafadzwa; Mukwenha, Solomon; Eghtessad, Rouzeh
Control of coronavirus disease 2019 (COVID-19) heavily relies on universal access to testing in order to identify who is infected; track them to make sure they do not spread the disease further; and trace those with whom they have been in contact. The recent surge in COVID-19 cases in Zimbabwe is an urgent national public health concern and requires coordinated efforts to scale up testing using the capacity already in existence in the country. There is a need for substantial decentralization of testing, investment in better working conditions for frontline health workers, and the implementation of measures to curb corruption within government structures.
COVID-19: An alternative approach to postgraduate supervision in the digital age
(2022) Hendrickse, Rozenda
Universities globally are facing enormous governmental pressure to increase postgraduate output, and in turn, contribute to the knowledge economy. This pressure is transferred to research supervisors, who have to navigate the complexities of research supervision to not only meet postgraduate output targets set by the university in particular, but postgraduate output targets set by government in general. Before the COVID-19 pandemic, research supervision mostly followed the traditional apprenticeship or group model approach to supervision, where engagement took the form of face-to-face interactions. With the COVID-19 pandemic came social distancing, which forced research supervision to move to online platforms. The core objective of this article was to peruse selected research supervision models or approaches to determine which model or approach would be most suited to an online supervision context, if any. This article advances a re-imagined view of research supervision in higher education. The author proposes an argument for an alternative approach to research supervision, most appropriate to the online supervision environment. The ontological stance, from the perspective of constructivism, underpinned the interrogation of selected research supervision models or approaches with the view to engender a different understanding of what the core components of a research supervision framework could be in the context of COVID-19, with due regard to the “pedagogy of supervision”. This article will be of value to emerging South African research supervisors and scholars in the higher education realm.
COVID-19: Focus on masks and respirators – Implications for oral health-care workers
(2020) Mulder, Riaan; Layloo, Nazreen; Mulder van Staden, Sune
The emergence of the novel human coronavirus (Severe acute respiratory syndrome coronavirus 2; abbreviated as: SARS-CoV-2) generally known as COVID-19 is a global health concern.1 On 11 February 2020, the World Health Organization (WHO) named the novel viral pneumonia as “Corona Virus Disease” (COVID-19). The International Committee on Taxonomy of Viruses (ICTV) suggested this novel coronavirus be named “SARS-CoV-2” due to the phylogenetic and taxonomic analysis of this virus.2 Thus, both terms are utilised interchangeably in the literature. Undoubtedly, COVID-19 will change the way we practice dentistry with vast implications for Oral health-care workers (OHCW) and practice staff. Additionally, if rigorous safety protocols are not implemented based on a risk assessment outlined by the CDC, the dental practice can potentially become a nexus for disease transmission due to the high volume of aerosol production on a daily basis. Personal protective equipment (PPE), staff training and practice disinfection protocols have now especially become important in the light of the current pandemic. This is not a fight that one profession can fight alone, it requires joint efforts, it requires all stakeholders, it requires foresight and it requires us to put the health of the communities above all else.
COVID‑19 Lockdowns: Impact on facility‑based HIV testing and the case for the scaling up of home‑based testing services in Sub‑Saharan Africa
(Springer Nature, 2020) Mhango, Malizgani; Chitungo, Itai; Dzinamarira, Tafadzwa
In December 2019, China reported the emergence of a pneumonia of unknown cause in Wuhan [1]. By 7 January 2020, the etiology of the pneumonia was attributed to a virus of the coronavirus family, and later on the disease was named coronavirus disease (COVID-19) on 11 February 2020 by the WHO [2, 3]. The symptoms of COVID-19 appear after an average incubation period of 5.2 days [1].
The emergence and ongoing convergent evolution of the SARS-CoV-2 N501Y lineages
(Elsevier, 2021-09) Martin, Darren P; Weaver, Steven; Tegally, Houriiyah
The independent emergence late in 2020 of the B.1.1.7, B.1.351, and P.1 lineages of SARS-CoV-2 prompted renewed concerns about the evolutionary capacity of this virus to overcome public health interventions and rising population immunity. Here, by examining patterns of synonymous and non-synonymous mutations that have accumulated in SARS-CoV-2 genomes since the pandemic began, we find that the emergence of these three ‘‘501Y lineages’’ coincided with a major global shift in the selective forces acting on various SARS-CoV-2 genes. Following their emergence, the adaptive evolution of 501Y lineage viruses has involved repeated selectively favored convergent mutations at 35 genome sites, mutations we refer to as the 501Y meta-signature. The ongoing convergence of viruses in many other lineages on this meta-signature suggests that it includes multiple mutation combinations capable of promoting the persistence of diverse SARS-CoV-2 lineages in the face of mounting host immune recognition.
HIV and human Coronavirus coinfections: A historical perspective
(MPDI, 2020) Makoti, Palesa; Fielding, Burtram C.
Seven human coronaviruses (hCoVs) are known to infect humans. The most recent one, SARS-CoV-2, was isolated and identified in January 2020 from a patient presenting with severe respiratory illness inWuhan, China. Even though viral coinfections have the potential to influence the resultant disease pattern in the host, very few studies have looked at the disease outcomes in patients infected with both HIV and hCoVs. Groups are now reporting that even though HIV-positive patients can be infected with hCoVs, the likelihood of developing severe CoV-related diseases in these patients is often similar to what is seen in the general population.
The Impact of Import on inflation in Namibia
(ID Publications, 2017-01) Munepapa, Mika; Sheefeni, Johannes
This study examined the impact of imports on inflation in Namibia using quarterly data from the period 1991Q1 to 2013Q4. The model estimated used imports as a dependent variable, while gross domestic product, money supply (M2), lending rate, and exchange rate as the explanatory variables. An error correction modelling approach was applied on the double log functional form in order to investigate the significance and effect of explanatory variables to inflation in Namibia. The results for the unit root test showed that all the variables were stationary in first difference. The residual based test to cointegration revealed that there is cointegration among the variables. The error correction model showed that imports have a positive effect on inflation in the long run while in the short run the effect is insignificant.
The Impact of import on inflation in Namibia
(ID publications, 2017-01) Sheefeni, Johannes; Munepapa, Mika
This study examined the impact of imports on inflation in Namibia using quarterly data from the period 1991Q1 to 2013Q4. The model estimated used imports as a dependent variable, while gross domestic product, money supply (M2), lending rate, and exchange rate as the explanatory variables. An error correction modelling approach was applied on the double log functional form in order to investigate the significance and effect of explanatory variables to inflation in Namibia. The results for the unit root test showed that all the variables were stationary in first difference. The residual based test to cointegration revealed that there is cointegration among the variables. The error correction model showed that imports have a positive effect on inflation in the long run while in the short run the effect is insignificant.
The Negative Impacts of COVID-19 Containment Measures on South African Families - Overview and Recommendations
(2021-03) Adebiyi, Babatope O; Roman, Nicolette V; Chinyakata, Rachel; Balogun, Tolulope V.
The World Health Organization (WHO) reported various pneumonia cases (‘Coronavirus Disease 2019’ [COVID-19]) on 31 December 2019 in Wuhan City, China, which has spread to many countries, including South Africa. In response to this, the President of South Africa declared a state of national disaster on 15th March 2020, followed by introducing various COVID-19 containment measures to minimize the spread of the virus. This paper examines the negative impacts that COVID-19 containment measures may have had on the family as a unit of society and furthermore provides recommendations to mitigate the impacts of these measures. It can be concluded that COVID-19 containment measures, specifically the lockdown restrictions, would yield both short-term and long-term impacts on proper family functioning. Several families in South Africa have been impacted financially due to the closure of business which led to the temporary/ permanent unemployment of some breadwinners in the families. This also has had a cascading impact on the food security of families and their ability to afford other basic necessities. Distress as a result of financial challenges or failure to provide for the family alongside spending much time locked down together as a family has also led to violence in the family. This was further exacerbated by the fact that the victims were stuck with the abusers and some could not report or find help due to the restricted movements. Furthermore, since most institutions predominantly moved learning online, results indicated that the lockdown restrictions affected the ability of some individuals especially those from poor families to access formal education during the period due to the lack of digital devices and internet facilities. In order to mitigate the impacts of the COVID-19 containment measures on the family, there is a need for collaborative efforts at intrapersonal, interpersonal, institutional, community and policy levels using the ecological framework.
A new logistic growth model applied to COVID-19 fatality data
(Elsevier, 2021) Triambak, S; Mahapatra, D P; Mallick, N; Sahoo, R
follows a sub-exponential power-law scaling whenever effective control interventions are in place. Taking this into consideration, we present a new phenomenological logistic model that is well-suited for such power-law epidemic growth. Methods: We empirically develop the logistic growth model using simple scaling arguments, known boundary conditions and a comparison with available data from four countries, Belgium, China, Denmark and Germany, where (arguably) effective containment measures were put in place during the first wave of the pandemic. A non-linear least-squares minimization algorithm is used to map the parameter space and make optimal predictions. Results: Unlike other logistic growth models, our presented model is shown to consistently make accurate predictions of peak heights, peak locations and cumulative saturation values for incomplete epidemic growth curves. We further show that the power-law growth model also works reasonably well when containment and lock down strategies are not as stringent as they were during the first wave of infections in 2020. On the basis of this agreement, the model was used to forecast COVID-19 fatalities for the third wave in South Africa, which was in progress during the time of this work. Conclusion: We anticipate that our presented model will be useful for a similar forecasting of COVID-19 induced infections/deaths in other regions as well as other cases of infectious disease outbreaks, particularly when power-law scaling is observed.
Pathogenic human Coronavirus envelope protein: A clear link to Immunopathology?
(MPDI, 2020) Schoeman, Dewald; Fielding, Burtram C.
Since the severe acute respiratory syndrome (SARS) outbreak in 2003, human coronaviruses (hCoVs) have been identified as causative agents of severe acute respiratory tract infections. Two more hCoV outbreaks have since occurred, the most recent being SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19). The clinical presentation of SARS and MERS is remarkably similar to COVID-19, with hyperinflammation causing a severe form of the disease in some patients.
The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal
(Researchgate, 2021) Ashish, K C; Peterson, Stefan Swartling; Kinney, Mary
Background The COVID-19 pandemic has led to system-wide disruption of health services globally. We assessed the effect of the pandemic on the disruption of institutional delivery care in Nepal. Methods We conducted a prospective cohort study among 52356 women in nine hospitals to assess the disruption of institutional delivery care during the pandemic (comparing March to August in 2019 with the same months in 2020). We also conducted a nested follow up cohort study with 2022 women during the pandemic to assess their provision and experience of respectful care. We used linear regression models to assess the association between provision and experience of care with volume of hospital births and women’s residence in a COVID-19 hotspot area. Results The mean institutional births during the pandemic across the nine hospitals was 24563, an average decrease of 11.6% (P<0.0001) in comparison to the same time-period in 2019. The institutional birth in high-medium volume hospitals declined on average by 20.8% (P<0.0001) during the pandemic, whereas in low-volume hospital institutional birth increased on average by 7.9% (P=0.001). Maternity services halted for a mean of 4.3 days during the pandemic and there was a redeployment staff to COVID-19 dedicated care. Respectful provision of care was better in hospitals with low-volume birth (β=0.446, P<0.0001) in comparison to high-medium-volume hospitals. There was a positive association between women’s residence in a COVID-19 hotspot area and respectful experience of care (β=0.076, P=0.001). Conclusions The COVID-19 pandemic has had differential effects on maternity services with changes varying by the volume of births per hospital with smaller volume facilities doing better. More research is needed to investigate the effects of the pandemic on where women give birth and their provision and experience of respectful maternity care to inform a “building-back-better” approach in post-pandemic period.
A perspective on nanotechnology and covid-19 vaccine research and production in south africa
(MDPI, 2021) Egieyeh, Samuel; Dube, Admire
Advances in nanotechnology have enabled the development of a new generation of vaccines, which are playing a critical role in the global control of the COVID-19 pandemic and the return to normalcy. Vaccine development has been conducted, by and large, by countries in the global north. South Africa, as a major emerging economy, has made extensive investments in nanotechnology and bioinformatics and has the expertise and resources in vaccine development and manufacturing. This has been built at a national level through decades of investment. In this perspective article, we provide a synopsis of the investments made in nanotechnology and highlight how these could support innovation, research, and development for vaccines for this disease. We also discuss the application of bioinformatics tools to support rapid and cost-effective vaccine development and make recommendations for future research and development in this area to support future health challenges.
Predictors of mask-wearing during the advent of the COVID-19 pandemic: Evidence from South Africa
(Oxford University Press, 2022) Burger, Ronelle; English, Rene; Maughan-Brown, Brendan; Christian, Carmen
Background: In the absence of a vaccine, the global spread of COVID-19 during 2020 has necessitated non-pharmaceutical interventions to curb the rise of cases. Purpose: The article uses the health belief model and a novel rapid mobile survey to examine correlates of reported mask-wearing as a nonpharmaceutical intervention in South Africa between May and August 2020. Methods: Two-way tabulations and multivariable analysis via logistic regression modeling describe correlations between reported mask-wearing and factors of interest among a sample of 7074 adults in a two-period national longitudinal survey, the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM). Results: In line with the health belief model, results showed that self-efficacy, the prevalence of others’ mask-wearing in the same district, and affluence were positively associated with reported mask-wearing. Those who reported staying at home were significantly less likely to report wearing a mask. There was little evidence that the expected severity of the disease if contracted, affects these decisions. Hypertension, obesity, or being overweight (measured three years earlier) did not have a significant association with maskwearing. The prevalence of mask-wearing increased significantly from May to August 2020 as COVID-19 cases increased and lockdown restrictions were eased. Contrary to the health belief model, we found that despite having a higher mortality risk, the elderly had significantly lower odds of mask-wearing. Conclusion: In South Africa, the mask-wearing adherence has increased rapidly. It is concerning that the elderly had lower odds of mask-wearing. This should be examined further in future research.
South Africa and the COVID-19 vaccine
(José Frantz, 2021) Fielding, Burtram C
Scientists, public health experts and politicians have been telling us that, to stop Covid-19, we need to embark on a massive vaccine rollout. But do we really need to vaccinate more than 70% of our population to stop this virus? What is the science telling us?
Understanding varying COVID-19 mortality rates reported in Africa compared to Europe, Americas and Asia
(Pub med, 2021-07) Okonji, Emeka Francis; Okonji, Osaretin Christabel; Mukumbang, Ferdinand C
The SARS-CoV-2 infection, which causes the COVID-19 disease, has impacted every nation on the globe, albeit disproportionately. African countries have seen lower infection and mortality rates than most countries in the Americas Europe and Asia. In this commentary, we explore some of the factors purported to be responsible for the low COVID-19 infection and case fatality rates in Africa: low testing rate, poor documentation of cause of death, younger age population, good vitamin D status as a result of exposure to sunlight, cross-immunity from other viruses including coronaviruses, and lessons learnt from other infectious diseases such as HIV and Ebola. With the advent of a new variant of COVID-19 and inadequate roll-out of vaccines, an innovative and efficient response is needed to ramp up testing, contact tracing and accurate reporting of infection rates and cause of death in order to mitigate the spread of the infection.

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