WEBVTT - South Africa's Multiple Epidemics

0:00:01.720 --> 0:00:07.320
<v Speaker 1>Welcome to Prognosis. I'm Laura Carlson. It's day one seventy

0:00:07.520 --> 0:00:12.720
<v Speaker 1>since coronavirus was declared a global pandemic. Today's main story.

0:00:13.720 --> 0:00:18.239
<v Speaker 1>South Africa was already dealing with other infectious disease outbreaks

0:00:18.640 --> 0:00:23.720
<v Speaker 1>like HIV. When COVID came along. The country went into

0:00:23.800 --> 0:00:27.680
<v Speaker 1>strict lockdown to try to keep the outbreak from overwhelming

0:00:28.040 --> 0:00:34.000
<v Speaker 1>It's already shaky health system. But first, here's what happened

0:00:34.159 --> 0:00:43.720
<v Speaker 1>in virus News today. The pandemic is speeding up the

0:00:43.760 --> 0:00:48.120
<v Speaker 1>demise of a controversial industry in the Netherlands. The Dutch

0:00:48.159 --> 0:00:52.320
<v Speaker 1>government is forcing all mink farms to close by March

0:00:52.400 --> 0:00:56.280
<v Speaker 1>of next year. According to a report from news agency,

0:00:56.600 --> 0:01:01.560
<v Speaker 1>A and P infected minks were found on forty two farms,

0:01:02.040 --> 0:01:05.760
<v Speaker 1>triggering mass cullings of the furry mammals that are bred

0:01:05.959 --> 0:01:10.959
<v Speaker 1>for their soft pelts. Before the outbreak, the mink industry

0:01:10.959 --> 0:01:14.319
<v Speaker 1>in the Netherlands had been scheduled to close in twenty

0:01:14.840 --> 0:01:20.800
<v Speaker 1>four on animal welfare grounds. Peru has set another grim

0:01:20.800 --> 0:01:24.480
<v Speaker 1>record by reporting the highest number of deaths per capita

0:01:24.680 --> 0:01:29.760
<v Speaker 1>from the coronavirus, with twenty eight thousand, two hundred and

0:01:29.800 --> 0:01:34.840
<v Speaker 1>seventy seven confirmed deaths from COVID nineteen, or just over

0:01:34.920 --> 0:01:39.839
<v Speaker 1>eighty six for every one hundred thousand inhabitants. Peru overtook

0:01:39.840 --> 0:01:43.440
<v Speaker 1>Belgium as the nation where the virus has been deadliest.

0:01:44.480 --> 0:01:48.280
<v Speaker 1>That's according to data compiled by Johns Hopkins University, the

0:01:48.360 --> 0:01:52.600
<v Speaker 1>I m F and Bloomberg. Peru has one of the

0:01:52.640 --> 0:01:57.919
<v Speaker 1>world's worst outbreaks by other measures too. Over the past

0:01:58.160 --> 0:02:02.960
<v Speaker 1>seven days, no country in the world has posted more cases.

0:02:04.640 --> 0:02:07.360
<v Speaker 1>The outbreak has been so bad that as much as

0:02:07.400 --> 0:02:10.400
<v Speaker 1>a quarter of the twelve million people currently living in

0:02:10.480 --> 0:02:14.360
<v Speaker 1>Lima may have already had the virus. According to a

0:02:14.440 --> 0:02:19.399
<v Speaker 1>government study published last month, Officials war in the country's

0:02:19.680 --> 0:02:25.880
<v Speaker 1>real death toll may be close to double the official figure. Finally,

0:02:26.280 --> 0:02:29.880
<v Speaker 1>a UK study has suggested all the children who have

0:02:30.040 --> 0:02:34.760
<v Speaker 1>died from COVID nineteen in the country had quote profound

0:02:35.320 --> 0:02:40.880
<v Speaker 1>underlying medical conditions. The report suggests that healthy school age

0:02:40.880 --> 0:02:45.359
<v Speaker 1>patients are at very limited risk of severe disease outcomes.

0:02:46.240 --> 0:02:50.560
<v Speaker 1>The report adds to previous indications that youthful patients suffer

0:02:50.720 --> 0:02:54.399
<v Speaker 1>less from the disease than older people, but it did

0:02:54.440 --> 0:02:58.000
<v Speaker 1>show that black or obese children are at a marginally

0:02:58.320 --> 0:03:08.480
<v Speaker 1>higher risk and now for today's main story. The coronavirus

0:03:08.600 --> 0:03:12.560
<v Speaker 1>has swept through South Africa, but the country was already

0:03:12.639 --> 0:03:17.799
<v Speaker 1>carrying a heavy burden of chronic and infectious diseases. Its

0:03:17.800 --> 0:03:22.400
<v Speaker 1>health care system is fragile. So what happened when the

0:03:22.400 --> 0:03:26.000
<v Speaker 1>country went into a strict lockdown to prevent the spread

0:03:26.000 --> 0:03:33.360
<v Speaker 1>of COVID nineteen from overwhelming its medical facilities. Johannesburg based

0:03:33.440 --> 0:03:43.240
<v Speaker 1>reporter Janice Q explains. In the early hours of July thirty,

0:03:43.680 --> 0:03:46.960
<v Speaker 1>protests from a heavy green countryside in South Africa's northeast

0:03:47.360 --> 0:03:49.600
<v Speaker 1>set fire to some parts of the hundred and seventy

0:03:49.600 --> 0:03:53.720
<v Speaker 1>bed Katherine Booth Hospital. Their complaints they didn't want COVID

0:03:53.800 --> 0:03:56.960
<v Speaker 1>nineteen patients at the facility. It was the second protest

0:03:57.000 --> 0:03:59.360
<v Speaker 1>in as many months after the local government Sate had

0:03:59.400 --> 0:04:03.480
<v Speaker 1>wanted it to become the region's COVID hospital. Katherine Booth

0:04:03.520 --> 0:04:07.440
<v Speaker 1>is already dealing with many high risk patients. Our hospital

0:04:07.640 --> 0:04:11.800
<v Speaker 1>has a lot of people suffering from hypertension, diabetes, HIV

0:04:11.960 --> 0:04:17.000
<v Speaker 1>and TV. In fact, we our hospital that initiates medication

0:04:17.120 --> 0:04:21.120
<v Speaker 1>for certain people who are resistant to certain drugs for TV,

0:04:21.800 --> 0:04:26.200
<v Speaker 1>so that is a speciality. This is Dr Martinez Duplusy

0:04:26.240 --> 0:04:28.680
<v Speaker 1>one of nine doctors who work at Katherine Booth. He

0:04:28.800 --> 0:04:32.000
<v Speaker 1>joined the hospital in July twenty nine and usually works

0:04:32.000 --> 0:04:35.200
<v Speaker 1>in the outpatients department and in the emergency room. When

0:04:35.200 --> 0:04:38.440
<v Speaker 1>South Africa started its initial strict lockdown in March, he

0:04:38.520 --> 0:04:41.919
<v Speaker 1>largely became the de factor coronavirus doctor, doing most of

0:04:41.960 --> 0:04:44.040
<v Speaker 1>the unside testing and making many of the calls on

0:04:44.080 --> 0:04:47.799
<v Speaker 1>who should be admitted. While frequent slewness in getting COVID

0:04:47.880 --> 0:04:51.359
<v Speaker 1>nineteen test results has made his job challenging, he's grateful

0:04:51.520 --> 0:04:54.200
<v Speaker 1>that other than gowns, there haven't been any real shortages

0:04:54.240 --> 0:04:58.080
<v Speaker 1>in protective clothing. What is more concerned about is the tuberculosis,

0:04:58.120 --> 0:05:01.359
<v Speaker 1>diabetic and hypertension patients that he hasn't seen in the

0:05:01.360 --> 0:05:05.359
<v Speaker 1>past five months. After a few months, you realize that

0:05:06.080 --> 0:05:09.760
<v Speaker 1>a lot of the familiar faces aren't they anymore. And

0:05:10.240 --> 0:05:15.120
<v Speaker 1>coupled of that, people that present acutely in the hospital

0:05:15.400 --> 0:05:19.240
<v Speaker 1>that has a chronic illness, so let's say hy pretensive

0:05:19.320 --> 0:05:25.440
<v Speaker 1>crisis or diabetic crisis. Um, you make the assumption and

0:05:25.640 --> 0:05:29.440
<v Speaker 1>realization that a lot of these people passes away at

0:05:29.480 --> 0:05:33.160
<v Speaker 1>home because they never yeah, they never make it to hospital.

0:05:37.640 --> 0:05:40.760
<v Speaker 1>As South Africa entered its lockdown. Nurses had gone into

0:05:40.760 --> 0:05:43.360
<v Speaker 1>the community to ask people a series of questions as

0:05:43.360 --> 0:05:46.359
<v Speaker 1>a way of screening them for the coronavirus. At the

0:05:46.400 --> 0:05:48.839
<v Speaker 1>same time, they told people to please only go to

0:05:48.920 --> 0:05:52.480
<v Speaker 1>hospital for an emergency. The idea was to reduce the

0:05:52.560 --> 0:05:54.640
<v Speaker 1>number of people coming in so as to prepare for

0:05:54.680 --> 0:05:58.600
<v Speaker 1>the expected influx of COVID nineteen patients, but the hospital

0:05:58.640 --> 0:06:02.159
<v Speaker 1>mostly just emptied out, with occupancy dropping to less than half.

0:06:03.120 --> 0:06:06.560
<v Speaker 1>The diversion of resources from HIV and TB programs to

0:06:06.600 --> 0:06:10.799
<v Speaker 1>tackle the coronavirus outbreak is one of South Africa's significant losses.

0:06:11.520 --> 0:06:14.240
<v Speaker 1>Together with the reluctance of people to visit health facilities

0:06:14.279 --> 0:06:17.080
<v Speaker 1>for fear of contracting the disease, this has led to

0:06:17.120 --> 0:06:21.320
<v Speaker 1>collateral deaths. No one told them that they still need

0:06:21.400 --> 0:06:28.280
<v Speaker 1>to follow up every month to collect their medication. South

0:06:28.279 --> 0:06:30.839
<v Speaker 1>Africa has one of the world's biggest number of people

0:06:30.880 --> 0:06:33.640
<v Speaker 1>infected with HIV and one of the world's largest number

0:06:33.680 --> 0:06:38.240
<v Speaker 1>of tuberculoser sufferers. Together with extreme poverty, which exacerbates high

0:06:38.240 --> 0:06:41.360
<v Speaker 1>obesity levels that have boosted the number of diabetes patients,

0:06:41.880 --> 0:06:44.920
<v Speaker 1>it's understandable that the Health Minister took steps to mitigate

0:06:44.960 --> 0:06:48.359
<v Speaker 1>the chances of hospitals being in indebted. But still the

0:06:48.360 --> 0:06:52.919
<v Speaker 1>strict and prolonged lockdown has a diet economic consequences. You know,

0:06:53.040 --> 0:06:56.520
<v Speaker 1>if your need is really to put food on the table,

0:06:57.160 --> 0:07:00.520
<v Speaker 1>that trump's you know, thinking about your diabetes teas care

0:07:00.520 --> 0:07:02.280
<v Speaker 1>and the impact that that food may have on your

0:07:02.320 --> 0:07:05.839
<v Speaker 1>blood sugars and those diets tend to be very high

0:07:06.000 --> 0:07:11.200
<v Speaker 1>in carbohydrates, which then obviously impact significantly on on on

0:07:11.280 --> 0:07:14.600
<v Speaker 1>poor glucose control. This is Dr za and Stevens, a

0:07:14.600 --> 0:07:18.400
<v Speaker 1>specialist position an India chronologist at the Christian Barnard Memorial

0:07:18.440 --> 0:07:22.240
<v Speaker 1>Hospital in Cape Town. It's a private hospital named after

0:07:22.240 --> 0:07:25.040
<v Speaker 1>the famous South African surgeon who conducted the world's first

0:07:25.280 --> 0:07:28.840
<v Speaker 1>human heart transplant. It's also a stock reminder of South

0:07:28.920 --> 0:07:33.400
<v Speaker 1>Africa's high inequality for country that boasted this groundbreaking surgery

0:07:33.480 --> 0:07:38.240
<v Speaker 1>in nine. South Africa's history of four racial segregation during

0:07:38.240 --> 0:07:41.960
<v Speaker 1>the Partet regime set its healthcare system on a destructive path.

0:07:42.480 --> 0:07:45.280
<v Speaker 1>We've got this two tiered health system in South Africa

0:07:45.320 --> 0:07:48.400
<v Speaker 1>where we have a small group of people, probably about

0:07:48.400 --> 0:07:51.560
<v Speaker 1>twenty of the population, who are cared for with in

0:07:51.600 --> 0:07:55.680
<v Speaker 1>the funded healthcare sector, and then the overwhelming majority of

0:07:55.680 --> 0:07:59.080
<v Speaker 1>the population being cared for by the state healthcare sector.

0:08:00.040 --> 0:08:02.800
<v Speaker 1>Katherine Booth has a TV war that is good for isolation,

0:08:02.880 --> 0:08:05.080
<v Speaker 1>so the idea of using it as a COVID facility

0:08:05.160 --> 0:08:08.040
<v Speaker 1>makes some sense still for the community of about three

0:08:08.360 --> 0:08:11.160
<v Speaker 1>and fifty thousand people that it serves, many who have

0:08:11.240 --> 0:08:14.640
<v Speaker 1>little disposable income. Having to find money to travel further

0:08:14.680 --> 0:08:17.760
<v Speaker 1>to a different facility as a problem. So they're protesting

0:08:17.800 --> 0:08:21.240
<v Speaker 1>for their own health, which makes sense. Everyone has a

0:08:21.400 --> 0:08:24.480
<v Speaker 1>right to get medical care, and to take that away

0:08:24.520 --> 0:08:27.200
<v Speaker 1>by telling it in to a COVID hospital and telling

0:08:27.200 --> 0:08:29.320
<v Speaker 1>you to drive an hour and a half or two

0:08:29.360 --> 0:08:33.040
<v Speaker 1>hours to a different hospital, it's not feasible for the

0:08:33.080 --> 0:08:36.360
<v Speaker 1>people in my communities. Even so, in late August, the

0:08:36.400 --> 0:08:39.480
<v Speaker 1>local health authorities decided that Catherine Booth would be converted

0:08:39.480 --> 0:08:42.400
<v Speaker 1>to a COVID hospital. That means besides those heading for

0:08:42.440 --> 0:08:45.600
<v Speaker 1>the maternity ward, no new patients can be admitted unless

0:08:45.640 --> 0:08:49.560
<v Speaker 1>there are COVID patient. It's very time consuming to transfer

0:08:49.679 --> 0:08:53.800
<v Speaker 1>sick people and our closest hospital is mar b and

0:08:54.600 --> 0:08:57.920
<v Speaker 1>ha We which together with the dirt road, it takes

0:08:57.920 --> 0:09:00.160
<v Speaker 1>about an hour hour and a half to get the

0:09:00.200 --> 0:09:02.480
<v Speaker 1>patient there, But then you still need to book an

0:09:02.520 --> 0:09:06.520
<v Speaker 1>ambulance and discuss the patient, so it takes about four

0:09:06.559 --> 0:09:09.360
<v Speaker 1>to five hours for patients to get to the hospital.

0:09:10.080 --> 0:09:15.040
<v Speaker 1>So it's very frustrating, as frustrating for us as frustrating

0:09:15.080 --> 0:09:18.280
<v Speaker 1>for the patients. We still actually not sure how to

0:09:18.960 --> 0:09:21.400
<v Speaker 1>cope with all of this. It's not that the doctors

0:09:21.400 --> 0:09:23.480
<v Speaker 1>and Katherine Bruth are being left all alone to figure

0:09:23.520 --> 0:09:26.360
<v Speaker 1>it out. Through a research program, some doctors from the

0:09:26.360 --> 0:09:29.120
<v Speaker 1>bigger hospitals are coming to help them manage the COVID patients.

0:09:29.559 --> 0:09:33.200
<v Speaker 1>There are also more resources being provided. The Department of

0:09:33.240 --> 0:09:37.080
<v Speaker 1>Health has started its biggest ever medical intern allocation program

0:09:37.120 --> 0:09:42.120
<v Speaker 1>with almost recruits at Katherine Ruth. Construction to build new

0:09:42.120 --> 0:09:45.200
<v Speaker 1>wards have been fast tracked and since April, South Africa

0:09:45.240 --> 0:09:48.080
<v Speaker 1>has a cured fleet of new mobile coronavirus screening and

0:09:48.160 --> 0:09:53.040
<v Speaker 1>testing fans. The mobile testing like clinics, I think is

0:09:53.080 --> 0:09:57.319
<v Speaker 1>a great idea. Some of the units even will say

0:09:57.400 --> 0:10:02.319
<v Speaker 1>chronic mediation and then give own patients day chronic treatment.

0:10:02.960 --> 0:10:05.720
<v Speaker 1>Across the country. There's also be incorporation between the public

0:10:05.800 --> 0:10:08.320
<v Speaker 1>and private health sectors to an extent not seen before.

0:10:09.040 --> 0:10:11.520
<v Speaker 1>And here's with South Africa make it it's most significant

0:10:11.520 --> 0:10:14.800
<v Speaker 1>COVID related when the virus is breaking down walls that

0:10:14.880 --> 0:10:26.839
<v Speaker 1>could expedite the expansion of care. That was Janice Q.

0:10:27.559 --> 0:10:30.200
<v Speaker 1>And that's it for our show today. For coverage of

0:10:30.240 --> 0:10:33.840
<v Speaker 1>the outbreak from one twenty bureaus around the world, visit

0:10:33.880 --> 0:10:38.720
<v Speaker 1>bloomberg dot com slash coronavirus and if you like the show,

0:10:39.120 --> 0:10:41.920
<v Speaker 1>please leave us a review and a rating on Apple

0:10:41.960 --> 0:10:45.520
<v Speaker 1>Podcasts or Spotify. It's the best way to help more

0:10:45.600 --> 0:10:50.400
<v Speaker 1>listeners find our global reporting. The Prognosis Daily edition is

0:10:50.400 --> 0:10:55.360
<v Speaker 1>produced by topor foreheads Jordan gas Pure, Magnus Hendrickson, and

0:10:55.480 --> 0:10:59.880
<v Speaker 1>me Laura Carlson. Today's main story was reported by ja

0:11:00.120 --> 0:11:04.920
<v Speaker 1>This Cube. Original music by Leo Sidrian. Our editors are

0:11:05.040 --> 0:11:09.839
<v Speaker 1>Rick Shine and Francesca Levi. Francesca Levi is Bloomberg's head

0:11:09.880 --> 0:11:22.120
<v Speaker 1>of podcasts. Thanks for listening. H