Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one seventy
Speaker 1: since coronavirus was declared a global pandemic. Today's main story.
Speaker 1: South Africa was already dealing with other infectious disease outbreaks
Speaker 1: like HIV. When COVID came along. The country went into
Speaker 1: strict lockdown to try to keep the outbreak from overwhelming
Speaker 1: It's already shaky health system. But first, here's what happened
Speaker 1: in virus News today. The pandemic is speeding up the
Speaker 1: demise of a controversial industry in the Netherlands. The Dutch
Speaker 1: government is forcing all mink farms to close by March
Speaker 1: of next year. According to a report from news agency,
Speaker 1: A and P infected minks were found on forty two farms,
Speaker 1: triggering mass cullings of the furry mammals that are bred
Speaker 1: for their soft pelts. Before the outbreak, the mink industry
Speaker 1: in the Netherlands had been scheduled to close in twenty
Speaker 1: four on animal welfare grounds. Peru has set another grim
Speaker 1: record by reporting the highest number of deaths per capita
Speaker 1: from the coronavirus, with twenty eight thousand, two hundred and
Speaker 1: seventy seven confirmed deaths from COVID nineteen, or just over
Speaker 1: eighty six for every one hundred thousand inhabitants. Peru overtook
Speaker 1: Belgium as the nation where the virus has been deadliest.
Speaker 1: That's according to data compiled by Johns Hopkins University, the
Speaker 1: I m F and Bloomberg. Peru has one of the
Speaker 1: world's worst outbreaks by other measures too. Over the past
Speaker 1: seven days, no country in the world has posted more cases.
Speaker 1: The outbreak has been so bad that as much as
Speaker 1: a quarter of the twelve million people currently living in
Speaker 1: Lima may have already had the virus. According to a
Speaker 1: government study published last month, Officials war in the country's
Speaker 1: real death toll may be close to double the official figure. Finally,
Speaker 1: a UK study has suggested all the children who have
Speaker 1: died from COVID nineteen in the country had quote profound
Speaker 1: underlying medical conditions. The report suggests that healthy school age
Speaker 1: patients are at very limited risk of severe disease outcomes.
Speaker 1: The report adds to previous indications that youthful patients suffer
Speaker 1: less from the disease than older people, but it did
Speaker 1: show that black or obese children are at a marginally
Speaker 1: higher risk and now for today's main story. The coronavirus
Speaker 1: has swept through South Africa, but the country was already
Speaker 1: carrying a heavy burden of chronic and infectious diseases. Its
Speaker 1: health care system is fragile. So what happened when the
Speaker 1: country went into a strict lockdown to prevent the spread
Speaker 1: of COVID nineteen from overwhelming its medical facilities. Johannesburg based
Speaker 1: reporter Janice Q explains. In the early hours of July thirty,
Speaker 1: protests from a heavy green countryside in South Africa's northeast
Speaker 1: set fire to some parts of the hundred and seventy
Speaker 1: bed Katherine Booth Hospital. Their complaints they didn't want COVID
Speaker 1: nineteen patients at the facility. It was the second protest
Speaker 1: in as many months after the local government Sate had
Speaker 1: wanted it to become the region's COVID hospital. Katherine Booth
Speaker 1: is already dealing with many high risk patients. Our hospital
Speaker 1: has a lot of people suffering from hypertension, diabetes, HIV
Speaker 1: and TV. In fact, we our hospital that initiates medication
Speaker 1: for certain people who are resistant to certain drugs for TV,
Speaker 1: so that is a speciality. This is Dr Martinez Duplusy
Speaker 1: one of nine doctors who work at Katherine Booth. He
Speaker 1: joined the hospital in July twenty nine and usually works
Speaker 1: in the outpatients department and in the emergency room. When
Speaker 1: South Africa started its initial strict lockdown in March, he
Speaker 1: largely became the de factor coronavirus doctor, doing most of
Speaker 1: the unside testing and making many of the calls on
Speaker 1: who should be admitted. While frequent slewness in getting COVID
Speaker 1: nineteen test results has made his job challenging, he's grateful
Speaker 1: that other than gowns, there haven't been any real shortages
Speaker 1: in protective clothing. What is more concerned about is the tuberculosis,
Speaker 1: diabetic and hypertension patients that he hasn't seen in the
Speaker 1: past five months. After a few months, you realize that
Speaker 1: a lot of the familiar faces aren't they anymore. And
Speaker 1: coupled of that, people that present acutely in the hospital
Speaker 1: that has a chronic illness, so let's say hy pretensive
Speaker 1: crisis or diabetic crisis. Um, you make the assumption and
Speaker 1: realization that a lot of these people passes away at
Speaker 1: home because they never yeah, they never make it to hospital.
Speaker 1: As South Africa entered its lockdown. Nurses had gone into
Speaker 1: the community to ask people a series of questions as
Speaker 1: a way of screening them for the coronavirus. At the
Speaker 1: same time, they told people to please only go to
Speaker 1: hospital for an emergency. The idea was to reduce the
Speaker 1: number of people coming in so as to prepare for
Speaker 1: the expected influx of COVID nineteen patients, but the hospital
Speaker 1: mostly just emptied out, with occupancy dropping to less than half.
Speaker 1: The diversion of resources from HIV and TB programs to
Speaker 1: tackle the coronavirus outbreak is one of South Africa's significant losses.
Speaker 1: Together with the reluctance of people to visit health facilities
Speaker 1: for fear of contracting the disease, this has led to
Speaker 1: collateral deaths. No one told them that they still need
Speaker 1: to follow up every month to collect their medication. South
Speaker 1: Africa has one of the world's biggest number of people
Speaker 1: infected with HIV and one of the world's largest number
Speaker 1: of tuberculoser sufferers. Together with extreme poverty, which exacerbates high
Speaker 1: obesity levels that have boosted the number of diabetes patients,
Speaker 1: it's understandable that the Health Minister took steps to mitigate
Speaker 1: the chances of hospitals being in indebted. But still the
Speaker 1: strict and prolonged lockdown has a diet economic consequences. You know,
Speaker 1: if your need is really to put food on the table,
Speaker 1: that trump's you know, thinking about your diabetes teas care
Speaker 1: and the impact that that food may have on your
Speaker 1: blood sugars and those diets tend to be very high
Speaker 1: in carbohydrates, which then obviously impact significantly on on on
Speaker 1: poor glucose control. This is Dr za and Stevens, a
Speaker 1: specialist position an India chronologist at the Christian Barnard Memorial
Speaker 1: Hospital in Cape Town. It's a private hospital named after
Speaker 1: the famous South African surgeon who conducted the world's first
Speaker 1: human heart transplant. It's also a stock reminder of South
Speaker 1: Africa's high inequality for country that boasted this groundbreaking surgery
Speaker 1: in nine. South Africa's history of four racial segregation during
Speaker 1: the Partet regime set its healthcare system on a destructive path.
Speaker 1: We've got this two tiered health system in South Africa
Speaker 1: where we have a small group of people, probably about
Speaker 1: twenty of the population, who are cared for with in
Speaker 1: the funded healthcare sector, and then the overwhelming majority of
Speaker 1: the population being cared for by the state healthcare sector.
Speaker 1: Katherine Booth has a TV war that is good for isolation,
Speaker 1: so the idea of using it as a COVID facility
Speaker 1: makes some sense still for the community of about three
Speaker 1: and fifty thousand people that it serves, many who have
Speaker 1: little disposable income. Having to find money to travel further
Speaker 1: to a different facility as a problem. So they're protesting
Speaker 1: for their own health, which makes sense. Everyone has a
Speaker 1: right to get medical care, and to take that away
Speaker 1: by telling it in to a COVID hospital and telling
Speaker 1: you to drive an hour and a half or two
Speaker 1: hours to a different hospital, it's not feasible for the
Speaker 1: people in my communities. Even so, in late August, the
Speaker 1: local health authorities decided that Catherine Booth would be converted
Speaker 1: to a COVID hospital. That means besides those heading for
Speaker 1: the maternity ward, no new patients can be admitted unless
Speaker 1: there are COVID patient. It's very time consuming to transfer
Speaker 1: sick people and our closest hospital is mar b and
Speaker 1: ha We which together with the dirt road, it takes
Speaker 1: about an hour hour and a half to get the
Speaker 1: patient there, But then you still need to book an
Speaker 1: ambulance and discuss the patient, so it takes about four
Speaker 1: to five hours for patients to get to the hospital.
Speaker 1: So it's very frustrating, as frustrating for us as frustrating
Speaker 1: for the patients. We still actually not sure how to
Speaker 1: cope with all of this. It's not that the doctors
Speaker 1: and Katherine Bruth are being left all alone to figure
Speaker 1: it out. Through a research program, some doctors from the
Speaker 1: bigger hospitals are coming to help them manage the COVID patients.
Speaker 1: There are also more resources being provided. The Department of
Speaker 1: Health has started its biggest ever medical intern allocation program
Speaker 1: with almost recruits at Katherine Ruth. Construction to build new
Speaker 1: wards have been fast tracked and since April, South Africa
Speaker 1: has a cured fleet of new mobile coronavirus screening and
Speaker 1: testing fans. The mobile testing like clinics, I think is
Speaker 1: a great idea. Some of the units even will say
Speaker 1: chronic mediation and then give own patients day chronic treatment.
Speaker 1: Across the country. There's also be incorporation between the public
Speaker 1: and private health sectors to an extent not seen before.
Speaker 1: And here's with South Africa make it it's most significant
Speaker 1: COVID related when the virus is breaking down walls that
Speaker 1: could expedite the expansion of care. That was Janice Q.
Speaker 1: And that's it for our show today. For coverage of
Speaker 1: the outbreak from one twenty bureaus around the world, visit
Speaker 1: bloomberg dot com slash coronavirus and if you like the show,
Speaker 1: please leave us a review and a rating on Apple
Speaker 1: Podcasts or Spotify. It's the best way to help more
Speaker 1: listeners find our global reporting. The Prognosis Daily edition is
Speaker 1: produced by topor foreheads Jordan gas Pure, Magnus Hendrickson, and
Speaker 1: me Laura Carlson. Today's main story was reported by ja
Speaker 1: This Cube. Original music by Leo Sidrian. Our editors are
Speaker 1: Rick Shine and Francesca Levi. Francesca Levi is Bloomberg's head
Speaker 1: of podcasts. Thanks for listening. H