We write to you today with an update and information about the COVID-19 pandemic that we as a nation are currently facing.
Amidst the propagation of news and information from a variety of sources - not all of which are reputable or trustworthy - many patients and the public have expressed a request for direct communication from qualified healthcare providers.
We take this opportunity to assure you that the full team at My Family GP is committed to staying abreast of any and all developments regarding the pandemic. Further to this, Dr Leon Geffen has been appointed to the WHO Expert Panel on guiding the management of COVID-19 in Long Term Care Facilities in Low and Middle Income Countries. Each of us is committed to providing our patients with the best scientifically-valid and evidence-based practice and recommendations available.
Who needs to be tested?
At present, the criteria for testing are as follows:
- Persons with sudden onset of at least one of the following: cough, sore throat, body aches and pains, shortness of breath or fever
AND, in the 14 days prior to onset of symptoms,
ONE or more of the following:
- Close contact with a confirmed or probable case of COVID-19, OR
- History of travel to areas reporting local transmission of SARS-CoV-2, OR
- Admission to hospital for a severe pneumonia with no other identified causative factor
These recommendations are always available at the NICD and WHO in their most updated form.
What if I don’t meet the criteria?
At this moment, persons not meeting the criteria should not be tested. A negative result in a person who has no symptoms does not preclude someone from becoming COVID-19 positive later on in the course of illness. All persons with a travel history to areas reporting local transmission should quarantine themselves for two weeks upon entry to South Africa.
What is the treatment for COVID-19?
Currently, there is no targeted antiviral therapy that has been shown to be effective against COVID-19. Particularly, drugs such as Kaletra (lopinavir/ritonavir) and chloroquine have not been shown to modify disease outcomes and, as such, should not be used. There is no scientific data to show that these drugs will prevent anyone from getting sick with COVID-19, or that they will aid in recovery for those who are infected.
Treatment for COVID-19 is supportive and includes measures to lower fever, treat muscle pains or headaches, and remain hydrated. Severely ill patients require in-hospital treatment that may include oxygen or respiratory support.
Most patients who contract COVID-19 will experience a mild illness that is self-limiting (i.e. it will go away on its own, in the absence of any medical intervention). The majority of these cases can and should be managed at home, with special care to ensure that infected persons remain isolated so that they cannot spread the disease.
As flu season is upon us, we recommend that all patients who are able to be vaccinated against influenza should be vaccinated as promptly as possible. Furthermore, persons 65 years of age or older, or those with certain pre-existing medical conditions, are advised to get the pneumococcal vaccine. Co-infection with COVID-19 and either influenza or pneumococcus are likely to result in vastly more severe illness, and steps to prevent this, of which vaccination remains the most effective, should be taken.
How can I stay safe?
As a collective, we wholeheartedly endorse and recommend the practices set forth by the WHO:
- Effective hand hygiene - washing hands thoroughly with soap and water, or using alcohol-based hand rub
- Social distancing - maintaining distance of at least 2 metres from anyone coughing or sneezing
- Avoid touching one’s eyes, nose or mouth - as these are entry points for the virus
- Respiratory hygiene - coughing or sneezing into one’s bent elbow, or into a tissue that is then immediately disposed of
- Avoid public spaces and gatherings
- Avoid shaking hands - greetings with no physical contact should be used instead of shaking hands or hugging
What happens when people get COVID-19?
Information from other countries, especially those in Asia, has shown us that enforcing swift responses, limiting gatherings, and employing social distancing has made significant changes in the spread of the disease, and that the majority of people infected have recovered fully without any serious complications. We should aim to follow this lead, and adhere as stringently as possible to the recommendations and guidance - precaution is warranted, panic is not.
Who is particularly at risk of severe illness?
Older persons, those with underlying diseases such as diabetes or cardiovascular disease, and those with suppressed immunity are more likely to face serious complications from COVID-19. We can best help to protect these groups by making sure we follow the guidance outlined above around social practices and hygiene.
Where can I get help?
Various resources exist that can supply reliable advice or information. Please be wary of content circulating on social media that may not be truthful or accurate, and could potentially be harmful.
Trusted resources include:
You may also phone your doctor’s office if you are unsure of what to do, or need advice.
Please avoid presenting yourself at the rooms if you suspect you may have COVID-19 without talking to your doctor first.
For more useful information, you can listen to Dr Anastacia Tomson answering questions on COVID-19, and read an article in the BMJ co-authored by Dr Leon Geffen.
Yours, in solidarity and health
Drs Leon Geffen, Graham Chivers, Orit Laskov, Dion Dorfman, and Anastacia Tomson