As of 1pm on 3 September, the Western Cape has 3272 active cases of COVID-19, with a total of 105 552 confirmed cases and 98 339 recoveries. 

Cape Metro Sub-districts: 

Sub-districts: 

Unallocated: 2282 (2246 recovered) 

Data note: It is not always possible to check and verify that the address data supplied for each new recorded case is correct, within the time frames required to provide regular and timely updates. This means that in some instances, cases could be allocated to the wrong sub-districts. We are working with the sub-districts to clean and verify the data and where errors are picked up locally, cases will be re-allocated to the correct areas.

More data is available here: https://bit.ly/2BsfdXt 

The Western Cape has recorded an additional 18 deaths, bringing the total number of COVID-19 related deaths in the province to 3941. We send our condolences to their family and friends at this time.

Surveillance strategies for COVID-19:

Earlier, I held my weekly digicon where the Department of Health in the Western Cape revealed some of the ongoing work and studies that they are conducting to ensure that our response to COVID-19 continues to be data-led and evidence based.

We do not have reliable tools to predict the likelihood, location or timing of a resurgence in COVID-19 cases in the province, and ongoing surveillance remains key to ensuring that we understand emerging trends. 

One of the surveillance strategies available to us is the use of serology testing, which helps us to determine the proportion of people who have been previously infected. More detailed information on the results of this kind of testing are provided below.

One of the ways that we can explore whether there is an increase in the number of new cases in a specific area is to look at waste water testing. We have seen this kind of science being used all around the world and waste water epidemiology is not new to South Africa. The country has been conducting polio surveillance for a number of years in this way and the country has sufficient skills in this area. The Western Cape and the City of Cape Town are part of a national network of partners, which includes the NICD, which will be taking this kind of testing forward.

Using these kinds of research tools, coupled with a quick response to emerging data is critical in our ongoing management of this virus.

Seroprevalence study results:

The Western Cape Government Department of Health (WCGH) and the National Health Laboratory Service (NHLS) have jointly initiated routine serological (antibody) surveillance as part of the ongoing monitoring of the COVID-19 epidemic in the Province, in partnership with local academic institutions. Antibodies to the SARS-CoV-2 virus which causes COVID-19 are generally detectable two weeks after infection.

This is an anonymised sentinel surveillance program using residual clinical specimens from patients who attended health services for reasons unrelated to possible COVID-19 symptoms or diagnoses. Initially the study has included specimens from pregnant women attending antenatal care, and people living with HIV attending services for routine HIV viral load testing. The 3600 stored specimens tested to date were originally collected in late July and early August, the majority (2700) from primary care clinics in the Cape Town metropolitan area.

The testing has been conducted by the NHLS using an automated serology assay in accordance with SAHPRA approved section 21 use. The assay had been demonstrated to have high sensitivity and specificity (91,2% and 99.7% respectively) in a local validation study of individuals with known past symptomatic SARS-CoV-2 infection or from specimens predating the epidemic.

The results of the study revealed:

• The SARS-CoV-2 antibody prevalence in the tested specimens from Cape Town clinics was 40%.
• Higher seroprevalence was observed in HIV viral load (42%) compared to antenatal residual specimens (37%). 
• Seroprevalence was higher in those from more densely populated subdistricts. 
• It was also higher in women compared to men (33% for men with HIV compared to 45% for women with HIV).

It is anticipated that prior infection in these selected public sector patient groups is substantially higher than in the general and public sector populations as a whole, and that there will additionally be wide variation in the seroprevalence across the province. The findings nevertheless provide a broad indication of the extent of COVID-19 transmission experienced to date in large parts of the province, in keeping with the epidemic trajectory we have seen. 

Robust population surveys are planned nationally which will provide more definitive results on population seroprevalence and variability, and these are anticipated to begin in the Western Cape in the coming weeks. More detailed analyses of the sentinel serological surveillance data will be forthcoming.

Platform update:

The Western Cape continues to record declining test positivity rates, deaths and hospitalisations for COVID-19. Other indicators, such as oxygen usage, also point to a continued decline- even in the two weeks since the country moved to alert level 2.

Currently COVID-19 admissions to acute hospitals in the Cape Metro account for 9% of all hospital admissions, while oxygen usage has decline to 46% of total capacity.

We are also starting to record declines in our rural districts, with rural districts now starting to report spare critical care capacity.

All of these are very positive signs for the province, but they must not be seen as a sign that we are out of the woods. Our urgent focus must be on ensuring that we are able to fully re-open our economy so that we can save jobs and avoid a pandemic of unemployment, hunger and starvation. In order to do this, we must ensure that businesses are operating safely and that the number of infections in the Western Cape remains low.

We can do this by wearing masks, washing our hands and practicing social distancing. We encourage people to go out and support businesses and the economy but we all have a personal responsibility to ensure that we go out and interact safely. 

Issued by: Western Cape Office of the Premier