Health24.com | Coronavirus morning update: Cele vows booze crackdown, school talks ‘ongoing’, US deaths pass 20 000

WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 2 028.

Another death has been recorded in the Western Cape – there are now 25 deaths in the country.

So far, 75 053 tests have been conducted.

READ MORE |All the confirmed cases of coronavirus in SA

Latest news:

Police Minister Bheki Cele has vowed to crack down on illegal alcohol sales and looters who have struck several times since the lockdown began.

Cele visited Paarl and Cape Town’s northern suburbs on Saturday to inspect shopping precincts. 

In Mbekweni, Paarl, he was shown a liquor store which had been looted. 

He later reported this was one of 17 stores robbed since the lockdown kicked in, including the ban on the sale and transport of alcohol.

WATCH | ‘Sober up, there are serious matters here’: Cele cracks down on looters, illegal liquor sales

Suggestions that school holidays may be scrapped for the remainder of the year to make up for lost time are not concrete, says Sadtu general-secretary Mugwena Maluleke.

“There are many ideas floating around and we will be engaging with the education department on those ideas as well as sharing our own ideas,” Maluleke told News24.

On Friday, Basic Education Minister Angie Motshekga said one proposal under consideration by the department was cancelling school holidays to regain time lost in the 2020 academic year.

Even before the lockdown started last month, President Cyril Ramaphosa announced schools would be closed to deal with the coronavirus outbreak. With the lockdown extended to 30 April, schools will have been closed for more than six weeks.

READ MORE | School holiday cancellation ‘not concrete’, says Sadtu

Two Cape Town police officers have been arrested for allegedly buying alcohol during the national lockdown. A supermarket manager and cashier were also arrested.

The incident took place in Delft on Thursday at around 11:00 when the two officers allegedly attempted to buy liquor to the value of R4 000.  

“Two police officers, a supermarket manager and a cashier were arrested following the purchase and sale of alcohol in Delft,” said national police spokesperson Brigadier Vishnu Naidoo.

The two officers are stationed at Strand police station and have been charged under the Disaster Management Act.

READ MORE | Lockdown: Two Cape Town cops busted for buying booze worth R4 000

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Early on Sunday morning, cases worldwide were more than 1.76 million, while deaths were more than 108 000.

Deaths in the United States were more than 20 000, with nearly 525 000 cases.

READ MORE | All the confirmed cases worldwide

Latest news:

We watched the case counts rise in China. Healthcare workers shared harrowing accounts from the frontlines as China built hospitals in a matter of days.

Doctors weren’t sure how to treat this new coronavirus, and the Chinese government eventually locked down an estimated 50 million people to contain the disease.

But it took some world leaders months to take the threat seriously.

As death toll creeps higher every day, over one-third of the world has now been placed under lockdown, and countries are scrambling to halt the spread of Covid-19.

READ MORE | 8 times world leaders downplayed the coronavirus and put their countries at greater risk

Cheered by her doctors, 93-year-old Alye Gunduz was discharged from an Istanbul hospital after recovering from the novel coronavirus following 10 days of treatment.

Her recovery from the disease that is killing chiefly the old offered some hope to health workers at Istanbul’s Cerrahpasa Medical Faculty hospital as they battle the outbreak, which risks hitting Turkey hard.

“It is promising because patients at this age and with chronic diseases are most of the time unable to recover because they are at highest risk from Covid-19,” chief physician Zekayi Kutlubay told AFP.

“A 93-year-old woman walking out of intensive care sound and safe is inspiring for us as well as for other coronavirus patients at her age.”

READ MORE | Turkey hospital sees hope as 93-year-old coronavirus patient discharged

For weeks, nursing homes and other senior facilities have struggled to stop the rapid spread of coronavirus among their elderly residents. 

Now, two separate reports show the contagion among nursing homes is far worse than the federal government’s latest estimate.

The novel coronavirus has taken the lives of over 2,300 United States (US) nursing home residents and spread to over 2,100 senior facilities, according to a new tally reported by The Wall Street Journal. A separate NBC News report Friday found coronavirus outbreaks at nearly 2,500 senior facilities.

Those reports place the number of deaths linked to senior facilities far above the latest federal estimate. The federal government last estimated on March 30 that more than 400 nursing homes had been hit with Covid-19, meaning the new reports reflect a 500% increase since then.

READ MORE | Thousands of US nursing home patients have died of Covid-19 – far higher than federal reports

LATEST RESEARCH

A team of local scientists have successfully put together the first genetic fingerprint – or genome sequence – of SARS-CoV-2 (the virus that causes COVID-19) found in South Africa.

Together with the National Institute of Communicable Diseases (NICD), the University of the Western Cape’s South African National Bioinformatics Institute (SANBI) cracked the code that could unlock the origins of the country’s outbreak, and help healthcare workers and government better track and trace the spread of the virus.

Spotlight spoke to Peter van Heusden, SANBI researcher and co-author of the new report on the sequence, and Dr Mushal Allam, a medical scientist with the NICD’s Centre for Respiratory Diseases and Meningitis, who worked on the sequencing, about what this accomplishment means for the future of South Africa’s fight against the Covid-19 virus. 

“It’s been very fulfilling to be able to use these skills and to try and proactively assist with the outbreak,” van Heusden said.

“This is a whole society problem that we have to face with every set of skills that we’ve got. It did feel really fulfilling that this training I’ve put myself through for several years was able to be used for something more than making a research paper.”

“I’ve been very actively networking with my colleagues around the continent and around the world to make sure information flows as quickly as possible, in fact as soon as this hit the radar screens in January, I was already talking to [Allam] asking when we are going to be able to sequence this thing,” he said. 

READ MORE | How scientists found the fingerprint behind South Africa’s Covid-19 virus

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

READ MORE: Coronavirus 101 

Image credit: Getty Images

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Coronavirus: Boris Johnson ‘owes his life to NHS staff’

The prime minister thanks those who treated him for coronavirus, and is now expected to rest and recover.

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Coronavirus: Front-line NHS staff ‘at risk of PTSD’

There is a risk of a “future mental health crisis”, the British Psychological Society says.

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Coronavirus: ‘Local shortages’ of intensive care drugs

Some painkillers and sedative drugs used in intensive care are “a bit stretched”, the BBC learns.

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Health24.com | At the barbershop: a trim – and a diabetes screening

Hundreds of black men recently discovered they could get more than a trim at their local barbershops. They were offered diabetes testing, too.

A new study offered customers diabetes screenings at eight New York City barbershops. Among those who took the test, 10% learned they had average blood sugar levels that indicated type 2 diabetes. And almost 30% appeared to have prediabetes.

“For a long time, barbershops have been a place of trust, especially for black people. Because we had the barbers on board with us, people trusted us. Barbers are often important health advocates,” said the study’s senior author, Dr David Lee. He’s an assistant professor of emergency medicine at the NYU School of Medicine.

Lee and his colleagues said it’s important to reach out to black men in this way because their diabetes diagnosis is often delayed, and black men have significantly higher rates of diabetes complications once diagnosed. Black men are also less likely to live into their 70s than are men in other racial and ethnic groups.

A gathering place for men

Dr Anthony Clarke, an internal medicine doctor in Detroit, said, “Not seeking medical care is a common problem in men, and it’s worse in the black community. With a lot of men in general, they think, if you don’t know about a problem, it’s OK. A lot of men tell me, ‘My wife made me come in.'”

Clarke, of Detroit Medical Center’s Harper University Hospital, was not involved in the current study.

“I think the barbershop was a good way to do this. If patients aren’t coming to you, you go where the patients are. The barbershop is a gathering place for men,” Clarke said.

Some don’t want to know

The researchers partnered with eight Brooklyn barbershops, all owned by black people. The neighbourhoods were chosen because they had a higher prevalence of poor blood sugar control.

From September 2017 through January 2019, nearly 900 black men were offered the free finger-stick blood test for diabetes.

The researchers ended up testing 290 men. Their average body mass index (BMI) was 29.3. BMI is a rough estimate of body fat based on height and weight measurements. A BMI between 24.9 and 29.9 is considered overweight. A BMI of 30 or more is considered obese.

Of those who had undiagnosed diabetes, about 62% were obese, the study found. The average age of the men with undiagnosed diabetes was 41.

More than half of the men who didn’t take the test were willing to tell the researchers why. About half said they knew their health status or had been checked by their doctor, and 35% said they were healthy or they didn’t want to know their status. Eight percent said they were afraid of needles, Lee’s team noted.

Earlier detection needed

“The symptoms of type 2 diabetes are relatively few. A lot of people feel fine and think they’re healthy. Other research has shown that if you find diabetes from a screening test rather than symptoms, you’ll have half the premature mortality rate than those who find out later,” Lee said.

“I usually meet people late in the disease process at the [emergency department]. We need to start figuring out ways to detect chronic diseases like diabetes earlier,” he added.

Lee said he’s not sure if this approach would work in other cities or in more rural areas.

The study results were published as a letter in the online edition of JAMA Internal Medicine.

Image credit: iStock

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All 65 Stature Lessons Complete

Yesterday I finished creating and publishing all of the lessons for the co-creative Stature character sculpting deep dive.

The full course is 16 hours and 20 minutes of audio, with the average lesson being 15 minutes. I wanted to keep the lessons for this course very focused and tight.

There’s also a 138-page workbook to accompany the audio lessons, including a one-page summary for each lesson and exercises to apply each lesson. That’s complete as well.

Additionally we have full text transcripts published for most of the lessons now, and the remainder will be done within the next several days.

And next up there are several more bonuses to create for the course as well, so we’ll add those as soon as they’re ready.

Here’s the full list of published audio lessons:

Module 1: Awareness

  1. Introduction
  2. The Airing of Grievances
  3. The Airing of Commendations
  4. Who Do You Think You Are?
  5. Impossible Invitations
  6. Summoning Your Power
  7. Avoiding Your Power
  8. To the Pain
  9. To the Love
  10. Backstory
  11. Personal Trainers
  12. Self Sculpting
  13. Your Origin Story

Module 2: Harmony

  1. Choosing Harmony
  2. Ridiculous Ridicule
  3. Stepwise Character Growth
  4. Aligned Income
  5. Expressive Alignment
  6. Expressive Commitment
  7. Family
  8. Making Progress
  9. Sweet Surrender
  10. Character Care
  11. Immortality

Module 3: Desire

  1. Opinionated You
  2. Pointers to Desire
  3. The Child Inside
  4. Wanting
  5. Inner Demons
  6. Chorus
  7. Pretending to Care
  8. Spontaneity
  9. Decision Rituals
  10. You Are So Lovable

Module 4: Courage

  1. The Voice of the Heart
  2. Trust
  3. Dancing with Fear
  4. Edginess
  5. Directness
  6. Adaptability
  7. Don’t Get Stuck
  8. Opening the Heart
  9. Courage Training
  10. Defending Your Character

Module 5: Will

  1. Responsibility
  2. The Source of Power
  3. Investment
  4. Balance
  5. Fame
  6. Reputation
  7. Dreaming Sideways
  8. Character in Crisis
  9. Wireframing
  10. Defining Your Core
  11. Fire

Module 6: Voice

  1. Memories
  2. Sculpting the World
  3. Embodiment
  4. Mortality
  5. Experiences
  6. Authority
  7. Self-control
  8. Developing Discipline
  9. Releasing
  10. Journey’s End

While I could say that this was a 3-1/2 month project since I’ve been designing and recording lessons for it since December, it was actually a multi-year project since I’ve been engaging with these ideas and developing this course in some fashion for a few years.

Originally this was going to be conceived as a course on clarity, then it evolved into one on goal setting. But I realized that in order to do those topics justice, we have to get to know ourselves very deeply. In order to set aligned and intelligent goals, we have to know who we are and what matters to us. In order to have clarity about anything else in life, we must create sufficient clarity about ourselves.

Without this depth of self-understanding, it’s very difficult to set meaningful goals and work towards them consistently. If you’ve ever set a goal and then lost sight of it within a few weeks or months, then you’re already familiar with that experience.

To do such deep work into personal awareness, we need ample courage too, so that’s a major part of the course with a whole module being dedicated to it. Sometimes the most courageous acts involve looking deeply into the parts of ourselves that most disturb us.

I’m delighted that many of the lessons were co-creatively inspired by feedback and suggestions from course participants who signed up during the first quarter of the year. Some people provided some really great seeds of ideas that were developed into full lessons or parts of lessons. For instance, I recall that lesson 2.2 on Ridiculous Ridicule (i.e. your inner critic), lesson 3.5 on Inner Demons, lesson 5.5 on Fame, and lesson 6.9 on Releasing were all created because of suggestions received.

I’m absolutely delighted with how this course turned out. It’s been a tremendous amount of work and a huge focus of my life for so long. I’ve been publishing each lesson as soon as it’s ready, so new lessons have been getting added every week since we started in early January. Hundreds of people signed up for Stature in January and have been going through it. Some are going slowly, still on Module 2 or 3. Others are close to finishing Module 6.

I feel pretty happy now that the long journey of creating the core lessons for this course is complete. I have this nice warm feeling in my heart this morning. Even though many of us are in some form of lockdown right now, I feel a strong sense of connection with the people who’ve been going through the course, like we’ve been communicating energetically from a distance. I also feel that what we’ve co-created together is really beautiful and magnificent.

Creating this course is easily one of the top five projects of my life, largely due to the decades of experience it took to create it. It feels amazing to share this unique creative contribution with people.

It’s been transformational for me to engage with these ideas so deeply for so long. I feel that I’ve emerged from this process a different person, especially in terms of my ability to focus well and maintain good self-control. Developing this course refactored my previous ways of connecting the dots among ideas, so now I mentally and emotionally link ideas together in ways that feel fresh and exciting. It felt like going through a gradual rejuvenation process, and some aspects of life feel easier as a result.

While the world is undergoing major shifts right now, I feel grounded and safe in the midst of the chaos. Somehow this course gave me a deep sense of inner peace. That may also be because I’ve improved many of my habits and reworked my entire daily routine along the way.

It’s especially satisfying to know that since this is a timeless course, people can be benefitting from it for decades to come.

A huge thanks to my wife Rachelle as well for helping with the course creation, including compiling and editing the lesson transcripts, many discussions of ideas, and abundant cuddle breaks to recharge along the way. ❤️

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Health24.com | What are US dental offices doing to prevent coronavirus infection?

Dentists, hygienists and other dental professionals are at high risk for work-related exposure to coronavirus, but they can take steps to protect themselves.

“We have really good ways to pre-screen patients: by taking their temperature, asking them questions regarding travel in the last two weeks, asking how they’re feeling and if they have flu-like symptoms,” said Dr Fotinos Panagakos, vice dean of administration and research at West Virginia University School of Dentistry in Morgantown.

“But they may still answer ‘no’ to all of those questions, and their temperature may be normal, but they may still be infected though they’re not showing symptoms yet,” he said in a university news release.

Patients’ coughs and sneezes aren’t the only ways dentists can be exposed to the coronavirus.

Elective care suspended

“In dentistry, many of the procedures that we do require using a handpiece to drill a tooth, or an ultrasonic scaler to clean the teeth,” Panagakos said. “The water used can form an aerosol. If you aerosolise something, it’s going to end up in the air. You can just imagine what that means if a patient is carrying the virus.”

However, standard precautions such as gloves, goggles, gowns and mask can help minimise exposure during treatment. Patients also have a role to play.

On 16 March, the American Dental Association called on dentists to suspend elective care for three weeks to lower the risk.

“Call the dental office – if your office hasn’t reached out to you already – to determine whether you should come in or not,” Panagakos suggested. A cleaning or check-up can be postponed.

“If you’re having an actual dental emergency that involves pain, if you have swelling or if you have an apparent infection in your mouth, contact your dental provider right away and find out how they’re managing those emergency cases,” he said. “Most offices may see you, or they may refer you to another location that’s seeing emergencies.”

READ | Coronavirus: Basic protective measures

READ | Staying at home during the coronavirus pandemic? Use technology to stay connected

READ | Undetected cases may be driving coronavirus spread

Image credit: Jon Tyson, Unsplash

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Health24.com | Coronavirus morning update: SA cases more than 2 000 – but 410 recoveries, as global deaths top 100 000

WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 2 003.

Health Minister Zweli Mkhize said that there are now 24 coronavirus-related deaths in the country.

But Mkhize also said that there have also been 410 recoveries, more than 300 combined in Gauteng and the Western Cape.

READ MORE |All the confirmed cases of coronavirus in SA

Latest news:

Health Minister Zweli Mkhize has recommended that South Africans start wearing cloth masks to help limit the spread of Covid-19, rather than using medical masks reserved for healthcare workers.

“Wearing masks is important. We want to recommend widespread use of masks. We are recommending that people use cloth masks and just make sure there’s a three layer kind of thing,” he said during a briefing on Friday.

Mkhize said wearing a mask in public places can help slow the spread of the coronavirus, but that other hygiene measures were also crucial.

“Even when wearing a mask, hand-washing and social distancing remain the most important interventions to reduce the spread of Covid-19.

“Cloth masks are easy and not expensive to make, reusable and help reduce the transmission of Covid-19 by acting like a shield to contain the respiratory droplets through which the virus spreads,” said Mkhize.

READ MORE | Covid-19: Everyone in SA should wear a cloth mask in public, says Health Minister Zweli Mkhize

School holidays may be scrapped in order to recover lost time as Basic Education Minister Angie Motshekga contemplates the best way to salvage the 2020 academic year.

This is one of the proposals being considered by the department.

Even before the lockdown started last month, Ramaphosa announced that schools would be closed to deal with the coronavirus outbreak. With the lockdown extended to end April, schools will have been closed for over six weeks.

Motshekga’s spokesperson, Elijah Mhlanga, said the department is supporting President Cyril Ramaphosa’s implementation of the lockdown to curb the spread of the Covid-19 pandemic.

READ MORE | Lockdown: School holidays may be scrapped to salvage 2020 academic year, says Motshekga

Investigating officers looking into the case against Communications Minister Stella Ndabeni-Abrahams have already spoken to the National Prosecuting Authority, Police Minister Bheki Cele said on Friday.

Cele said the investigating officer had already met with the minister and was “taking the matter forward”.

This came after the EFF opened a case against Ndabeni-Abrahams who admitted in a recorded message that she had contravened the lockdown regulations.

President Cyril Ramaphosa summoned her to a meeting on Tuesday, where he expressed his disapproval and told her she had undermined the lockdown regulations which required all residents to stay at home to curb the spread of Covid-19, News24 reported.In a statement after the reprimand, Ramaphosa said the law should take its course.

READ MORE | Police question Stella Ndabeni-Abrahams, meet with NPA over lockdown breach – Cele

The South African government should allow the sale of alcohol to resume during the extension of the national lockdown, South Africa’s booze makers say – including at taverns, to keep things as local as possible.

But there should be strict rules, including that all drinks must be sold only on a takeaway basis.

“To ensure that consumers do not travel unnecessarily we recommend that licensed taverns and holders of micro-manufacturing licences should be granted a special dispensation to operate strictly as off-consumption outlets subject to the strict social distancing requirements,” the industry bodies wrote in a letter to government this week.

Under their proposal, bottle stores and taverns (newly made takeaway-only) would operate between 9AM and 6PM on weekdays, up to 4PM on Saturdays, and not at all on Sundays and public holidays, such as the upcoming Freedom Day.

READ MORE | The SA liquor industry’s plan to get booze back on sale: let taverns do takeaways until 6PM

The South African Chamber of Commerce and Industry (SACCI) is proposing the re-opening of fast food outlets as part a staggered approach to kickstart business activity in the wake of the extended coronavirus lockdown.

The organisation which represents various sectors of the economy said on Friday the industry which employs more than 150 000 people, already operates under strict hygiene and safety standards that are in line with the regulations aimed at curbing the spread of the deadly virus.

One of the conditions put forward by SACCI is that retailers could start making use of delivery services, drive-thru, followed by takeaways, or call and collect, conducted under strict physical distancing regulations. No sit-downs would be permitted, it said.

“Allowing them to go back to work under these strict conditions releases the pressure on the SME relief support measures and UIF funds.” 

READ MORE | Open fast food retailers, says business chamber as Ramaphosa extends lockdown

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Early on Saturday morning positive cases worldwide were nearly 1.7 million, while deaths are more than 102 000.

The Unites States edged closer to 500 000 cases, with Spain, Italy, France and Germany all more than 120 000.

Italy had nearly 19 000 deaths. The other two countries with more than 10 000 were Spain and France.

READ MORE | All the confirmed cases worldwide

Latest news:

Any premature lifting of restrictions imposed to control the Covid-19 pandemic could lead to a fatal resurgence of the new coronavirus, the World Health Organization warned on Friday.

WHO chief Tedros Adhanom Ghebreyesus said that while some states were considering ways to ease the restrictions which have placed around half of humanity under some form of lockdown, doing so too quickly could be dangerous.

“I know that some countries are already planning the transition out of stay-at-home restrictions. WHO wants to see restrictions lifted as much as anyone,” he told a virtual press conference in Geneva.

“At the same time, lifting restrictions too quickly could lead to a deadly resurgence. The way down can be as dangerous as the way up if not managed properly.

“WHO is working with affected countries on strategies for gradually and safely easing restrictions.”

READ MORE | Hasty virus lockdown lift could spark ‘deadly resurgence’: WHO

Brazilian health officials confirmed the first case of Covid-19, the disease caused by the new coronavirus, among the remote Yanomami tribe in the Amazon.

Health Minister Luiz Henrique Mandetta said at a press conference on Wednesday that a 15-year-old boy from the indigenous tribe has tested positive for the disease.

Mandetta said that the case was “worrying,” particularly because of the remote community’s separation from the outside world.

According to Brazilian newspaper Globo, the boy was admitted to the intensive care unit at a hospital in Roraima, Brazil’s northernmost state located in the Amazon region, on April 3. He reported shortness of breath, fever, chest pain, and sore throat.

READ MORE | A remote Amazonian tribe has recorded its first Covid-19 case

In Wuhan, China, the streets are abuzz. Donning masks and protective suits, some public health workers are still spraying disinfectant in well-trafficked areas. But on Wednesday, an 11-week lockdown was lifted, and a sense of normalcy is returning to the city of 11 million, where the novel coronavirus outbreak began in November.

As the threat of the virus fades, some residents welcomed the very aspects of everyday life that make it so monotonous.

“I hated traffic jams before,” said one person on Weibo, a popular blogging app, but “now it makes me happy to see them.”

“I won’t complain about congested traffic again, because it’s a sign the streets are flourishing,” said another.

READ MORE | People in Wuhan celebrate traffic jams as the once coronavirus epicentre lifts lockdown

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

READ MORE: Coronavirus 101 

Image credit: Getty Images

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Health24.com | How scientists found the fingerprint behind South Africa’s Covid-19 virus

A team of local scientists have successfully put together the first genetic fingerprint – or genome sequence – of SARS-CoV-2 (the virus that causes COVID-19) found in South Africa. Together with the National Institute of Communicable Diseases (NICD), the University of the Western Cape’s South African National Bioinformatics Institute (SANBI) cracked the code that could unlock the origins of the country’s outbreak, and help healthcare workers and government better track and trace the spread of the virus.

READ MORE | SA scientists make key coronavirus discovery – the lead researcher tells us more

Spotlight spoke to Peter van Heusden, SANBI researcher and co-author of the new report on the sequence, and Dr Mushal Allam, a medical scientist with the NICD’s Centre for Respiratory Diseases and Meningitis, who worked on the sequencing, about what this accomplishment means for the future of South Africa’s fight against the Covid-19 virus. 

“It’s been very fulfilling to be able to use these skills and to try and proactively assist with the outbreak,” van Heusden said. “This is a whole society problem that we have to face with every set of skills that we’ve got. It did feel really fulfilling that this training I’ve put myself through for several years was able to be used for something more than making a research paper.”

“I’ve been very actively networking with my colleagues around the continent and around the world to make sure information flows as quickly as possible, in fact as soon as this hit the radar screens in January, I was already talking to [Allam] asking when we are going to be able to sequence this thing,” he said. 

First the background

If you took biology in high school, you might remember learning about DNA and RNA. DNA being our genetic material, or basically the book containing all of our traits (like eye and hair colour) and RNA being the messenger between our DNA and the protein factories in our cells called ribosomes. 

DNA is stored in the cell’s nucleus, kind of like the brain of the cell. The RNA or messenger RNA (mRNA) takes information from our DNA in the nucleus, straight to the ribosomes which are in the cytoplasm (that yellow looking solution in our cells). Think of the RNA as someone delivering specific instructions to the ribosome’s factory workers on how to make proteins that our bodies need. 

Normally, our cells are constantly producing new, good proteins, after all, that is the ribosome’s job. However, when we become infected with a virus like SARS-CoV-2, something different happens in our cells. This coronavirus is a single strand RNA, and when it reaches our cells, it sneaks into the cytoplasm and behaves just like mRNA. But, it delivers bad instructions to our ribosome protein factories, resulting in the production of proteins that make us sick. The virus may act like messenger RNA, but it delivers the wrong message to our bodies. This is what makes the virus so dangerous.

How to sequence a genome

For this genome, the NICD used a sample from one of South Africa’s first confirmed cases infected with the Covid-19 virus, a patient from KwaZulu-Natal who had returned from Italy. In the sample, scientists had both human DNA and RNA as well as the SARS-CoV-2 RNA. In order to sequence the virus, they first had to separate it from everything else. “Currently we’re using a big, difficult method to sequence the virus,” said Allam. 

Using what are called sequencing kits, Allam and his colleagues had to separate the human DNA from the virus, and deplete the human RNA, leaving just SARS-CoV-2 to work with. Afterwards, the virus RNA is checked for quality, and then the sequencing process begins.  With the NICD’s current technology using an Illumina sequencer (Illumina is a brand name), the sequence is delivered in small parts of about 150 base letters at a time.

After the sequencing is finished, scientists have to assemble the sequence to construct the 29 000 base letter RNA-strand of the virus. “This bug is not easy to sequence,” Allam told Spotlight, adding that most of the reads are contaminated by human DNA and RNA. Allam said that since the outbreak, the NICD has prioritised two sequencing machines just for SARS-CoV-2. With this technology it can take 5 to 6 days to sequence one sample at a price of R7 000 per sample. 

The future of SARS-CoV-2 genome sequencing in SA

According to Allam South Africa was well-equipped to sequence during the pandemic in terms of facilities, but cost, timeliness and the procurement of SARS-CoV-2 sequencing kits were big challenges. However, he said that work is underway to cut the cost of sequencing for one sample down to between R400 and R500, and that new, more time-efficient sequencing machines were in South Africa’s very near future. 

“The WHO and the Africa CDC labs have asked [the NICD] to sequence some genomes from African countries which don’t have these technologies,” said Allam. Other countries including the Democratic Republic of Congo, Nigeria and Senegal have also sequenced SARS-CoV-2 genomes. According to the Global Initiative on Sharing All Influenza Data’s (GISAID) website, more than 5 000 SARS-CoV-2 genomes have been sequenced to date, and about 62 are from Africa, said Allam. 

Using genomics to map a pandemic

The sequencing data compiled by the NICD was shared with a project called Nextstrain, which then created what’s called a phylogenetic tree, or a family tree of viruses. This tree can help scientists better understand where each of these genomes come from and how they are related. For example, South Africa’s SARS-CoV-2 genome sequence has six unique differences compared to the original genome from Wuhan, and scientists can now see, using phylogenetics, that it’s likely that South Africa’s SARS-CoV-2 came from Europe or North America, which has very similar sequences. By constructing this so-called family tree, not only can scientists track the origins of an outbreak, but they can develop a better sense of what the pandemic looks like overall. 

Mutations don’t mean different strains

When talking about differences in the sequence, otherwise called mutations, it’s important to note that this does not mean there are different strains of the virus. “Differences seen in the collection on GISAID are minor, less than 100 bases across the whole 29 kilobase genome. There have been some more dramatic differences noted, such as deletions in parts of the genome, but these mostly seem to be related to culturing the virus in cells,” said van Heusden. 

Remember, SARS-CoV-2 is a single RNA-strand made up of 29 000 base letters. Three of these letters at a time make up a single amino acid, and a group (or chain) of amino acids make a protein. But, different combinations of these three letters doesn’t mean a different amino acid will be produced. For example, if you have two parts of red paint and one part yellow, by mixing them together you will still get the colour orange, no matter what order you mix them together. 

For South Africa’s SARS-CoV-2 genome, there were only two instances where different amino acids (or paint colours) were produced (this is called non-synonymous), but they showed no significant difference to protein structure – in other words – how the virus affects our bodies. Taking all of this into consideration, with the data that’s available, van Heusden said scientists are confident that currently there is no other strain of SARS-CoV-2. 

Can sequencing be used to help create a vaccine?  “The genomics let us understand [the virus’] proteins,” said van Heusden. “We can understand the life cycle, though it’s not strictly alive, and we can understand the way that its proteins work and interact with our proteins, and that’s important for [treatment] therapies. We can also understand from the diversity of genomics, which parts of the virus are stable and which parts are not. When you’re making a vaccine that’s very important information.” 

Van Heusden said that Moderna, the first company to do a human clinical trial to protect against SARS-CoV-2, was using a new approach to making a vaccine. “Normally what you do is use a weakened or killed version of the virus, or just bits, so actual virus.

What Moderna is doing is actually making their vaccine [so that it] would actually inject RNA into a cell which will be made into [a new kind of] protein, which will then [cause] an immune-response. It won’t be like an active virus, it’s just part of the virus that will be made by the vaccine.”This is called an mRNA vaccine.

Van Heusden noted that while sequencing is invaluable information for vaccine research and production, the primary use is to assist in tracing the virus and mapping the pandemic as a whole. He added that the sequencing of South Africa’s SARS-CoV-2 virus could help the government to improve contact tracing and testing. 

*This article was produced by Spotlight – health journalism in the public interest.

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