Masks, regular hand washing and sanitisers are the first and most critical line of defence.
A team of chemists from InnoVenton — the chemical technology research institute in the university’s faculty of science — is daily producing hundreds of litres of 70% alcohol sanitisers in our laboratories for distribution to our communities.
Our provincial hospitals are critically short of protective safety gear, and all gear from our laboratories not in use during lockdown, including face masks, goggles, lab gowns and gloves, is being donated to health care workers in these hospitals.
A team from our faculty of humanities’ departments of visual arts and media communication is engaging our garment industry and communities in a strategy to produce face masks and protective clothing.
Our microbiologists are on standby to advise the hospital in their capacity as experts in virology and how to respond to the spread of the pandemic.
When the decision for the lockdown was taken, local manufacturers engaged with our faculty of engineering, the built environment and technology (Ebet), to share what resources are available and to find out how to assist with the provincial effort.
Doctors were consulted regarding the most pressing needs and doctors at Livingstone Hospital expressed a dire need for face shields.
Two senior project engineers at eNtsa, Riaan Opperman and Akshay Lakhani, co-opted doctoral graduate and 3D printing specialist Sean Poole to print face shields, hundreds of which have since been supplied to the public and private sector.
Given the shortage of ventilators in the province, engineers at eNtsa are working with local manufacturers such as Hansens to investigate the production of ventilators.
The eNtsa team is also evaluating some innovative ideas involving scuba equipment and working with a consortium of companies and Walter Sisulu University on the reverse engineering and manufacturing of the Nuffield 200 ventilator system.
Anaesthetist Dr Lorenzo Boretti, also at Livingstone Hospital, urgently requested an intubation box to protect medical staff and patients when performing endotracheal intubation in patients with known or suspected Covid-19 during sedation and operating procedures.
Students in the faculty of Ebet’s advanced engineering design group, together with local companies CustomWorks and Shibah Engineering, came up with an intubation box that is designed to reduce the aerosolised droplets generated by patients during the intubation procedure, and stops the droplets from becoming airborne, putting the medical staff at risk.
To assist with the capturing of patient data, tracing and tracking of Covid-19 positive patients and mortalities, the faculty of Ebet’s centre for community technologies (CCT) is partnering with the ICT industry, the Eastern Cape department of health and the Nelson Mandela Bay Emergency Response team to develop and customise smart digital solutions for case identification.
CCT director Professor Darelle van Greunen and her team have created several ICT solutions for Covid-19 management, including a unique cloud-based patient identifier that can trace patients through the system at all levels.
This also assists to track and trace people who may have been in contact with infected patients.
The solution also facilitates the capturing of co-morbidities, that is, one or more disease conditions in the same person.
To boost Covid-19 testing, the Eastern Cape disaster management teams have identified high-risk areas and National Health Laboratory Services has provided six large mobile testing units which have been deployed across the province with more than 3,000 PCR testing kits, and more being sent to them as they go.
Results are available in 24 hours.
Our university has a large mobile clinic called Zanempilo (‘bringing health’) which brings medical services to communities without access to these in the Nelson Mandela metro, staffed by our health sciences professionals and students.
Zanempilo will serve as the seventh mobile testing unit.
The mobile units will significantly increase the testing throughout the province, including the deep rural areas.
By April 5, only 538 tests had been done in the Eastern Cape, predominantly in the urban areas; 25 were positive, 338 were negative and 170 were pending.
We fear the low number of positives is not an accurate reflection as it is almost impossible that there are so few positive cases in vast rural areas such as the former Transkei.
The PCR tests are the comprehensive tests, not the rapid tests, which can give incorrect results.
Many of us carry various strains of the coronavirus as other forms of influenza, such as swine flu and SARS and MERS, are strains of the coronavirus, and because we have been exposed to them and other coronaviruses, we carry the coronavirus Antigen, and the IgG and IgM antibodies.
The rapid test picks these up and can then give a positive result for Covid-19 when the person is negative.
If high numbers of people are incorrectly diagnosed as positive this puts strain on the quarantine and medical facilities, and dilutes care from patients with Covid-19.
Furthermore, antibodies against Covid-19 take a while to develop.
This leads to false negative rapid tests.
Planning ahead, we have been identifying potential field hospital spaces together with local and provincial government, including sports grounds on our campuses.
Our university’s new medical school facility on our Missionvale Campus could also be repurposed into a field hospital.
Along with seven other medical schools at SA universities, we will be participating in the World Health Organisation’s global Solidarity Trial.
These are clinical trials on the antiviral combinations being used to treat people for Covid-19, including combinations of ARVs, the anti-malaria drug hydroxychloroquine and other antiviral drugs.
Covid-19 has also highlighted the need for SA to manufacture life-saving drugs.
None of the advanced pharmaceutical intermediates (APIs) or drug substances for HIV, TB and malaria are made locally, which makes them incredibly expensive, and, with the advent of the coronavirus, there are concerns there could be a decrease in supply.
Professor Paul Watts, holder of the SARChI chair in microfluidic bio/bhemical processing in the faculty of science at NMU, explains their research group has done a huge amount of research into new ways of manufacturing generic drugs in SA for Aids, TB, malaria, cancer and influenza.
Watts says if the ARV/ hydroxychloroquine/antiviral drug combinations prove to be an effective treatment for Covid-19, they could produce these with their new flow process technology.
It has taken Watts and his team 20 years of collaboration with researchers in the UK to not only develop this technology for SA, but to manufacture the drugs for 20-30% cheaper.
The majority of SA’s APIs are imported from India or China.
Watts explains that, over the past 10 years, SA has spent about R120bn buying in Aids, TB and malaria APIs from India and China.
The local manufacture of key generic drugs for major diseases and viral pandemics in SA and Africa could ensure that more people have access to the drugs.
It could save billions, create jobs and establish a new manufacturing industry.
Time is not on our side, and as a metro and province we are going to need to considerably gear up our collaborative effort and emergency response.
This story was written by Professor Lungile Pepeta (Dean of the Faculty of Health Sciences), Professor Azwinndini Muronga (Dean of the Faculty of Science) and Professor Barend van Wyk (Dean of the Faculty of Engineering, the Built Environment and Technology) and appeared in The Herald on 9 April 2020.
Nelson Mandela University Health Sciences Dean Dr Lungile Pepeta
Image: Mark West