By Sibusiso Mkwananzi, CSDA
South Africa has now been included in the countries affected by the COVID-19 pandemic. It is also clear that there is now evidence of local transmission and not just imported cases. Numerous posts and articles have been circulated in ensuring that public health is kept up in the nation as much as possible. We remain aware that the most vulnerable are the elderly (65+) and those already with pre-existing chronic conditions that are associated with immunosuppression such as diabetes, individuals taking steroids, and those with HIV or TB. These groups are likely to experience a more severe version of Covid-19 than healthier individuals. The difference between severe and mild respiratory infection according to medical terminology means the need for assisted breathing through a ventilator when severe. However, it is important to note that everyone is at risk of acquiring covid-19.
Healthier and younger patients are likely to get the disease and the data have shown that just over 50% of cases are individuals under the age of 40. Although, these cases should be mild, which means they should not get to the stage of needing a ventilator as long as the disease is picked up on time, they will experience a certain level of discomfort and pain during the illness. No one wants that, but particularly within households no one wants to spread that to their children. Hence it cannot be overemphasized that all groups need to practice prevention measures (hand washing, social distancing and immune boosters), as well as vigilance.
As the numbers rose I began to check if there are any gender differentials occurring amongst the individuals affected. This was probably due to my avid interest in the health and well-being of women. In my quest from the NICD website’s daily reports I found that approximately 33-35% of overall cases between the 9th and 20th of March had been amongst women. I have given the percentage as a range due to some cases’ genders not being specified. However, over time the percentage of positive cases among women has risen from 33% on the 9th of March to 50% on the 19th of March. Nevertheless, in light of the above trend it is important to provide information for women as they make up 51% of the South African population and are usually primarily responsible for the care of children and the elderly. Additionally, women have contact with all family members as they carry out their daily functions as care workers and nurturers in most households of South Africa. Therefore ensuring women’s health remains paramount not only for themselves, but also for the household as a whole.
Here follows some facts about Covid-19 in relation to women and what the implications are for prevention:
Pregnant women: Thus far there seems to be no evidence to support a higher risk among this group of women. Also, no evidence has suggested the ability for the transmission from mother to child during pregnancy if the mother were to contract Covid-19. Although this is good news, reports suggest that pregnant women should still practise social distancing as a precautionary measure. This is because illness during pregnancy may affect optimum development of the foetus to varying degrees. Additionally, it is important to emphasise optimal levels of continued maternity, obstetric and gynaecological health services nationally during this pandemic. Research has shown that during times of epidemics, funds may be shunted to more immediate crises, which may lead to higher levels of maternal mortality as well as lower child health outcomes.
Caregivers: The effects on primary caregivers become an important element as schools have closed. Even more concerning is that about 60% of households in South Africa are headed by single-parents (with approximately 96% of these being single mothers). As we know during the flu season, it is easy for children to catch flu from their environments and for caregivers/moms to be infected while tending to their treatment. This may result in re-infection or infection of other children in the home. Caregivers will have to explain in simple ways the importance of frequent hand washing to little ones and ensure that they model the very behaviour that they are encouraging. It may be more beneficial to make this practice a fun and enjoyable experience of “wash time” rather than it being introduced as some form of punitive measure that may be misunderstood, disliked or rebelled against by young children especially. The UN, Save the Children and UNICEF offer helpful suggestions for how to talk to children about the virus. Watching these resources together with children and being present to answer any questions may be useful. Immune boosters will also help women in general as studies have shown that during the luteal phase (days 14-28) of the menstrual cycle, immunity may decrease amongst women. Although this differs vastly among women in intensity it is better to take precautionary measures at this time.
So in a nutshell women do not intrinsically have a higher risk of contracting covid-19 physically. However, over and above the inherent risk of women it is important to recognise the numerous careers that women take up in our societies . With development and labour laws becoming more favourable for women to work over time, they have the added responsibility of having careers. In particular, the health and social sectors are two essential services where numerous women make up the frontline. In South Africa it is estimated that women dominate domestic work, clerk and technician positions, while they make up 49% of professionals. These will include community health workers, laboratory technicians, nurses, allied health practitioners and doctors.
All are individuals who are in direct contact with covid-19 positive patients in the home or those going to testing centres, clinics, and hospitals when ill. Italy has reported that more than 2000 health workers have acquired covid-19 since the beginning of the pandemic. Thus far in South Africa thirteen health workers have tested positive with covid-19. Similarly the social sector that the government has now requested to come through to assist with psychosocial effects of the pandemic consists largely of women as well. The social sector includes services to build societal capacity and alleviate poverty. Here, workers may have direct contact with the vulnerable before they go through to health facilities. Considering that women will be going to and fro work and home on a regular basis increases the risk of their families and children acquiring covid-19 as well. Therefore, it is important to ensure that these individuals are not infected as they care for symptomatic and asymptomatic yet infectious individuals while carrying out their duties.
Therefore, it is advised that women take up all the preventative measures promoted by numerous organisations and the government. Additionally, boosting their immune systems and those of their loved ones will keep more families free of the virus. For pregnant women and women with sensitive systems I would suggest using natural immune boosters. These are effective with less side effects. I also would like to emphasise the importance of continuing to practice a new way of being through social distancing. It is hoped that as more of us take up such recommendations and advise others to do the same the curve will flatten and fewer cases will occur in our beautiful country. May we all keep safe and support each other via calls, messages and emails as we face this challenging time.
The views expressed here are the author’s personal opinion and do necessarily reflect the editorial policy of The Daily Vox.