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Provinces at a Glance

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Provinces at a Glance COVID-19 WEEKLY EPIDEMIOLOGY BRIEF SOUTH AFRICA WEEK 37 2020 CUMULATIVE DATA FROM 31 12 JANUARY SEPTEMBER CASES PERSONS 649 793 1 105.6 IN TOTAL INCIDENCE RISK* 9 815 40 THIS WEEK MEDIAN AGE LIMPOPO PROVINCES AT 14 185 237.1 IN TOTAL /100,000* A GLANCE CASES NORTH WEST GAUTENG 27 206 675.6 215 144 1 417.6 IN TOTAL /100,000* IN TOTAL /100,000* CASES CASES NORTHERN CAPE MPUMALANGA 13 392 1 059.6 25 751 560.8 IN TOTAL /100,000* IN TOTAL /100,000* CASES CASES WESTERN CAPE KWAZULU-NATAL 108 431 1 584.3 116 392 1 031.0 IN TOTAL /100,000* IN TOTAL /100,000* CASES CASES EASTERN CAPE FREE STATE 87 415 1 302.3 41 877 1 450.3 IN TOTAL /100,000* * Incidence risk - cases per 100 000 persons IN TOTAL /100,000* CASES ** based on samples collected/received in current reporting CASES week www.nicd.ac.za TOLL-FREE NUMBER 0800 029 999 PAGE 1 COVID-19 WEEKLY EPIDEMIOLOGY BRIEF WEEK 37 2020 SUMMARY Overview of report Disease surveillance is a core function of the National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS). This report summarises data from a national laboratory-based surveillance system that is used to monitor the coronavirus disease 2019 (COVID-19) pandemic in South Africa. This report is based on data collected up to 12 September 2020 (week 37 of 2020). Note: COVID-19 is the name of the disease and SARS-CoV-2 is the name of the virus. Trends in numbers of new cases by province and age group may be affected by changes in testing practice and delays in testing of specimens. The numbers reported may change as more data becomes available. Highlights INCIDENCE • As of 12 September 2020, a total of 649 793 laboratory-confirmed COVID-19 RISK FOR cases had been detected in South Africa. Of these, 11 276 were cases reported since the last report. The number of new cases detected in week 37 (9 815) was WEEK 37 lower than the number of new cases detected in week 36 (11 942) • An additional 558 deaths were reported since the last report. The overall case- fatality ratio was 2.4% (15 447/649 793) 16.7 • To date, five provinces, Gauteng (215 144/ 649 793, 33.1%), KwaZulu-Natal (116 CASES PER 392/649 793, 17.9%), Western Cape (108 431/649 793, 16.7%), Eastern Cape (87 100 000 415/649 793, 13.5%) and Free State (41 877/649 793, 6.4%) continued to report the PERSONS majority (569 259/649 793, 88.0%) of total COVID-19 cases in South Africa • In the past week, Gauteng Province reported the highest number of new cases (1 966/9 815, 20.0%), followed by Free State Province (1 851/9 815, 18.9%), and KwaZulu-Natal Province (1 321/9 815, 13.5%) • Western Cape Province continued to report the highest cumulative incidence risk (1 584.3 cases per 100 000 persons). Free State Province (1 450.3 cases 20% per 100 000 persons) replaced Gauteng Province (1 417.6 cases per 100 000 OF CASES persons) as the province with 2nd highest cumulative incidence risk and the REPORTED IN Northern Cape Province (1 059.6 cases per 100 000 persons) replaced KwaZulu- Natal (1 031.0 cases per 100 000 persons) as the province with the 4th highest GAUTENG IN cumulative incidence risk WEEK 37 • In the past week all provinces, except for North West Province, reported a decline in weekly incidence risk which varied in magnitude by province, reduction ranged from 14 cases per 100 000 persons in Northern Cape Province to 1 case per 100 000 persons in Westerrn Cape Province compared to week 36 • Similar to the trend in the past three weeks, in the past week, Northern Cape Province (89.7. cases per 100 000 persons) followed by Free State Province (64.1 ≥80 cases per 100 000 persons) and North West Province (23 cases per 100 000 YEAR AGE persons) reported the highest weekly incidence risk. The weekly incidence risk GROUP HAS in all the other provinces was less than 20 cases per 100 000 persons HIGHEST • Similar to the previous weeks, among cases detected in week 37, the highest INCIDENCE weekly incidence risk was in cases aged ≥80 years (35.0 cases per 100 000 RISK FOR persons) followed by cases in the 50-54-year age group (31.6 cases per 100 000 persons) and the lowest weekly incidence risk was in the 0-4-year age group WEEK 37 (1.9 cases per 100 000 persons) • To date, the majority of COVID-19 cases reported were female (58.3%, 375 626/ 644 208). This trend continued in the past week, 59.2% (5 764/9 739) of cases were female. www.nicd.ac.za TOLL-FREE NUMBER 0800 029 999 PAGE 2 COVID-19 WEEKLY EPIDEMIOLOGY BRIEF WEEK 37 2020 Methods or care seeking. Until the week 29 report, new cases were defined as all cases reported since the last Testing for SARS-CoV-2 began on 28 January 2020 at report, irrespective of when the sample was collected. the NICD and after the first case was confirmed in Subsequent to the week 29 report, new cases are now early March 2020, testing was expanded to a larger defined as cases detected in the past epidemiologic network of private and NHLS laboratories. Respiratory week based on date of sample collection or sample specimens were submitted from persons under receipt. It is therefore possible for numbers reported investigation (PUI). Initially, tested individuals were as new cases for the current reporting week not to those who had travelled to countries with COVID-19 tally with total additional cases reported since the last transmission but the PUI definition was changed over report. This will be the case when there was a delay in time. Community symptom screening and referral for reporting of cases. PCR testing was implemented in April 2020 but the strategy was changed to a more targeted approach National and provincial trends of in May 2020. Community screening was largely COVID-19 cases in South Africa discontinued and testing efforts then focussed on areas identified as hot spots and on investigating As of 12 September 2020, a total of 649 793 laboratory- clusters. Contacts of cases were traced and tested confirmed COVID-19 cases were reported in South if symptomatic. In some provinces and in certain Africa. This is 11 276 more cases than the number circumstances (e.g. closed settings, workplaces), reported in the last report. The number of new cases asymptomatic contacts were tested. In recent weeks, detected in week 37 (9 815) was lower than the number testing has been prioritised for healthcare workers of new cases detected in week 36 (11 942). Similar to and hospitalised patients. Laboratories used any one the trend in past few weeks, in the past week, Gauteng of several in-house and commercial PCR assays to test Province reported the highest percentage of new cases for the presence of SARS-CoV-2 RNA. We excluded (1 966/9 815, 20.0%), followed by Free State Province (1 specimens collected outside South Africa. Date of 851/9 815, 18.9%), and KwaZulu-Natal Province (1 321/9 specimen receipt in the laboratory was used when 815,13.5%) (Table 1). Five provinces, Gauteng (215 144/ date of specimen collection was missing. A case of 649 793, 33.1%), followed by KwaZulu-Natal (116 392/638 COVID-19 was defined as any person, resident in 517, 17.9%), Western Cape (108 431/ 649 793, 16.7%), South Africa, with a single positive SARS-CoV-2 PCR Eastern Cape (87 415/649 793, 13.5%) and Free State (41 test. We used 2019 mid-year population estimates 877/649 793, 6.4%) provinces continued to contribute from Statistics South Africa to calculate the incidence the majority (569 259/649 793, 87.6%) of total COVID-19 risk (cumulative or weekly incidence), expressed cases in South Africa. In keeping with the data reported as cases per 100 000 persons. Aggregate data on the past three weeks, there was minimal change in the number of deaths by province were obtained percent contribution of cases in the different provinces from the Department of Health. Data on number of from week 36 to week 37. tests conducted in the past week as reported in the simultaneously-published COVID-19 weekly testing The cumulative incidence risk for the country report was used to calculate tests conducted per increased from 1 089.3 cases per 100 000 persons in 100 000 population. We estimated the time-varying week 36 to 1 105.6 cases per 100 000 persons in week (weekly) doubling time of the COVID-19 epidemic for 37. The cumulative incidence risk varied by province the provinces with sufficient data and from weeks over time (Figure 3). This is partly explained by testing with sufficient number of cases and complete data differences by province (Table 1). The Western Cape (week 12 to the week before the current reporting Province had the highest cumulative incidence risk (1 period). The unit of analysis (epidemiological week) 584.3 cases per 100 000 persons) followed by Free State was defined from Sunday to the following Saturday. Province (1 450.3 cases per 100 000 persons), Gauteng We first estimated the weekly growth rate of the Province (1 417.1 cases per 100 000 persons), Eastern epidemic by fitting a linear regression model to Cape Province (1 302.3 cases per 100 000 persons), the logarithm of the daily cumulative number of Northern Cape Province (1 059.6 cases per 100 000 laboratory-confirmed COVID-19 cases.
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