In a virtual meeting, the Ad Hoc Committee was briefed by the Western Cape Department of Health on a health strategy update in relation to cases, hospitalisations, mortality and health care worker infections. The briefing also provided Members with an update on hotspot containment strategies, testing capacity, acute service platform responses, a review of the health system response and re-introduction of the comprehensive health services.
On the theme of schooling and education during the covid19 pandemic, the Independent Schools Association of Southern Africa (ISASA) briefed the Committee. The presentation covered the SA schooling system, independent school sector, schools in the Western Cape and ISAS’s role.
The Governing Body Foundation (GBF) briefed Members on the issues/problems facing schools during the pandemic and how the GBF has assisted its member schools during this period.
The Federation of Governing Bodies of South African Schools (FEDSAS) presented on covid9 activates of the organisation, its findings and what more can be done.
Members asked if decommissioning the Cape Town International Convention Centre’s (CTICC’s) Hospital of Hope was premature, especially considering the country just moved to Level Two, and questioned measurements put in place for the possibility of a second wave of infections.
Members asked ISASA how parents who requested a break in school fees were accommodated.
Members asked for statistical information on how many schools are assisted with discrimination workshops and assisted with complaints around racism and discrimination.
Opening remarks by MEC
Dr Nomafrench Mbombo, Western Cape Provincial Minister of Health, said in the context of Covid-19, seven days is seven years. Situations constantly change and evolve. The Department may not have direct ABC answers or strategies for some of the questions Members have.
Western Cape Department of Health: Health Strategy Update Presentation
Dr Keith Cloete, Head of Department (HOD): Western Cape Department of Health, said approximately 50% of cases occur in the private sector. The majority of those cases and contacts are followed up by private doctors taking care of those individuals. Approximately 10% of all cases use COVID Connect, its contact tracing application.
The Department is working on improving the data system for case and contact tracing. The idea is to bring together multiple contact tracing systems.
COVID-19 in Western Cape Government: Health workers- 16 August 2020
- Total Cases: 4428
- Recoveries: 4124
- Active: 269
- Deaths: 35
- Infection rate: 13.61 %
- % recovered: 93.13 %
Hotspot Containment Strategy
Continued emphasis on hotspot containment strategy
- Essential to impact on, and continue to drive behaviour change in every local community through the hotspot strategy. This is until a full vaccine programme is in place (potentially 12 to 24 months).
- Behaviour change drive will focus on the uptake of masks, social distancing, hand and surface hygiene.
Global vaccine initiative
- Countries, including South Africa were invited to participate in the Covax Facility (an investment opportunity of US $2 billion which will provide vital seed funding.)
Ten vaccines against SARS-COV-2 are in clinical trials. Researchers at the University of Oxford and AstraZeneca hope to have the First Phase Three data in hand this summer. Although many infectious disease experts argue 18 months for a first vaccine is an incredibly aggressive schedule, a few optimists believe hundreds of millions of doses of vaccine might be ready for roll-out by the end of 2020.
Testing Capacity and Priorities
- The Department had significant success with the high risk diabetic strategy. It now focuses on moderate and low risk diabetics
- A big National seroprevalence survey is planned.
Key message from diabetic project
- Of the total high-risk diabetic patients contacted and admitted over the last 2 weeks, 39 were admitted and only 2 had an adverse outcome of death.
- The background mortality in this risk group is several fold higher (at least 37%).
- The low risk COVID diabetic phase of the project was launched on Friday 7th August. More than 60 patients were contacted and are being followed up daily.
Acute service platform
Cape Town International Convention Centre (CTICC) Hospital of Hope:
- cumulative admissions – 1 502
- cumulative discharges – 1 440
- current admissions – 57
- deaths - 82
- cumulative admissions – 201
- cumulative discharges -153
- current admissions – 54
- deaths - 4
- Brackengate will admit more patients as CTICC is decommissioned.
Thusong Centre, Khayelitsha:
- cumulative admissions – 241
- cumulative discharges – 194
- deaths – 34
- This facility has now closed.
As at 17 August 2020 total hospital bed occupation in the Western Cape was 68%. Bed availability was 3804 across the Province
Progress: Private Hospitals
- All private hospital groups signed, sufficient hospitals and specialists ready to accept patients should the need arise.
- 5 patients were transferred, largely to test the system.
- It is still the strategy to exhaust in-house capacity first.
- Given the current projections, the need to activate referrals to private hospitals for COVID patients, diminished.
Status: Temporary mass fatality facility
Metro Mass Fatality Centre:
- The facility is now fully operational and receiving cases, assisting in scientific identifications where required, issuing the DHA1663 (Cause of death notification) along with bereavement counselling to those families visiting the Centre.
- The facility currently has 28 cases admitted.
- Rural Preparedness for fatalities: the mortuary container, currently at the CTICC Hospital of Hope, will be moved to rural areas as required, to assist with mass fatalities in rural areas.
What is surveillance?
Epidemiological surveillance is the systematic collection, analysis and dissemination of health data - in this case, data on COVID-19 - for the planning, implementation and evaluation of public health programmes. Surveillance aims to identify infections before it becomes outbreaks, to limit the spread of disease and to enable public health authorities to manage COVID-19 risk.
Re-introduction of Comprehensive Clinical Services
Comprehensive clinical services will be re-introduced onto the clinical service platform from the first week in August 2020
Prioritised five main areas for review:
- Containment Strategy
- Health Platform response
- Corporate Response (including Occupational Health Safety (OHS))
- Health Intelligence, Organizational learning and Information Technology (IT) Systems
- Governance for Health (other sectors)
For full presentation, see attached document.
Ms W Philander (DA) thanked the Department for the update. Employee contact tracing mentioned the decentralised approach. Regarding this, she asked if the Department issued any assistance or directives of guidance to the sector to ensure the pandemic is contained, and ultimately diffuses the chances of a second wave of infections.
Secondly, she asked what additional measurements are in place to deal with the possibility of a second wave of infections.
Ms R Windvogel (ANC) asked if decommissioning the CTICC’s Hospital of Hope is premature, considering the country just moved to Level Two.
Secondly, she asked what time period is allocated to address all factors leading to the high infections in hotspot areas.
Lastly, she asked for a breakdown of the number of healthcare workers at the Hospital of Hope who were employed permanently, and had been employed in other provinces. She asked how many will be sent to different facilities, and how many seasonal workers were employed.
Mr M Xego (EFF) said the public healthcare system struggled with its facilities. The resources ought to be kept for permanent arrangement to improve the South African public health system. Facilities must not be demolished post-Covid but rather be further used for the country.
Lastly, he asked how the Department explored a vaccine.
Mr B Herron (GOOD) asked if the Department did any modeling or trajectory, regarding if it was heading towards a virus free province. He asked what Dr Cloete meant when he spoke about an initial surge, and asked if he anticipated resurgence.
He asked why the testing criteria were being reviewed.
Regarding the CTICC Hospital of Hope, he asked what the peak admission numbers were.
Lastly, he wanted to know what the capacity of the Brackengate facility is, as well as its operational costs.
Mr F Christians (ACDP) asked how certain the Department is about each and every area within the Metro having reached its peak. Coming to the second wave of infections, he asked if the modeling took this into account.
Concerns are circulating about the availability of alcohol. He asked if there was any type of engagement between Departments on how to manage the situation correctly.
Lastly, he asked if any timeline was supplied regarding when transmissions are likely to stop, as well as the curve flattening completely.
Mr P Marais (FF+) said he was vehemently opposed to converting the Convention Centre into a hospital. He believed there were other options, and it was ultimately a waste of money. He asked what influenced the decision to close the Hospital in the current month of September. He asked if in hindsight the Freedom Front Plus was right, while the Democratic Alliance was wrong. He wanted more information on the average utilisation efficiency of the CTICC, along with what percentage of the 800 beds were never occupied at any particular moment over the past few months.
The Chairperson asked if the testing criteria changes, assuming everything else stays the same going forward, would the results be different.
Dr Cloete replied, saying part of the Department’s Mitigation Strategy Review is to look at its behavior chain strategy in every geographic area. This includes every rural and sub-rural district. The Department is looking at mechanisms, as well as enhancing mask uptake and behavior changes in every one of those geographic areas. The CTICC was commissioned for 860 beds at the peak. Its highest utilisation was 400 beds.
On staff members he said, the Department’s plan was to employ 900 staff members. However, it only employed sufficient staff members to be able to manage 400 beds. Above this, no additional staff was employed. Each of the staff members had an opportunity to be redeployed. Many of the staff members employed at the CTICC were re-interviewed and appointed to work in the Garden Route.
There is a big portion of the nursing staff who comes from KwaZulu-Natal, and are on short contracts. The use of agency staff radically decreased during the pandemic period. The Department offered everyone the opportunity to be absorbed into other places within the Department’s organizations, in accordance with staff needs.
The peak occurred during the June-July period. The Department made sure it had sufficient capacity with staff and beds. All the other private and public hospitals were running at full capacity. In hindsight, it was still the right thing to do. The Department is not extending any contracts. It will vacate the premises and hand it over in accordance with its initial contract, which was to have the place until the middle of September.
Brackengate has 330 beds. However, it was running approximately 50 patients in the previous week and 70 patients in the current week. The Department believes every geographic area reached its peak. Khayelitsha is the furthest down from the peak. The closest to the peak, which only began to go down recently, is the Garden Route.
There were fewer cases at the peak than originally predicted. There was an overestimation of how many people were susceptible to Covid-19. The second thing is, it moved at different paces, along with the impact of behavior change from time to time. The Department’s surveillance strategy aim is to get to a situation where it gets very close to no new cases or no new cases at all. Its proposal is for it to work from a strategy where if there happens to be a small outbreak, the Department can catch it early to avoid it developing into a big outbreak.
It is in communication with, and working alongside the Departments of Community Safety and Economic Development to combat the alcohol issue. From an economic perspective the Department understands the wine industry must go back to what it should be doing. However, it is strongly working with these two departments to establish regulations or restrictions to minimise the impact on the health care system and society in general.
Independent Schools Association of South Africa (ISASA)
Mr Lebogang Montjane, Executive Director for ISASA, said ISASA is the largest and oldest Independent Schools Association in Southern Africa. It has 851 member schools, of which 793 are South African. It has over 15000 educators and over 200 000 learners. There is a significant range of membership, from low-fee (or no-fee) to high-fee schools. It quality assures schools on application for membership, and every six years thereafter.
Reduced Cost Connectivity for Member Schools
ISASA managed to negotiate special pricing on data and devices from South Africa’s largest mobile networks, Vodacom and MTN. Both providers agreed to make standard data available at a reduced cost, as well as URL-linked (site-specific) data at a significantly reduced cost, for the duration of lockdown. Several device options are also available from each providers. ISASA is also exploring the possibility of extending this special pricing beyond the lockdown period.
ISASA’s Role: Collegiality
- Maintained a strong connection between member schools, even during lockdown and school closures.
- Significantly Ramped Up Online Presence:
-Frequent website updates.
-Many online meetings relating to COVID regulations.
-Several meetings for schools simply to discuss issues amongst themselves.
For full presentation, see attached document.
Governing Body Foundation
Dr Malcolm Venter, Executive Officer for the Governing Body Foundation, said many factors impact school governing bodies.
- Lack of information
- Late information
- Changing information
- Contradictory information
School Governing Body’s (SGB) not at schools:
- Principals going it alone
- SGBs going it alone
- Trying to connect but not able to
- Issue of virtual meetings
Financial and Staff Issues
- Fees / fund-raising declined
- How to handle non-payment of fees : Do not need to pay, Cannot pay
- Impact on staffing and dealing with reduced salaries / retrenchments
It draws on:
- Western Cape Education Department (WCED) officials
- Labour lawyer
- Industrial psychologist
- Own experience and training
- Giving clear and timeous information, filling in gaps
- Taking stands and showing leadership
For full presentation, see attached document.
Federation of Governing Bodies of South African Schools (FEDSAS)
Mr Tony Marshall, Deputy Provincial Manager, FEDSAS, said FEDSAS is a national Non Profit Organisation (NPO), with head offices in Bloemfontein and branches in all provinces. FEDSAS focuses on developing effective and efficient school governing bodies to deliver quality education in public and independent schools. Its advice, training, and facilitation are based on applying law and policy, including King Four principles, for governance and school management.
FEDSAS supports the preservation and promotion of a culture of excellence in teaching, education, and service delivery. It continuously strives to establish and build healthy relationships with all stakeholders in education to serve the best interests of learners. It meets with WCED management at provincial and district levels, education labour unions, and education sector stakeholders such as other NPOs and Non Government Organisations (NGOs) regularly.
FEDSAS has a full-time education law desk of specialists to support members. It assists governing bodies across the spectrum of school governance, including staff appointments, labour relations, strategic planning, and financial management. Western Cape FEDSAS has 550 members in all Quintiles, half of whom are no-fee schools. This amounts to more than a one in three schools in the Western Cape.
Covid-19 Activities New Reality
Changed modes of interaction:
- National and provincial webinars
- Radio – national stations
- Zoom tailored sessions
- Newsletter and newsflashes
- Social media platforms
What FEDSAS found?
- WCED Guidelines are practical and useful.
- WCED feeding scheme is vital but safety is required at all schools for collection.
- Online and Distance learning depend on auto-didacts: learners who are self-starters.
- Printed work for learners is a praiseworthy solution but monitoring is essential.
- Fake news and anxiety created unnecessary disruption.
What more can be done?
- Support trustworthy, sensible information and behaviour.
- Support the school feeding scheme and trimmed curriculum delivery.
- Retain the moral high ground of the best interests of the learners.
- Develop job opportunities for the youth.
Ms L Botha (DA) asked ISASA how the parents who requested a break in school fees are accommodated. She asked about the number of teachers who teach from home because of co-morbidities.
She also asked for clarity on how teachers were assisted about fears.
Mr G Bosman (DA) asked what the future of independent schools will be under the hybrid model. Addressing the Governing Body Foundation, he asked what methods are used to give a learner a voice in the Governing Body Association, as learners are legally supposed to be involved in the Governing Council. Lastly, he asked what percentage of Members asked for access to psycho-social support during the pandemic, and if any was provided.
Mr K Sayed (ANC) referred to slide nine, and asked if the deviation will widen the inequalities in education. He asked for statistical information on how many schools were assisted with discrimination workshops. He also asked how the organisation assists with complaints around racism and discrimination, especially in the formal Model-C schools. Addressing the Governing Body Foundation, he asked for engagement on the disconnect it noted in the presentation, and what challenges it presented, including which matters were basically affected. Lastly, he wanted to get a sense about the impact of retrenchments and reduced salaries, including how many people were affected.
Mr Christians said non-payment of school fees leads to an increase in the teachers: learners ratio. The increase of the ratio in the classroom for teacher – learners is particularly concerning, but he said he is unsure if there is an answer on how to deal with it.
Mr Marais asked ISASA who it was who gave consent for deviation from directions, and what the nature and extent of the deviations from the directions are. He wanted to know if ISASA felt there was enough public participation when it comes to both the Western Cape Education Department and the National Department of Education.
Mr Montjane said all parents who had difficulty paying school fees, or who lost jobs, were encouraged to contact the respective schools to make provision, and alert the schools to the situation. Parents who paid school fees prior to the lockdown will be treated differently to those who were in arrears before the lockdown began. Each school makes a determination about payments and loss of revenue, but schools work really hard to give discounts on an individual basis, and based on the needs of each family. One of the greatest advantages of the independent schools is that it is able to continue with online learning. As a result, those teachers who have co-morbidities did not have to go back into schools. These teachers were either assisting with marking, or teaching remotely.
It is basically a way of honouring social distancing. Students attend classes every two to three days. The hybrid model seems to be working well for independent schools.
ISASA unfortunately did not interact with teachers because of structures, but each school is trying to do psychosocial support. As a startup, it needs to do a lot more regarding this, which is why it is working on it. The divide can clearly be seen between fee paying and non-fee-paying schools. As stated by the Governing Bodies Association, it continues to work and teach. The Western Cape did an excellent job with food parcels and delivering cellphone data deals. Regarding telecoms, it is beginning its discussions with telecom companies, and will hopefully be able to reach an agreement. However, it alerts Members as parliamentarians to take an interest in ensuring those deals are made available to all learners within South Africa and not only those from independent schools.
Regarding discrimination, he said the organisation worked extremely hard to educate members about inclusion. However, it saw its efforts for inclusion had not necessarily worked.
School readiness is a passion which happens to be a problem within the country. It is what distinguishes children whose parents are educated and those who are middle-class. Children need to be prepared for school readiness. It is a main factor for not doing well in education, because children are going to school not having gross motor skills, not knowing primary colors, not being pre-numerate and pre-literate. He encouraged everyone to support the Governments move to education and said the WCED always supports its efforts to achieve this goal.
Dr Venter (GBF) said regarding learner’s role in governing bodies, it does not have any sort of picture regarding this, but suspects there was not any sort of particular involvement. Governing bodies and schools were not as involved as what it used to be, and schools differed in the extent to which it brought learners on board. There was a big disconnect between governing bodies and learners.
Regarding retrenching staff, he said he does not have precise information about it. The implications of the ratios are not a good thing. In fact, there will not be any more teachers next year. This means no more state employee teachers for next year, but more learners in schools. The entity’s interactions with the WCED is not a very exciting one, but it always listens and tries to take things into account. He is not into the trend of praising the WCED, as he believes in not taking sides but rather speaking from factual experience.
Mr Marshall said the idea of fake news items, particularly on social media, regarding the opening or not opening of schools is concerning. He believes the most damaging is the fake news about medical information or misinformation. He commended the marvellous resilience of people who went back to schools and are currently running the schools very well. Everyone with co-morbidities were given a death sentence. People were told not to go near schools because children are going to be infected, and can die as a result, along with the person who has the co-morbidity. Diabetics were said to be sure to die. All this misinformation or information which was not relayed properly created a shockwave of anxiety throughout not only schools, but the country in general. Governing bodies must be very careful in how it negotiates those particular areas when dealing with the decision to open or not to open. Very often the governing bodies consider what is best for the school, along with the same issues of fake news, not to mention sanitising schools, delivery of personal protective equipment (PPEs), and various other elements which only add to anxiety and stress levels.
Its principals, schools, and governing bodies, handled the situation not only to the best of its abilities, but with dignity. It based all its information on medical information and erred on the side of caution. Regarding training, it had a lot of training with governing bodies around governance and management. One element of training is the management and government distinction. While the other is for the entity knowing what is available to it, and where its limits are.
Lastly, the election of the Chairperson is something which was done online. The Department of Basic Education (DBE) required governing bodies to be fully stocked with parents.
Mr Montjane said the directions from the National Department of Education as issued by the Minister, indicated if a school wanted to bring in different grades earlier than those set out in the directions, it can apply to the Head of Department of its Province to deviate. It must indicate which grades it wants to bring back to school, which is what the Western Cape Education Department did.
All schools in the Western Cape had to indicate compliance with the Covid-19 provisions, and also enforce social distancing. Those deviations came out of the law itself. It is therefore a legal act.
Regarding school fees, many schools are actually increasing fees. The Independent Schools are seeing the increase of school fees at a much slower pace than previously. While its subscription for the next year will increase for its Members, it suspects the increase of school fees will not be something all will implement, and if done, will be much less than before.
The Chairperson thanked the delegation and Members for attendance. Due to running overtime it was put forward the meeting minutes be dealt with in the next meeting. All agreed.
The meeting was adjourned.
Mackenzie, Mr R
Allen, Mr R
America, Mr D
Baartman, Ms DM
Bosman, Mr G
Botha, Ms L
Christians, Mr F
Herron, Mr BN
Lekker, Ms P
Marais, Mr PJ
Mbombo, Ms N
Mitchell, Mr D
Nkondlo, Ms ND
Philander, Ms W
Sayed, Mr MK
Windvogel, Ms R
Xego, Mr M
van der Westhuizen, Mr AP
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