Be Alert and Take Preventative Measures

Dear Fellow South Africans,

This morning, Thursday 5 March, the National Institute for Communicable Diseases (NICD) confirmed that a suspected case of Coronavirus (COVID-19) has tested positive.

In a statement by the Minister of Health- Dr Zweli Mkhize, it was confirmed that the patient recently returned from his travels to Italy on 1 March 2020 and thereafter consulted with a private GP on 3 March 2020. It is confirmed that both patient and doctor have been in isolation since.

What is COVID-19?

COVID-19 is a term used to identify the infectious disease caused by the most recently discovered Coronavirus. This stems from a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. These viruses cause illnesses ranging from the common cold to more severe diseases such as bronchitis, pneumonia and respiratory and multi-organ failure. Coronaviruses are spread through aerosol droplets which are expelled when an infected individual coughs or sneezes within a range of about 1.8m.

The signs of infection include fever, cough, shortness of breath, and breathing difficulties. In more severe cases, it can lead to pneumonia, kidney failure and even death.

The incubation period (the period between exposure to the virus and the appearance of the first symptoms) is between 10 – 14 days. Infected patients can also be asymptomatic, meaning they do not display any of the symptoms above, despite having the virus in their systems.

Who is at risk?

  • Individuals with a recent travel history
  • Individuals with a history of exposure to those infected with COVID-19
  • Individuals with unprotected exposure to farms and wild animals
  • Individuals with pre-existing conditions such as diabetes mellitus, asthma, cancer and other immunosuppressive conditions like pregnancy

How to take preventative measures:

Global authorities, including the World Health Organisation (WHO) and the South African NICD recommends the following:

  • Good hand hygiene (frequent hand washing with soap and water)
  • Cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing and wash hands thoroughly)
  • Avoiding contact with animals when in high-risk countries
  • Avoiding close contact with people suffering from acute respiratory infections
  • Avoiding visiting markets where live animals are sold
  • High risk individuals are advised to delay all non-essential travel until the situation abates

According to the Council for Medical Schemes (CMS), CMScript 1/2020, diagnosis and management of uncomplicated COVID-19 infection is not included in the Prescribed Minimum Benefits (PMBs). COVID-19 infection may, however, result in various complications. Most of the complications are included in the PMBs and should be treated as specified for the specific condition.

One of the most common complications of COVID-19 infection – Pneumonia – is a prescribed minimum benefit (PMB) condition under the Diagnosis and Treatment Pair (DTP) code 903D. This DTP refers to “Bacterial, viral, fungalpneumonia”. The treatment component for this condition is specified as “Medical management, ventilation”.

All medical schemes are required by law to pay for the diagnosis, treatment and care costs for this condition in full irrespective of plan type or option. Medical schemes are not allowed to fund PMB conditions from a member’s Medical Savings Account, as this is not in line with the PMB Regulations. In cases of uncomplicated COVID-19 infection where there are no PMB-eligible conditions, the scheme may fund all health care costs as per scheme rules.