Abstract:
The inaugural issue of The South African General Practitioner
(SAGP) is published in an unprecedented time of uncertainty,
fear and a 21-day nationwide lockdown. The country is rallying
to limit the spread of the spiky, single stranded RNA, severe
acute respiratory syndrome coronavirus, SARS-CoV-2. It is
hoped that isolation, quarantine, social and physical distancing
as well as stringent hygiene measures will flatten the curve to
decrease the potentially overwhelming burden of coronavirus
disease (COVID-19),1 a burden that our country can ill-afford.
Global figures of this closely watched pandemic that are being
recorded in real time on various interactive web based casetracker
maps, reveal that there are 1.4 million confirmed cases
of this infectious disease to date, a figure that is on the rise.
Approximately 20% have a severe (15%) or critical (5%) illness,
characterised by pneumonia with biochemical evidence of an
exaggerated immune response,2 and acute respiratory distress.
Treatment is supportive. There is no vaccine (yet),3 and no proven
pharmacotherapy for COVID-19, although some drugs, notably
intravenous remdesivir, chloroquine or hydroxychloroquine, and
the protease inhibitor combination, lopinavir/ritonavir, with or
without beta interferon, are being repurposed and assessed in he
WHO’s global SOLIDARITY clinical trial.4 Convalescent plasma is also being tested. The majority of patients appear to seroconvert
within 2–3 weeks of illness onset, and are theoretically able to
donate a rich source of IgM and IgG antibodies to the seriously
ill.