Flying Buddha

28/11/2021

https://youtu.be/uiW3eyIyD3U

World Health Organisation special envoy for COVID-19, David Nabarro, says travel bans won't help keep South African variant at bay.Flights to the UK from six...

16/03/2021

ONE YEAR REFLECTIONS
Dr Sheri Fanaroff
16 March 2021


It is difficult to comprehend that it is one year since the first COVID-19 case was diagnosed in South Africa. Last year this time, we could not predict the massive changes that were about to permeate our daily existence. Twelve months have been a massive learning curve for the global medical community and have permanently changed the world as we knew it.

One year ago, when I wrote my first “Coronavirus Update” on 15th March 2020, we had 61 confirmed cases of COVID-19 in the country, nearly double the previous day’s. There was not yet community spread in South Africa. People were fearful of getting ill and everyone was desperate for knowledge on how to keep safe. Six months ago, I wrote an update called “Reflections”, documenting events of the prior six months. At this time, on 15 August 2020, there were 583 653 cases in South Africa and 11 677 deaths. Just over a year after our first South African case, we are at the end of the second wave and have identified 1 530 033 positive cases and 51 421 deaths due to COVID-19. The number of cases has tripled and deaths have gone up nearly five times in the last six months.

WHAT DO WE KNOW IN MARCH 2021 THAT WE DIDN’T KNOW IN MARCH 2020?

1. IT’S A MARATHON, NOT A SPRINT
At the beginning of the first lockdown, the impression was that if we could hold out for the three weeks of lockdown, we would “flatten the curve” and life could go back to normal. As three weeks became five weeks of level five lockdown, followed by months of extended restrictions, school closures and ongoing lockdowns, we realised that we were going to have to live with and adapt to the “new normal”. In March 2021, as we go about work and school in Level 1 lockdown, we need to be aware that the question is not “Will there be a third wave?”, but “When will the third wave be?”. With vaccines rolling out at an excruciatingly slow pace, we will need to continue to observe COVID protocols until we have reached herd immunity. This is daunting, because we don’t yet know the exact length of the marathon - however, like with viruses that have afflicted past generations, “This too shall pass”.

2. MASKS
In March 2020, the WHO, the CDC, the SA Department of Health and all global authorities were advising that masks were not necessary for the general public, but should only be worn by sick people. This was partly due to the shortage of masks and PPE for healthcare workers, partly because the transmission of the virus by asymptomatic individuals was not yet fully understood, and partly because there was a concern that masks worn incorrectly could get contaminated. It was only in April 2020 that “Masks for all” became policy. Recommendations for cloth masks for the public have been proved to be one of the most effective ways of reducing transmission of spread of COVID-19, and together with social distancing and hand hygiene, were responsible for aborting the winter influenza season. While several groups continue to protest the use of masks as unnecessary, unhealthy or unconstitutional, recent recommendations in March 2021 in fact promote the use of TWO masks as studies show that “double masking” is even better at preventing infections.

3. QUARANTINE AND ISOLATION GUIDELINES
These have shortened from 14 days in March 2020 to 10 days in 2021. The US gives the option for an early end to quarantine in people who have been exposed (a negative test on Day 5 to 7 means they can return to work on Day 8). This however, comes with the risk of a 5 to 12 percent infection rate on day 8 to 10, whereas after the full 10 days of quarantine, there is only a 1% risk of infection. The South African Department of Health and NICD have stuck to a ten day quarantine period both for quarantine (contacts) and isolation (infected people).

4. GROCERIES AND SHOPPING
In March 2020, we were more worried about the risk of picking up the virus from infected surfaces than we are this year. At that time, we were advising people to wipe down and sterilize all parcels brought in from outside. In March 2021, we know that although the virus survives on surfaces for hours to days, there has not been documented transmission from touching surfaces or food. However, stringent hand hygiene remains important, and washing hands well after touching surfaces and before eating or touching your face remains prudent.
Last March with the threat of lockdown and toilet paper shortages, people were urged to “stock up but not stockpile” so that they would have enough to sustain them through lockdown without contributing to shortages. In March 2021, despite not being free to buy alcohol after curfew, the panic has passed and most products are available.

5. SOCIALISING, VISITING AND GATHERINGS
Last Easter and Pesach, doctors were urging people not to visit at all outside of their immediate family circles. This year, with case numbers relatively low, it seems reasonable that families share these special holidays together WITH CAUTION. I would still advise socialising within a restricted bubble, maintaining social distance, keeping masks on and eating outside and at a distance of two metres. Gatherings where families are eating together should not be more than two or three families, family units should sit together to eat, and food should preferably be served by one person with sanitised hands. Large functions still carry a high risk of infection. Older and vulnerable people need to do a risk/ benefit analysis and decide whether they can attend safely if all COVID protocols are in place.

6. TRAVEL AND EATING OUT
Last March, interprovincial travel was prohibited and restaurants were closed,, but now these are possible. I often repeat that “It’s people that are the problem, not places''. The COVID risk is much the same wherever your location, and if the basic principles of social distancing, mask wearing, staying in ventilated spaces and hand sanitising are observed, risks can be kept to a minimum. Travel in aeroplanes and taxis needs to be done with strict protocols in place. International travel has changed and one now needs a negative PCR test in order to travel overseas. Some countries have introduced Immunity passports or green passports where only vaccinated people can access travel, restaurants or even beach chairs. In South Africa, we are a long way from this situation.

7. SCHOOLS
We now know that children are much less likely than adults to develop severe COVID illness, less likely to transmit it and seldom the index case in a family outbreak. As such, children are encouraged to attend school in person rather than online, with all the social, medical and physical benefits that school provides. Children under the age of 6 are no longer required to wear masks in public. Schools have made major progress in using blended learning and online platforms to educate students, and have become adept at mitigating students’ risks by applying COVID protocols.

8. TESTING
One year ago, COVID PCR swabs were the only tests available and were limited to people with symptoms who had travelled or been exposed, due to testing shortages. In March 2021, there is no shortage of tests and thus the criteria for who can get tested is less strict. In certain cases, contacts of positive patients are encouraged to test on day 7 or 8 even if they remain asymptomatic. In March 2021, although the PCR test remains an expensive gold standard, we now have a broader spectrum of tests available, including rapid antigen tests,and antibody tests (NB antibody tests can only show exposure after about ten days and cannot diagnose new infections). Last year this time we were waiting four to seven days to get PCR tests back, while now we receive results in 6 to 24 hours. Rapid antigen and antibody tests can give results in ten minutes but are less accurate than PCR tests and a negative test should be viewed with caution.

9. TREATMENTS
A year into the pandemic, doctors are much more knowledgeable and better prepared to treat COVID-19. The speed of development of medications and sharing of information, both locally and internationally has been unprecedented. Multiple trials of old and new drugs continue to be done on a large scale around the world. Medications like Remdesivir, convalescent plasma, cortisone, anticoagulants and colchicine are now widely accepted and used. Vitamins are routinely used, although only Vitamin D shows definite benefits in trials. Other medications like chloroquine, initially thought to be promising, have proved disappointing. Still others, like Ivermectin, remain controversial. Although small studies and anecdotal results have shown good results, the bigger randomised trials that have been completed are not showing the expected benefits.

10. VACCINES
In March 2020, few doctors would have believed that it would be possible to have vaccines available within the space of one year. Although our country has been frustratingly slow in the initial rollout, the healthcare workers trial at least means that we have started.
Below is a link to a South African vaccine calculator, that allows you to see how many people are in front of you in the vaccine queue and when you can expect to be vaccinated.
IF all goes according to plan, elderly people or those with comorbidities can expect to be vaccinated by the end of July. Of course this hinges on vaccines that have been purchased from various sources arriving in the country on time and an ability by the government to set up and manage vaccine venues where these can be delivered. It does seem like an impossible task, but I remain optimistic that the pace will pick up and we will get going soon.

https://www.omnicalculator.com/health/vaccine-queue-sa

11. FLU VACCINES
This is one thing that hasn’t changed from last year. I highly recommend that both children over six months and adults get vaccinated against Flu again this year. We expect a third wave of COVID in Winter (following patterns from the Northern hemisphere). Influenza can present very similarly to COVID-19 with high fevers, body pains and a cough, and having a flu vaccine massively diminishes this risk. Flu vaccines are expected to be available at the end of March or the beginning of April. Elderly people or those with respiratory illness can also consider vaccines against pneumococcal pneumonia like Pneumovax and Prevenar if they haven’t had them. Please discuss these with your doctor.

12. NEW STRAINS
In March 2020, we were just starting to learn about what the coronavirus was. Unfortunately, coronaviruses mutate, and there are now multiple new strains around the world, including the highly transmissible 501.V2 variant attributed to South Africa. Last week two more new strains were identified in South Africa. The months ahead will reveal the effects that these will have on infections and vaccines. It is likely that vaccines will have to be continually updated to be effective against new resistant strains.

CONCLUSIONS
One year ago, I quoted Michael Leavitt , a former US Health and Human Sciences secretary, who wrote in 2007, “Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate.” While it sometimes feels like the South African response has vacillated between “alarmist” and “inadequate”, I do think that, on balance, we have handled the pandemic better than most countries. The next six months, which include Winter, will be critical as we endeavor to keep the inevitable 3rd wave under control and hopefully steadily increase the number of vaccinated individuals. If we continue to be careful, I am hopeful that I won’t be writing these updates in March 2022.

07/02/2021

Local is Lekker

Check out the best spots to braai and picnic in Durban this summer. Explore your local parks & reserves & check out the best places to put down the picnic basket and set up the braai.

28/01/2021

Beautiful South Africa

My return to Londolozi after an eight month stretch away from work due to the pandemic just happened to coincide with some absolutely phenomenal game viewing. Ok, it’s phenomenal all ...

31/12/2020

As a second wave of Covid-19 hits the country and we are plunged into a harder lockdown, we answer your frequently asked questions on what you can and cannot do.

16/12/2020

Is it still safe to go on Holiday this December?
Dr Daniel Israel


Enraged by the ‘Rage’ outbreak and ambivalent about upcoming ‘simple’ travel plans, patients have increasingly contacted me this week, enquiring as to the safety of going on holiday this December. What a complicated - yet unsurprising - situation we have landed in, as we reach the “pot of gold” at the end of an isolating and protracted 2020. Internationally, COVID-19 is still unremitting and in most countries, even those with the best preventative measures in place, a significant second wave has occurred at a mean of 57 days after the first wave.

We all expected another rise in cases in South Africa. What is unique to South African is that this potential second wave coincides with our festive season. With a 2020 mantra of ‘stay home save lives’ in mind and now apparent proof that those who didn’t stay home and attended the matric Rage celebrations indeed contracted COVID-19, our community members are justifiably asking questions like ‘Doctor, am I crazy to be going to Umhlanga next week?’

The April 2020 level 5 lockdown was partly informed by panic. Our understanding of COVID-19 has evolved significantly since then. I clearly remember the WhatsApp video clips I received of citizens in Wuhan seemingly dropping dead from COVID-19 after ‘breathing in its air’ in April. We have since learnt that COVID-19 is spread primarily through respiratory droplets. Its main route of spread is direct contact, at less than 2m, and that simple mask wearing reduces the risk of transmission significantly. Conversely, in the initial weeks of this pandemic, it was unclear as to how sick a patient had to be in order to transmit the virus to another individual. We have since learnt that asymptomatic transmission is very real (as seen at the Rage festival). We have, therefore, learnt to take precautions. Another real shift in understanding has been the shift from sterilising surfaces to sterilising hands. I may not have let my children sit on a public bench in April 2020. Today, I maintain my focus on cleaning hands. These examples of the evolutions of COVID-19 knowledge talk to the point that we are much better equipped to go on holiday in December 2020 than we would have been 10 months ago.

There is no doubt in my mind that the safest way to live through this pandemic is to confine yourself to a room indefinitely. Don’t leave. Ensure you pass sterilised food only through a small crack in the door, and you will not contract COVID-19!

In reality, the challenge on mental and developmental health on a personal and family level as a direct result of COVID-19 isolation measures has never been greater. I am still, every day, seeing patients with significant depression, anxiety, loss of income and relationship breakups as a direct result of ‘preventing’ COVID-19. We need a holiday more than any other year. Holidays help recover relationships, shift perspectives and allow for rejuvenation.

CAN YOU GO ON HOLIDAY SAFELY THIS DECEMBER?

In my mind, absolutely yes. Safe holidays require a return to boring basics though. (I have attempted to stratify the following tips in order of importance in my mind)

• Ventilation at social interactions is vital. Unless you are exposing yourself to family you live with, all other social interactions should happen outdoors or at least in VERY well-ventilated spaces.

• Masks work. Pics with friends look great with masks too. Set the tone of: It’s cool for us to have fun and wear our masks too - just in case.

• Avoid Large Crowds. Full supermarkets with social distancing and sanitising are not ‘large crowds.’ Packed night-clubs, clubhouses or concerts are.

• Hosting guests over for a meal must be done with thought. Ensure that there is at least a 3m distance between you, if you are eating, and do so for as short a time as possible. Serve the food while wearing masks. Let the host do the serving as much as possible.

• Alcohol magically washes masks away and closes distances. Take extra precautions if you drink.

• If you feel unwell, contact a doctor and get tested. Do not go to work or socialise. Identifying a positive case early prevents major outbreaks. The Rage super-spreader event started with a couple of cases at most.

WHAT IS THE SAFEST WAY TO TRAVEL TO AND FROM YOUR HOLIDAY?

Car travel with adherence to festive season road safety is certainly the safest option. It also allows for possible return home should you become infected. However, a study published in the JAMA Journal in October 2020 showed that with the new air travel regulations implemented, the incidence of COVID-19 cases were negligible.

I recently flew. Scrutinising my trip, these are my tips for safe air travel:

• Wear a well fitted mask throughout the process. Door-to-door. A 3-layer cloth mask (or a medical mask if they are available).

• Don’t touch your eyes or your face on the flight.

• Use your hand luggage as a barrier to ensure other passengers do not come too near to you during embarking and disembarking.

• Stay in your seat at the departure gate or on the plane until there is ample space for you to move.

• Keep the air vent above your seat blowing on you throughout the flight. (The air is HEPA filtered).

• Try not to eat or drink on the flight. You can manage a short flight without refreshments.

LASTLY, HOW ABOUT ‘HOTSPOTS’? SHOULD YOU BE ANXIOUS IF YOU ARE TRAVELLING TO PLETTENBERG BAY ON THE GARDEN ROUTE AS OPPOSED TO THE MAGALIESBERG?

The most challenging issue with ‘hotspots’ is the relative lack of resources for patients who may complicate in that region. For example, ICU’s in the Garden Route have been saturated lately. If you are a patient with significant co-morbidities and lack the means to be privately transported home early in an infection, I believe you may want to reconsider your choice. It is prudent to avoid indoor restaurants and bars. However, it is important to remember that by adhering to basic principles and daily keeping in mind that COVID-19 is still with us, even in the hottest spots in South Africa, you can enjoy a well-earned holiday and pace yourself for a better and healthier 2021.

Dr Daniel Israel

16/12/2020

Unique Experience of the Kruger, suspended over the Sabie River.

One of the most anticipated and exciting new offerings coming to the iconic Kruger National Park, South Africa. A perfect combination of Africa’s most breathtaking natural splendours with well-deserved luxuries aboard a newly refurbished train that’s reminiscent of African excellence.

Permanently stationed in Skukuza on the historically-rich Selati Bridge above the Sabie River, Kruger Shalati will offer the most unique luxury accommodation in a re-envisioned train

The Kruger Shalati Train on a Bridge is officially open to visitors. The hotel incurred various delays due to COVID-19 but is now ready to welcome guests.

15/12/2020

09/12/2020

Don’t make the drive a mad dash when there’s so much to see along the way. Nick Yell has some suggestions

29/11/2020

27/11/2020

The New Normal🙏

22/09/2020

HOW TO TRAVEL SAFELY IN THE TIME OF COVID.
Dr Venitha Seeraj
Dr Karin van der Merwe


Travel using any form of public transport poses risks for contracting COVID-19. One should always weigh up the risk of travel versus the benefit of the trip. In other words, only travel if really necessary. Do not travel if you have any symptoms suggestive of COVID-19. If you have had contact with someone with COVID-19 you should not travel for the 14 days you are in quarantine. It is preferable not to travel if you are at high risk for severe COVID - age more than 60 years and/or comorbidities. If you live with someone who is at high risk it may also be a good idea not to travel

Before your trip make sure you know the quarantine procedures and health facilities available at your destination. Enquire whether your medical insurance will cover medical expenses due to COVID-19. Some international flights require you to have a negative COVID test before flying. Find out the incidence of COVID-19 at your destination so that you can assess the risk and implement extra precautions as necessary.

During travel it is very important to abide by the basic principles of COVID-19 prevention:
Wear an appropriate mask at all times. Consider getting an N95 mask or surgical mask as these probably offer slightly more protection than fabric masks. Take spare masks and a clean plastic container with you to store your mask while eating or drinking.
Keep 1.5 - 2m distance from people. This may not be possible in fixed seating arrangements like aeroplane cabins but should be observed whenever possible.
Limit contact with frequently touched surfaces. Have some wipes with you and wipe down your seat, arm rest, tray and anything else you may touch. Clean and sanitize hands after touching any surfaces. Remember to take sanitiser in a container with a volume less than 100ml, otherwise you will not be allowed to take it onboard.
Avoid contact with anyone who is sick.
Avoid touching your mask, eyes, nose and mouth.

Airports and train stations are high risk areas due to multiple surfaces touched by many people, crowds of travelers and rebreathing of air.

AIR TRAVEL
Reassuringly, no super spreading events have been traced to a specific flight. Transmission of COVID-19 between passengers in the aircraft cabin is low as most planes have HEPA filters (High Efficiency Particulate Air Filters). These block 99.7% of airborne microbes. Cabin air is circulated vertically from ceiling to floor and refreshed every 2-3 minutes. Regulations require that cabins are wiped down with antimicrobials between flights. Check airline policy on their website on cleaning procedures of the cabin.
There is usually no/limited food or beverage service to limit contact between customers and crew. If you are able to, sit next to the window as aisle seats have more people moving past and therefore theoretically higher chance of infection. Studies show that most illness is likely to be transmitted only to passengers within 1 row of the infected person. However, if a crew member is ill they could potentially infect an average of 4.6 passengers according to a study done in 2018 after the SARS outbreak. Decrease your bathroom visits rather use the airport restroom as these are cleaned more often. Stay in your seat for the entire journey if you can and decrease stretching your legs or using the overhead storage bins. Try to fly during off peak times to decrease the amount of people on the flight. Boarding the plane - when the ventilation system is not running and people are unable to stay distanced from one another - is one of the riskiest parts of the travel process. Minimizing this time period is important to reduce exposure - get to your seat with your mask on and sit down as quickly as possible.

Remember the flight itself is probably not the most dangerous part of the trip. If you take an Uber or taxi to the airport, wipe down the seat, and door handles and keep the window open. It is advisable to sit at the back and to handle your own bags. If you rent a car, it’s surfaces also need to be wiped down.

Be extra vigilant at the airport. Use an airline app to check in. Opt for touchless boarding and cashless transactions. Avoid eating at the restaurants by taking your own food when possible. Decrease any items in bags that may warrant searching of the bag. Have sanitizer available. Wipe your baggage handles on collection. If you need to be patted down for security reasons, the officer should wear a clean glove.

The lockdown is on its way out but COVID-19 will be with us for a while. As we are able to travel more freely, it is prudent to do so as safely as possible.

16/09/2020

SA Moves to LEVEL 1 ... Download the CovidAlert App

What is COVID Alert SA? COVID Alert SA is South Africa’s free exposure notification app. It lets people know when they have been in close contact with someone who has tested positive for COVID-19. Who can use it? Everyone in South Africa who has a Bluetooth-enabled smartphone

18/07/2020

Next Stop , Everywhere.....

Renowned industry experts weigh in on the million dollar (travel) question: where to next? May their answers inspire you to reclaim your love of travel.

05/04/2020

As the world’s largest international airline, we will one day reconnect the world and fly you better than ever before.

14/03/2020

The ongoing coronavirus outbreak is having significant impact on travel around the globe. Also known as COVID-19, the speed with which the outbreak is unfolding has created an atmosphere of uncertainty for travelers wondering if they should alter their plans. Travel is a personal choice and we encou...

11/03/2020

You don't know what you don't know. Travel agents make your trips better, easier, less stressful, and often cheaper.

28/02/2020

World Health Organization Safety Tips ..

26/01/2020

A SARS-like virus has claimed 26 lives since emerging on December 31 in a market in the Chinese city of Wuhan.

20/12/2019

Happy Holidays!

09/12/2019

Insight on the Hong Kong Protest.

14/11/2019

A seven-hour layover has never looked so appealing.

12/08/2019

Top 10 Most Dangerous Airports in the World

top 10 most dangerous airports in the world 2019 including their dangerous runways Many pilots believe that the most dangerous stages during the flight - are...

11/06/2019

Amazing Accommodation in Umhlanga ...
School Holidays around the corner...

http://www.airbnb.com/rooms/33767600

Entire home/apt in Umhlanga, South Africa. This spacious, inviting, and modern family house is like a home away from home situated in a central area of Prestondale, Umhlanga. This neatly fur...

19/05/2019

South Africans Injured.
https://www.cnn.com/2019/05/19/africa/egypt-museum-blast-tourists-intl/index.html

At least 14 people were injured in an explosion that targeted a tourist bus carrying 25 South African citizens, Egypt's state-run Ahram daily reported.

16/02/2019

Once a year, go someplace you’ve never been before.” – Dalai Lama

Ever wonder which are the most beautiful cities in the world? New York, London, Paris, Rome, Tokyo - these are all cities that nearly everyone on the planet ...

30/11/2018

Holiday Season is loading ...Let it be a hassle free one....