Background: Non-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse.Aim: This study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave.Setting: Two public health sector primary care sites in the Cape Town Metro, including a Community Orientated Primary Care (COPC) learning site.Methods: A rapid appraisal with convergent mixed-methods design, including semi-structured interviews with facility and community health workers (CHWs) (n = 20) and patients living with NCDs (n = 8), was used. Interviews were conducted in English and Afrikaans by qualified interviewers. Transcripts were analysed by thematic content analysis. Quantitative data of health facility attendance, chronic dispensing unit (CDU) prescriptions and routine diabetes control were sourced from the Provincial Health Data Centre and analysed descriptively.Results: Qualitative analysis revealed three themes: disruption (cancellation of services, fear of infection, stress and anxiety), service reorganisation (communication, home delivery of medication, CHW scope of work, risk stratification and change management) and outcomes (workload and morale, stigma, appreciation and impact on NCD control). There was a drop in primary care attendance and an increase in CDU prescriptions and uncontrolled diabetes.Conclusion: This study described the service disruption together with rapid reorganisation and change management at primary care level during the first COVID-19 wave. The changes were strengthened by the COPC foundation in one of the study sites. The impact of COVID-19 on primary-level NCD care and management requires more investigation.
Growing evidence, including 60 confirmed deaths and >2 000 electronic cigarette-related acute lung injuries reported in the USA, [1] has prompted the banning or restriction of e-cigarette sales in some US states [2] and in >98 countries to protect the health of citizens. [3] South Africa (SA) is yet to follow suit. To evaluate the need for urgent regulation of e-cigarette use in SA, considerations of key arguments are reviewed below. Conclusions The growing evidence raises concerns, revealing harmful effects from short-term e-cigarette use. The long-term health effects are largely unknown at this stage, but current evidence points to the need for caution with regard to e-cigarettes. We call on the SA government to take swift action to avoid the public health risks of e-cigarettes and speedily pass the Control of Tobacco Products and Electronic Delivery Systems Draft Bill [33] into law, which will provide for the regulation of e-cigarettes as for other tobacco products.
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