Expert Advice from Bonitas Medical Fund
Bonitas – innovation, life stages and quality care

All about Boosters

As the COVID-19 pandemic waxes and wanes around the globe, it is universally accepted that as many people in the world as possible need to be vaccinated to develop immunity. Depending on which vaccine you received, you will either have had one or two initial vaccines doses and then, between 2 and 6 months afterwards are eligible for a booster. Kathy Malherbe speaks to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, about COVID-19 immunity, vaccines, boosters and the way forward.  What do boosters and vaccines do? They develop immunity against infections. In the case of COVID-19, when we are fully vaccinated, we acquire what is called ‘vaccine-induced immunity’.  However, it has been shown that the immunity created by vaccines may wane over time so an additional dose of the vaccine (full or half strength) – in the form of a booster- is then given to provide the strongest and long-lasting protection possible. What exactly is immunity? Simplified, it is your body’s ability to protect you from becoming ill when you encounter a germ (virus, parasite, fungus, bacteria). It is not a simple process but essentially your body produces cells that try to stop the invading germs. This includes cells which ‘memorise’ a particular infection or germ and then recognise it when it returns and try to destroy it.  Immunity can be natural or vaccine induced Natural immunity is your body’s natural ‘fighting mechanism’ which creates antibodies to fight an infection. If you get a disease mildly (like COVID) you do not develop a powerful natural immunity and your natural immunity, regardless of how strong it is, weakens over time – faster than immunity from a COVID-19 vaccine. For this reason, it is recommended that even if you have natural immunity, you still need a COVID-19 vaccine. Why is a booster necessary when you are fully vaccinated Fully vaccinated people have proved to be well-protected from becoming severely ill or dying from COVID-19. So, you may ask why a booster then? Even though vaccines protect you, their efficacy does lessen over time, regardless of which variant of COVID, especially with people 65 years and older. This is not only in the case if a COVID vaccine. If a vaccine does not contain a live, (weakened) virus, a booster is required in most cases.  The COVID vaccine does not contain any form of live viruses and, like other inactivated vaccines, will need several doses over time to remain effective. The booster is designed to help people maintain their level of immunity for longer. It is important to know that immune responses can differ in people who get COVID-19 and recover from the illness There are many vaccines which require a booster so you’re more than likely going to receive at least one in a lifetime.  When should you have a booster shot? For those who received the double-dose Pfizer vaccine, you’re eligible for a booster shot at least 6 months after the final dose of the vaccine was administered  If you received the Johnson & Johnson vaccine, you should get a booster if you’re 18 or older and got vaccinated two or more months ago Can you have different booster shots from the original vaccine? The South African Health Products Regulatory Authority (SAHRPA) has not licensed mix and match vaccines. However, there is good evidence that mix and match vaccines are just as effective (and sometimes better) at increasing antibody levels. SAHRPA has requested submission of evidence to support this approach, so watch their website for updates.  Do booster shots use the same ingredients as existing vaccines? Yes. COVID-19 booster shots are the same ingredients (formulation) as the current COVID-19 vaccines. Some boosters have the same ingredients but it is not a full dose. J&J and Pfizer boosters are the full dose. Are there side effects from the booster shot? There is a chance you may feel like you have mild flu after your booster shot. This could include a sore and even slightly swollen arm, a temperature, a headache and fatigue for a day or two. These symptoms mean that your immune system is responding to the shots and building up immune protection against the coronavirus. Can I have a booster if I am immune compromised? Yes, but should be referred by your doctor. Persons who are immunocompromised should receive an additional Pfizer or J&J booster at least 28 days after receiving their last vaccination.  Presently, persons who are considered immune-compromised should have the same booster as the initial vaccine dose (or doses).  Even though there is talk that COVID-19 will move from being a pandemic to endemic, there’s no getting away from the fact that this virus will be part of our lives for a long time and we will need to learn to live with it. Which means that in order for the world to develop immunity against the virus, as many people as possible need to be vaccinated and also receive booster shots.  

Bonitas – innovation, life stages and quality care

Health at School

The school year is in full swing and children are as busy as ever with all their activities and homework. By following a few lifestyle tips you can keep your child healthy and cut down on their sick days says Bonitas Medical Fund.

Bonitas – innovation, life stages and quality care

Your pre- hospitalisation check list

Waves of Covid-19 and the emerging variants meant that several elective surgeries were postponed to minimise the use of hospital beds and to avoid unnecessary exposure to the virus.  As the number of infections decrease, surgeons and hospitals are catching up on the backlog of elective surgeries.  So, what exactly is elective surgery? It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience.  Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says there are pre-hospitalisation requirements for those going in for elective surgeries. Here’s a quick checklist.   Hospital networks Medical schemes negotiate preferential rates with Designated Service Provides (DSPs) who have partnered with them to ensure that members get the best quality services, at the most cost-effective rate so that benefits are optimised. If you use a network hospital, doctor or pharmacy you will not be charged more than the agreed rate. This will help you avoid co-payments and make your medical aid last longer. So, to reduce co-payments and even avoid them altogether, find a healthcare professional on your schemes network.  Pre-authorisation All procedures that take place in a hospital must be pre-authorised. Essentially, it’s an agreement between the medical aid and the hospital, indicating a willingness to pay for costs associated with the visit. But even if you do have pre-authorisation your medical aid is not promising to cover 100% of the costs.  All pre-authorisation requests are evaluated against the different schemes’ rules and clinical funding policies however, you remain responsible for any shortfall, including any co-payments. If you are unsure how to go about the process speak to your broker or your medical aid.  Quotes A quote is not the same as a pre-authorisation. Most medical aid plans have varying hospital benefits, according to the level of cover you have chosen and they also have a ‘rate’ and which they reimburse healthcare providers. This means that even if the payment is 100% of the rate, this is not necessarily what the healthcare provider will charge, they may charge 200% of your medical aid rate. Asking for a quote prior to being admitted to hospital means you will know what your medical aid will pay and what payment you might be responsible for. It gives you an opportunity to negotiate and eliminates any additional ‘surprise’ co-payments required after the procedure. Co-payments Medical practitioners, hospitals and pharmacies often charge more than medical aid scheme rates, which could be between 100% – 300% of the medical aid tariffs. A co-payment refers to the outstanding portion of the account, for which the member is responsible. This co-payment varies from one medical scheme to another and is sometimes not required if members use DSPs or network hospitals.   Day hospitals Consult with your surgeon to see if your surgery can be done in a day hospital. Globally, day surgery hospitals have changed the experience of patients by offering an alternative to acute/conventional hospital surgery. The advantages include: No overnight stay, ideal for children so they don’t have the trauma of overnight stays; there is a lower risk of infection because patients go home on the same day and there is a decreased waiting list.   Step-down facilities Your medical aid will stipulate the number of days you need to stay in hospital and check whether you will need a step-down facility when you are discharged. There are several facilities where patients can be cared for and start rehabilitation in conjunction with other medical professionals, for example physiotherapists.   Home-based care Find out if you are eligible for home-based care after your procedure. Many patients prefer to be discharged from hospital as soon as possible and receive Hospital-Level Care at home. This means good, clinical quality care which translates into a great patient experience and is also more affordable With Hospital-Level Care at Home, nurses, other health providers and caregivers are an essential element of the care continuum and play a critical role in recovery. GAP Cover Gap Cover is an additional insurance cover that complements medical schemes.  It helps to pay the difference in cost between the amount the specialist or hospital charges and the amount paid by a hospital or medical plan. You will be required to pay any shortfalls (co-payments), after which you may claim from your Gap Cover. Keep all documentation related to the surgery and hospitalisation to submit to the Gap Cover provider.  Covid-19 Test For emergency admissions, a Rapid Antigen Test is performed at the hospital but for elective surgery you are required to have a PCR test a maximum of 72 hours before admission. If your test is positive, you will have to delay your surgery by at least 10 days and then re-test. Pre-admission Pre-admission can be done a few days before you are scheduled for surgery and makes the admission process less stressful on the day. Pre-admission involves answering a series of questions and tests to eliminate the possibility of allergic reactions, drug interactions or physical complications before, during and after the surgical process. For administrative purposes the following items are required upon admission: Your identification document or passport Your medical aid card Authorisation number supplied by your medical aid, or the letter of guarantee issued by your insurer X-rays, if applicable Chronic medication, if staying overnight Dr Mkhatshwa says, ‘In addition to these, remember to take any chronic medication you are on to the hospital and make sure the doctor/anaesthetists are aware of what you are taking.  By following this checklist and making sure the surgeon and hospital have all the necessary information, you will eliminate unnecessary stress ahead of your procedure and prevent unpleasant surprises when you are supposed to be recovering.’

Bonitas – innovation, life stages and quality care

Give your body a leg up – immune boosting

Now more than ever we need to find ways to boost our immune systems as much as possible. And, while there are no medications or immunity-boosting supplements that can cure or prevent the coronavirus, there are some simple lifestyle changes we can make and steps we can take to strengthen our defences. Good nutrition can also reduce developing other health problems including obesity, heart disease, high blood pressure, diabetes, and some types of cancer. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund says, ‘Eating a healthy diet, high in immune-boosting nutrients, is just as important during this pandemic. What we eat and drink can affect our body’s ability to prevent and fight disease and recover from it. This is one of the ways in which we can improve our health proactively.’   What is the immune system? The immune system is a complex network of cells and proteins that defends the body against infection. It also keeps a record of every germ (microbe) it has ever defeated, so it can recognise and destroy the microbe quickly if it enters the body again. There is no magic pill that will instantly boost your immune system. However, together with a healthy lifestyle, various supplements can boost your immune system and give you a fighting chance.  Together with those people who have not been vaccinated, it is well documented that people with co-morbidities and poorly functioning immune systems are at the highest risk of getting really ill from Covid-19. Although you cannot suddenly reverse a co-morbidity or instantly boost your immune system, now is a good time to make your health and natural defences a priority.  Tips for maintaining a healthy diet: Eat a variety of food, including wholegrains (like maize, oats, rice, and legumes) as well as plenty of fruit and vegetables in your diet Limit salt intake to 5 grams (a teaspoon) a day Eat moderate amounts of fats and oils. Avoid saturated fat (animal fat). Try steaming instead of frying when cooking Limit sugar intake. This includes sweets, fizzy and sugary drinks. Choose fresh fruit over biscuits, cake, and chocolate Drink water. Good hydration is crucial for good health so make sure you drink enough water. There are many foods with high water content – such as cucumbers and celery – add these or lemon and mint, to a glass of water.  ‘Ideally we should try and get all our vitamins from the food we eat. However, that’s not always possible which is why taking vitamin supplements can help bridge the gap,’ says Dr Mkhatshwa. ‘The recommendation for general health is a combination of essential vitamins and minerals to keep your body healthy.’ Vitamin C: Key to fighting infection is to increase white blood cell production, eating foods high in vitamin C – such as grapefruit, oranges, sweet red pepper, broccoli, strawberries, kale, and tomato juice – are thought to help plus Vitamin C has been shown to reduce the duration and severity of upper respiratory tract infections.  Beta-Carotene: Beta-carotene converts into vitamin A, which is an anti-inflammatory vitamin that can help your antibodies respond to toxins, such as a virus. Beta-carotene is found in carrots, spinach, kale, apricots, sweet potato, apricots, and squash.  Vitamin E: Is an essential antioxidant that helps fight cell damage and supporting immune system function. Foods rich in vitamin E include nuts, peanut butter, seeds, avocado and spinach. Antioxidants: Green tea is packed with antioxidants that have been shown to enhance immune system function. It also contains amino acids that may aid in the production of germ-fighting compounds in your T-cells, which reduces inflammation in the body and helps fight infection.  Vitamin D: This vitamin also fights off infections and maintains strong bones. It is found in salmon, canned tuna, egg yolks, milk, cereals, breads, and mushrooms. Alternatively, make sure you expose your body to 13-15 minutes of sunshine three times a week for a natural Vitamin D fix. Studies have shown that Vitamin D can expedite healing and stall inflammation in the respiratory system but there has not been robust clinical evidence to prove its use against Covid-19. Probiotics: Live cultures, known as probiotics, are said to help stimulate the immune system to fight off disease. Yogurt, Kombucha, Sauerkraut, Kimchi, pickles as well certain types of cheese contain live cultures. Vitamin B-6: Is essential in the formation of new and healthy red blood cells and helps maintain the lymphatic system. Chicken, turkey, cold-water fish (salmon and tuna), chickpeas (traditional hummus), bananas, fortified breakfast cereal and nutritional yeast are great options for consuming vitamin B-6. Zinc: Is a mineral that our body doesn’t store or produce, however our Immune system cells need zinc to function as they are intended, it boosts the metabolism along with healing wounds. Red meat, shellfish, poultry, beans/legumes, and nuts/seeds are high zinc foods.  ‘During this global pandemic we need to understand that our actions are not just to protect ourselves but also those around us,’ says Dr Mkhatshwa. ‘The risk of contracting Covid-19 is higher in crowded spaces so, reiterating what the President said, we need to heed the call to make sure you socialise outdoors or have plenty of fresh air flowing through your homes and workplaces. The World Health Organization talks about avoiding the 3Cs: Spaces that are closed, crowded, or involve close contact. ‘We need to work together to contain the spread of Covid-19 especially during the various mutations of the virus. With the 4th wave upon us, we need to vaccinate, wear masks, keep our distance, follow good hygiene protocols, boost our immune systems and get plenty of exercise and fresh air.’

Bonitas – innovation, life stages and quality care

Vaccinations proving to be the best defence

As the fourth wave of Covid spreads, South Africa is seeing a considerable increase in positive cases. Just as the Delta variant became part of our daily vocabulary, the Omicron or BI.I.529 strain has too. Omicron has more than 30 mutations (double those carried by Delta) that may have an impact on how it behaves. This includes how easily it spreads and the severity of the illness it causes. The Omicron variant was found in 74% of the 249 Covid-19 samples that were gene-sequenced in November in SA. It appears with more than double the mutations carried by Delta, Omicron is virulent enough to take over from Delta. Current international data shows that there are far more positive cases, meaning that Omicron appears to be highly transmissible. However, although more people are testing positive, they are presenting with mild symptoms with fewer hospital admissions. Medical professionals believe this is a direct result of the immunity acquired through vaccinations. The first wave of Covid-19 took the world by surprise but globally everyone is better prepared for this new wave. This includes a sustained effort to vaccinate as many people as possible. What the World Health Organization (WHO), the National Institute for Communicable Diseases (NICD) and most people involved in the healthcare sector agree on unanimously, is that the best form of protection from serious disease is vaccination.  Lee Callakoppen, Principal Officer, Bonitas Medical Fund says, “We have been proactive in urging our members and the public to be vaccinated. Our statistics show that, of our members over 60, there are 90% fewer admissions to hospital after full vaccination and 56% fewer after one vaccination. Research across the public healthcare environment has shown the same results. With this information freely available it is disturbing that only 16 944 413 people living in SA have been vaccinated. This is only 35.5% of adults and 23.7% of the total population. ‘The cost of hospital admissions too, especially ICU, are very high. Our figures show that up to November 22, the Bonitas Covid-19 costs totalled R1.75 billion. 80% of this (R1 399 181 922) was hospital costs, while only 4.9% (R85 669 068) was for vaccinations.  ‘The average cost of admission to ICU, per patient, was R533 969. There is no doubt that vaccinations not only save lives but also reduce the burden on the public healthcare system, as well as save the country billions in costs related to treating Covid. Vaccinations are a fraction of the cost of treating Covid.’ Both in the public and private sector, the unvaccinated are filling our hospitals. Dr Waasila Jassat, from NICD, announced at the end of November that ‘unvaccinated patients suffered more severe symptoms than vaccinated ones and were most likely to face hospitalisation if infected by the new Covid-19 variant.’  She said that 90% of patients admitted to hospital in Pretoria (one of the current hotspots) are unvaccinated. ‘Not only is there a higher incidence of hospital admissions but also that the chances of death amongst unvaccinated are considerably higher.’ Callakoppen says there is enough clinical evidence to show that the vaccination reduces the severity of Covid and he encourages everyone to be vaccinated. He urges those who have been vaccinated to encourage others to do the same. However, this doesn’t mean you can forgo following the Covid protocols: Wearing a mask; sanitising your hands, maintaining social distancing; staying in well ventilated spaces; coughing or sneezing into your elbow or a tissue. Bonitas has reported the following Covid related figures for 2021 as of 22 November. Total lives older than 18 estimated to have received at least 1 jab 66.4% Total tests performed:  441 929 Total Covid-19 hospital admissions: 20 376. (12 264 during 2021) Bonitas lives currently in hospital: 0.3% Admission rate: 25% ICU Admission Rate: 22% Total Covid deaths: 3 515 (2 292 in 2021)  Total Bonitas membership vaccinated: 70% Highest number of people vaccinated is in the 35-49 age group followed by the over 60s ‘I must reiterate that our best defence against Covid-19 is to be vaccinated,’ says Callakoppen. ‘It won’t necessarily stop you from getting the coronavirus but it will reduce the severity of the disease. I contracted Covid in September but thankfully because I was fully vaccinated, my symptoms were mild which meant I was able to heal and recover at home. My experience is not unique.’   Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund answers some common questions around Omicron What is it? It’s a new, heavily mutated Covid variant known as BI.I.529. When was Omicron first detected? The earliest sample was detected on 11 November in Botswana. Is it more transmissible? Circumstantial evidence indicates it is. Within two weeks of its detection, it has outpaced Delta to become the main strain in Gauteng. Will vaccines work against it? Yes, most likely. A crucial objective remains to increase vaccination rates. Current vaccines remain critical to reducing severe disease, hospitalisation and death. Should updated vaccines be developed, they will be rolled out globally and used as guided by WHO. Will prior infection provide me with immunity? Preliminary evidence suggests there may be an increased risk of reinfection with Omicron but information is limited. More information on this will become available in the coming days and weeks. What about treatment? Currently Oxygen and Dexamethasone have been saving lives. There is however very exciting data coming from two antivirals. What about the current tests? The widely used PCR tests continue to be the global standard to detect infection including Omicron. Studies are ongoing to determine whether there is any impact on other types of tests including rapid antigen tests.

Bonitas – innovation, life stages and quality care

Medical aids can’t bear the brunt of hospital increases

Hospital admissions are one of the biggest cost drivers for any private medical scheme which is why the tariffs are under review and negotiated annually by Bonitas Medical Fund. If no agreement is reached, medical aid members will bear the brunt of high co-payments. According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, hospital admissions account for half of the Scheme’s annual claims cost. ‘Last year due to the pandemic, hospital admissions and the utilisation of other medical aid benefits fell to record lows. However, the 2021 claims’ experience has shown that a lot of services, particularly the day-to-day benefits and several hospital admission categories, are already close to 2019 levels.  Since the start of the pandemic Bonitas has spent more than R2,7bn on COVID-19 related costs, of which R1,73bn pertain to 2021 year-to-date. More than 80% of these COVID-19 costs relate to hospitalisation. Non-COVID utilisation patterns are almost back to typical levels and, since June this year, overall claim ratios have returned to pre-COVID levels. Schemes are therefore not generating the same level of short-term surpluses in 2021 as was seen in 2020. ‘We anticipate that during 2022, utilisation is going to go back to where it was in 2019 or even higher. Which is why it is critical that schemes, such as Bonitas and hospital groups, through an annual negotiation process agree fair and equitable tariff charges, to ensure the lowest possible increases in the interest of members. This will not only help keep costs down but also ensure quality and affordable healthcare for current and future members, while maintaining the sustainability of schemes. We must acknowledge that over the last three years concerted efforts have been made by hospital groups to support and keep tariffs low. However, there are still significant opportunities to drive healthcare cost down. ‘We know that all sectors had been hard hit by the pandemic and the poor economic outlook in this country. Healthcare and medical schemes are no exception. However, we need to remain mindful that key to the survival of the private medical aid industry is its members. If hospital costs balloon above CPI, so will membership premiums, which will result in medical aid becoming unaffordable. We are appealing to all our service providers, including hospital groups, not to pass their costs on to schemes and, by extension, to members.  The pandemic saw healthcare facilities and healthcare providers intensify their efforts to ensure that South Africans received the appropriate care for Covid-19 as far as possible. And while their efforts have been lauded, consumers have had to contend with tough conditions as well.  Moving into 2022 There are major concerns about 2022 utilisation levels, notably due to the risk of an increased burden of disease due to gaps in care that may have arisen during the pandemic, which is no fault of any party. We anticipate an elective procedure claims catch-up after so many were cancelled in 2020 and 2021 during national lockdowns. Other areas of concern include the unknown impact of long-haul COVID as well as new or more expensive COVID-19 treatment costs, including booster vaccines, which may emerge,  All stakeholders in the healthcare value chain need to be prudent in managing their costs of doing business. The intention of negotiated hospital tariffs is to reach an agreement that supports sustainability of the healthcare ecosystem and, ultimately, members. The issue comes when there is no agreement reached and members may have to pay in the difference between what the hospitals charge versus what the scheme is able to pay. We try to avoid such a situation so as not to have a negative member impact, but if parties are unreasonable in their demands, this situation may arise.’ To assist our members and reduce the effect of significant contribution increases for 2022, Bonitas used R600m of its reserves to keep increases as low as possible. Contribution increases were kept below 5% for both 2021 and 2022 despite underlying claims expenditure increasing by a significantly higher margin. Bonitas’ medium-term objective is to sustain solvency levels above the statutory minimum of 25% and to make strategic decisions about current reserves in the interests of its members. This while facing significant uncertainty, especially in terms of the cost and prolonged impact of COVID-19, non-COVID-19 utilisation and roll-out of vaccines. All non-healthcare costs are capped below CPI for 2022.  However, if healthcare providers and hospital groups do not negotiate favourable tariffs for the year ahead, it results in higher increases in the long run, for all patients and unnecessary out of pocket costs.  The benefits of negotiations Negotiations resulted in a 3.1% saving in 2021 terms – these savings could exceed R200 million in 2021 – while in 2020 strategic purchasing yielded hospital negotiation savings of R346 million. These savings contribute to a lower contribution increase. The impact of failed negotiations However, when the costs of doing business is passed on to schemes and, by extension, customers – or medical aid members – things become complicated, especially where tariff increases agreements cannot be reached.  In these instances, there are two possible scenarios: A scheme pays what it deems to be a reasonable rate and the hospital bills its rate. This means the member would be required to pay in the shortfall on the account unless the hospital decides to override the difference A scheme excludes the hospital from on its network and actively discourages a member from using this hospital. The member may need to pay a deductible or co-payment if they choose to be admitted at this facility unless the hospital decides to override the difference. ‘Neither of these situations is a favourable outcome,’ says Callakoppen. ‘Which is why reaching a workable middle ground on hospital cost/tariffs is imperative.’

Advice from the experts
Parenting Hub

Food security for children starts at the breast – support breastfeeding

South Africa has one of the lowest breastfeeding rates in the world. Not because women do not understand the importance of breastfeeding for their children but because women face a hostile environment to care for their children. This World Breastfeeding Week, observed from 01 to 07 August, the South African Civil Society for Women’s, Adolescents’ and Children’s Health (SACSoWACH) are focusing on creating an environment that enables and supports women to breastfeed successfully. Due to our current global crises, with the engulfing COVID-19 pandemic and the subsequent economic crash, women are bearing the brunt of job losses. Female-headed households, especially, are experiencing a financial shock,1 adding to the burden of finding food for their families and caring for their children. In South Africa, nearly one in two households are headed by women, skewing the need to provide unfairly on mothers. South Africa is known as ‘the fatherless nation’ as it has one of the highest numbers of absent fathers in the world. It is estimated that nine million children in South Africa grow up without fathers.2,3 In a recent media report, even our Springbok captain has had to call on men to support and eradicate the scourge of abuse and violence against women.4 Breastfeeding is excellent for infants and young children as a food source, for immunity and for neurocognitive development, and emotional self-regulation.5 “The first step to creating a supportive and safe environment for women and children is the essential provision of food for pregnant women and breastfeeding mothers. Safety and protection for moms, as the life-carrier and carer of children, is non-negotiable,” explains Dr Tshepo Motsepe, First Lady of South Africa, patron of the Coalition, passionate breastfeeding activist and humanitarian. The high rates of violence in South Africa cannot be ignored. Breastfeeding is associated with less violence in societies.5 Research also shows that 80% of rapists are the product of absent fathers.3 Young men who grow up without involved fathers are more likely to develop ‘hyper-masculine’ behaviours such as aggression and emotional instabilities. In contrast, young women are more likely to develop lower self-esteem and become victims of violence.3 Many hungry and stunted children live in fatherless homes1 where suicide is more likely in these individuals.3 “We need fathers and empowered men to step up and invest in the future of our society. Children are our future; the outcomes we want for tomorrow begins with what we do today. We call on all men to set an example and provide emotional and financial support, as far as possible, for the family and breastfeeding partners. This will help women to breastfeed exclusively and relieve them of the pressure to return to work too early,” explains Patrick Shivuri, Maternal and Child Health Programme Manager from Save the Children and a father himself. “Food security for infants and young children starts at the breast. Breastmilk is a living food; it protects against many infections that include COVID-19. If we want to protect children’s health, we need to protect and support their mothers,” adds Dr Chantell Witten, nutrition lead for SACSoWACH and lecturer at the University of the Free State. This has never been more relevant in a time when food is scarce and financial resources constrained. “Reducing Gender-Based Violence starts with protecting, promoting and supporting breastfeeding mothers at all cost. Paternal presence both emotionally and financially is a long-term investment for a healthy and less violent South Africa,” ends Precious Robinson, SACSOWACH chairperson and health advocate from Right to Care. In celebration of World Breastfeeding Week, SACSoWACH will host a breastfeeding dialogue on Thursday, 06 August 2020. The discussion will be live-streamed on their website; please visit www.sacsowach.org.za to find out more and sign up.

Delite Foods

Boosting the immune system during the pandemic

The outbreak of the global coronavirus pandemic earlier this year had caused much anxiety and uncertainty for many. It has been a roller-coaster of emotions for parents since lockdown started and the decision to implement home-schooling either by distant-learning or privately was something no parent was prepared for. The pandemic shifted the roles and responsibilities of parents alike, adding “home-school teacher” to the already long list of roles.  Public schools in South Africa are set to close from 27 July to late August with the exceptions of grades 12s and 7s. Grade 12s will only take a week’s break and return on 3rd August 2020. Grade 7s will get a two-week break returning on 10th August 2020.President Cyril Ramaphosa, said that the decision to close schools was not taken lightly by the government.  The decision to reopen schools has been met with mixed reviews as parent’s stress over the wellbeing and safety of their children and family. Boosting the immunity during the pandemic has been a high priority according to pharmacies. Parents have been taking extra precautionary measures to ensure that their little ones stay healthy and well.  We asked registered Pharmacist, Ashleigh Bruce for advice on what parents can do to boost their kids immune system during this pandemic, “The whole family should be taking Vitamin C and Zinc supplements daily”, says Ms Bruce. Not forgetting the basic and simple action of washing the hands often and sanitizing.  The Delite Foods jelly range is packed with Vitamin C! An oblivious way to ensure kids get the Vitamin C they need without them realising it.  She has also advised on trying DIYs, meditation and yoga as a form of self-care distraction to manage your stress and emotions during this difficult time.  Stay connected and engage with us on Facebook, Instagram and Twitter.

Baby's and Beyond

COVID-19 is taking its toll on SA’s mental health

Fear and anxiety have gripped the globe as COVID-19 continues to take its toll on human life, economies and society at large. Experts are becoming increasingly concerned about the psychological effects of the epidemic, particularly on the poor, elderly, children and teens, and frontline healthcare workers. Abdurahmaan Kenny, mental health portfolio manager at Pharma Dynamics, says levels of distress are bound to increase as more South Africans become infected, lose their income and social isolation becomes a way of life beyond the lockdown. “Vulnerable populations, such as the elderly, those with mental health conditions and pre-existing health concerns are likely to experience higher levels of psychological distress due to the major threat that the outbreak poses to their own personal health. “Another high distress category is likely to include the poor who rely on odd jobs to make a living. Staying at home means they cannot provide for themselves or their families. “Doctors and nurses, particularly those at the frontline of the crisis, may experience secondary traumatic stress (STS) reactions—a by-product of working in a traumatic environment. “Equally, parents who are dealing with childcare responsibilities during school closures and work-from-home obligations may experience greater levels of anxiety as they try to juggle it all while taking care of elderly parents and reassuring their children.” He says that stress during the outbreak can include fear and concern about one’s own health and the health of loved ones, which is completely normal.  More detrimental changes to watch out for include sleeplessness, difficulty concentrating, feelings of hopelessness, suicidal thoughts and worsening of chronic health problems. Those with pre-existing mental health conditions are also encouraged to continue with their treatment. Should their symptoms worsen, they should contact their healthcare provider (remotely if possible). Advice to parents “Arming yourself with the real facts about COVID-19 and the risk that it poses to yourself and your family can make the outbreak less stressful. If you remain calm and provide reassurance, children will follow your lead. However, teens are likely to be exposed to more communication from friends and social media, which may lead to excessive worry or sadness, unhealthy eating or sleeping habits or acting out. “Keep the lines of communication open between you and your children. Answer questions they may have around COVID-19 based on facts provided by credible organisations such as the World Health Organisation (WHO) or the SA government (sacoronavirus.co.za).  Share advice on how to cope with stress and try stick to a routine with educational, fun and relaxing activities to make the days meaningful. “Be a role model to your children. Limit your news coverage of the outbreak to once a day, including social media. Stick to a wholesome routine of your own by getting enough sleep, eating healthily, exercising and connecting with friends and family. Your children will take their cue from you.” Feature Supporting frontline responders  “Many of our doctors, nurses and other healthcare personnel will be directly involved in the diagnosis, treatment and care of people with COVID-19, which places an extraordinary burden on them both physically and mentally. “It is vital that they remain focused by taking care of their own health in order to continue to respond to the outbreak. “Take regular breaks, eat right, practice deep breathing and relaxation techniques, get enough sleep and work in teams to help ease the burden. Also ensure that childcare, household and pet care responsibilities are in hand while you’re on duty. Communicate with loved ones, even if it’s just once during a shift.  Helping those in quarantine “For the 112 people who have been released from quarantine in Polokwane, many of whom have been separated from their families for more than 65 days (first while being in lockdown in China for 51 days and then another 14 days in SA), a range of emotions may follow. “These could include feelings of relief, stress from constant monitoring for signs and symptoms, sadness, frustration and even anger. Guilt about not being at home and caring for children or other emotional or mental health challenges may surface. Families should be extra supportive and allow those returning from quarantine time to adjust. “It can also be traumatic being separated from loved ones after testing positive for COVID-19. Remain in contact as much as you can via phone or video calling to provide patients with the love and support they need.” Kenny says knowing how to respond to these challenges when they arise will help you to stay mentally focused while caring for those closest to you. “For now, we need to embrace the new rhythm of life and the chance it gives us to connect with others in different ways.” As a leading provider of central nervous system (CNS) medication for the treatment of depression, anxiety and bipolar disorders, amongst others, Pharma Dynamics is committed to the mental wellbeing of all South Africans.  The company advocates for prevention services, early identification and intervention for those at risk. Those who feel mentally overwhelmed by COVID-19 or experience signs of depression can contact Pharma Dynamics’ toll-free helpline on 0800 205 026, which is operated by trained counsellors who are on call from 8am to 8pm, seven days a week. The call centre is a critical service to the public and is therefore operational during the lockdown. Also visit www.letstalkmh.co.za for additional tips and videos to ensure mental well-being during the lockdown. The public is also being encouraged to share photos and ideas of their own on the platform to help others get through this challenging time.

Happy Family Organics

Easy tomato soup with cheesy bread dippers

This comforting tomato soup can be made in less than 20 minutes and enjoyed by both you and your toddler. Don’t forget to make the cheesy bread dippers – sure to be the most fun part of the meal for your toddler! This meal is suitable for toddlers 12 months+. Makes four small and two adult servings. What you’ll need Ingredients for soup: 1 tablespoon olive oil 1/2 cup chopped onion 2 cloves garlic, minced 1 tin diced tomatoes 1 cup low-sodium vegetable broth / vegetable stock 1/2 teaspoon dried basil Pepper to taste (optional) 1/2 cup plain Greek yogurt Ingredients for cheesy bread dippers 4 slices of whole wheat bread 1 tablespoon butter or olive oil 1/2 cup shredded mozzarella cheese 2 teaspoons Italian spice mix How to make it: In a medium pot, heat olive oil over medium heat. Add the onion and garlic and cook until tender, roughly 4 minutes. Add in the tomatoes, broth, basil and pepper. Bring to a boil, then reduce heat and simmer for 10-15 minutes. Meanwhile, you can make the cheesy bread dippers. Heat the oven to a broil and line a baking sheet with tin foil. Butter or oil one side of the bread and place it (butter side up) on the baking sheet. Broil until golden brown. Remove from oven, carefully flip the bread over and sprinkle the non-cooked side with cheese and Italian spice mix. Place back under the broiler and heat until cheese is golden brown. Let cool and then cut into 2-inch strips. When soup is done, add in the yogurt and using a blender or hand immersion blender, blend the soup until smooth and creamy. Let cool slightly and then serve the soup with the cheesy bread dippers. Always check with your child’s doctor first if you have any questions about introducing new foods and textures. Launched on Mother’s Day 2006, Happy Family Organics is one of the largest and fastest growing organic food brands to offer a comprehensive line of nutritious foods for babies, toddlers, kids and their mothers. Constantly innovating, Happy Family strives to offer families the right nutrition for every stage of development, and is on a mission to change the trajectory of children’s health through nutrition.  Happy Family Organics products are available at all Baby City stores, Babies R Us, Wellness Warehouse, Selected Clicks, Selected Spars, Selected Pick N Pay stores, Selected Baby Boom, selected Dis-Chem and selected Medicare pharmacies, and online from Takealot.com, Babiesafrica.com and Faithful to Nature.

Impaq

Five brain-boosting foods and drinks

Our bodies need “fuel” for every organ, and the brain is no exception. Giving our brains the right food can aid concentration and memory greatly, both of which are necessary for studying and completing tasks and assignments. In today’s article, we discuss five of the best foods and drinks for boosting brain function. Fatty fish Omega-3 is a type of fatty acid that is most commonly found in fatty fish like salmon. Our brain cells consist mostly of fat, 50% of which is the same kind as omega-3 fatty acids! By eating fatty fish or taking omega-3 supplements, your brain maintains optimal levels of fat.  It also helps strengthen the structure of the brain cells themselves, both of which result in optimal brain function. These acids also increase blood flow, which is essential for optimal organ performance. One last benefit of this fatty acid is that it increases the amount of grey matter in your brain, which is the other component of the nerve cells (the other is fat), and more grey matter means better cognitive function. Younger children might not enjoy the taste of fish like salmon, so be sure to incorporate an omega-3 supplement in their daily vitamin regimen!  Nuts Nuts contain high levels of something called antioxidants, which are natural compounds that slow down oxidation. Oxidation is a naturally occurring process that can damage the body’s cells. With particular regard to the brain, oxidation negatively affects our cognitive function, and consequently our ability to focus, learn and remember. By consuming foods high in antioxidants, we can improve these cognitive functions that are critical for academic success.  Antioxidants can also be found in blueberries. Here, they take the form of something called anthocyanin, which is a type of flavonoid. Flavonoids are molecules that give food its colour, and they contain high levels of antioxidants. Blueberries also improve cell-signalling (how brain cells communicate with one another). Good cell signalling is essential for making and storing both short-term and long-term memory, both of which are crucial for studying and writing tests and examinations. Also read: Do’s and Don’ts for Making Healthy Food Choices During the Lockdown  Leafy greens Leafy greens like lettuce and spinach contain a compound called carotenoids. These are similar to the flavonoids found in blueberries as they are the compound which gives food its colour and, like flavonoids, they also contain antioxidants and help improve cell signalling. When digested and absorbed, carotenoids often migrate to the frontal cortex, which is the region of the brain that is responsible for such functions as problem-solving and memory – in essence, it is the “control panel” of our brain, so keeping it healthy is essential for optimal cognitive functioning! Unlike many other foods, chopping and cooking foods that are rich in carotenoids actually increases the strength of the nutrients when they enter the bloodstream, so be sure to incorporate plenty of steamed spinach or cooked kale in your child’s diet. Water We all know hydration is important given that our body’s cells consist of 60% – 70% water, but it’s particularly important for our brains. This is because dehydration leads to a lack of sufficient water in our cells which, in turn, leads to poor organ function. In the brain, this means reduced/impaired cognitive function, particularly the brain’s ability to create short-term and long-term memories. As a result of this, we are unable to convert the information we are learning into memories, and if we are unable to create these memories in the first place, we’re unable to recall them later on. Experts recommend drinking 6 – 8 glasses of water a day, but fewer are needed depending on your child’s age (generally one 235 ml cup for every year of the child’s age): Green tea Green tea contains a compound called L-theanine, which is an amino acid (amino acids are compounds that make up the proteins in your body’s cells). L-theanine is thought to increase GABA activity (GABA is a brain chemical that reduces the activity of brain cells). Higher levels of GABA tend to make people feel more relaxed, which leads to decreased stress, which in turn helps improve concentration. L-theanine also increases your brain’s alpha waves, which are a type of brain activity that is thought to aid mental coordination, calmness, alertness, and learning, all of which are essential for studying. Now, green tea might not be to the taste of younger children, but certainly, teens might enjoy the flavour, so give it a go! by Jacqui Smit

Vital Baby

Tips for keeping coughs and colds away

Winter is an incredibly beautiful season. Apart from the inconvenience that the seasonal weather can bring, in a country where drinking water is often scarce, the rain is always welcome! Less welcome, however are the germs and nasties that creep into our homes. With people coughing and spluttering all around us during winter, it’s important to step up our own personal hygiene. This rings particularly true in the current circumstances we find ourselves in. With Covid-19 still very much a part of our daily lives, keeping germs at bay, is now more important than ever.  What can you do to prevent catching a cold or flu this winter?  Wash hands religiously With the number of people catching the flu virus at an all-time high, it’s important to keep the spread of germs to a minimum. Wash your hands regularly – particularly after a cough or sneeze, with warm, soapy water for at least 20 seconds. Also, keep hand sanitiser gel and wipes within easy reach if necessary. Vital Baby’s Hygiene Hand & Face Wipes (R35.00) are great to keep in the car, at home and in your handbag. They’re gentle enough to use on baby’s face, and effective at removing germs and dirt. Cough into elbows This is one that both adults and kids can adopt. Encourage coughing and sneezing into the elbow crease rather than hands. Sneezing into hands can spread germs even more as we use them to do so much. Make up a silly song If your child doesn’t like washing their hands for long, or with soap, make it fun. Make up a silly song or find one on the internet that encourages them to do it thoroughly. For example, make up words to the tune of ‘Row your boat’ such as: Wash, wash, wash your hands, make them nice and clean, scrub the germs and wash them off, dry them in between. Get rid of the snot Help to clear little noses using a nasal decongester. This handy little device helps to remove snot quickly, efficiently when they are sniffling and unable to do it themselves. Sterilise after use to make sure it remains hygienic. Stay active Staying active and taking regular exercise can also boost your immune system. Encourage your child to play outside, take them to a park, or head to an activity centre where they can tear around without worrying about the weather. Watch out for fevers If your child has caught a cold, keep an eye on their general health. Take their temperature regularly and their body temperature seems hotter than normal, offer the correct dosage of children’s paracetamol and ibuprofen to keep their temperature under control. Try to focus on fruit and veg We all know that eating a balanced diet packed full of fruit and veggies can give our immune system a boost. During the winter months, try to sneak even more into your child’s diet. If they reject it, hide them in their favourite meals or sauces. Get enough rest Ok, ok, so if you’re a parent, don’t laugh at this suggestion! We know that sleep might be something that you struggle to get enough of, but it really does affect wellbeing. If you think your child is coming down with something, cancel some plans and encourage them to get plenty of downtime. Take the idea on board for yourself too; switch off your phone and try to get an early night. Even an hour extra can really help with your own energy levels. We hope that you manage to stay healthy this winter! Follow Vital Baby on social media: @vitalbabysa Vital Baby products are available at Clicks, Babies R Us, Loot, Baby City, Takealot and at www.babiesafrica.com. 

Parenting Hub

Mental strength when you need it

The pandemic has shown us we are more resilient than we think Covid-19 has had devastating effects on the people of South Africa and the world over. As the rate of infection continues to skyrocket, especially in our urban centres, people are starting to grow more fearful of what the future holds.  This is on the backdrop of an already ailing economy where our country’s official unemployment rate surpassed 30% in June. Despite the government’s Covid-19 economic stimulus and relief package, the unemployment rate is projected to peak anywhere between 41% and 54% as a result of the lockdown. Projections by the International Monetary Fund suggest that debt repayments will account for more than 80% of our GDP by the end of next year. These statistics paint a gloomy portrait. At the start of 2020, we never thought we’d be forced to retreat into our homes in an attempt to survive this ruthless virus, and social distancing wasn’t even a part of our lexicon. We didn’t anticipate such a sudden, severe threat to our lives and livelihoods. Adjusting to this new way of life and pervading sense of uncertainty has been challenging. It’s easy to lose perspective, to forget what we’re trying to accomplish, to feel scared and alone.  The irony, however, is that the physical distancing forced us into a space of introspection, and we were able to connect on a deeper level with not just ourselves but each other. This sense of connection is what drew us closer together, because we were able to see that we might not physically be with one another, but we’re in this together, united in a common cause to overcome an invisible enemy. Sometimes when we feel overwhelmed – whether it’s about our health, children, finances or broader social issues – it helps to have a friendly reminder that adversity is a test of strength, and that we are much stronger than we think. Metropolitan’s Three Word Stories campaign did just that. The radio and social media campaign ran on Ukhozi FM, Thobela FM, Lesedi FM, Umhlobo Wenene and Motsweding FM, which have a combined listenership of around 22 million people, and hundreds of thousands of followers on Facebook and Twitter. By encouraging listeners to speak openly about their concerns, Metropolitan’s Three Word Stories sought to build resilience and inspire mental strength to help us cope with the stresses of a new and uncertain world. It created a much-needed platform for us to share our experiences and gain wisdom through our collective knowledge. The conversations emphasised that mental health is essential for our wellbeing. It eased our anxiety about the future by helping us find ways to navigate new challenges. Sharing our stories reminded us that we already have the fortitude to handle whatever life throws at us, especially when we’re there for one another.  The voices we heard during the campaign spoke to our resilience, our shared humanity, our deep connection to everyone in South Africa and the world. We needed reminding.  Jane Mokoena from Limpopo shared how – amidst the difficulties presented by the pandemic – she was able to use the time at home to reconnect with her children. Anna Maake from the Free State said that the turbulent past few months were reminiscent of her humble beginnings. She was reminded of her innate strength and resilience, which helped her get through dark times before – and reminded her that she will again get through this.  Financial concerns featured prominently in stories such as: ‘Smart Money Goals” Should we be trying to save more? How should we restructure our finances? How can we pull ourselves out of debt? What can we do to help others while we wait out the storm? How do we balance the need to stay safe with the need to earn a living? Hearing these fears articulated let us know that there are thousands of people in similar situations who are willing to listen and help. So is Metropolitan. Take comfort: we’re here for you and will continue to be for the long run. But more importantly, we hope the insight we were able to share into the hearts and minds of ordinary South Africans during this campaign helped remind them just how strong, capable and resilient they are. Post-Covid our lives are likely to be forever changed, but what will remain is our ability to overcome whatever challenges we encounter. We’re all strong, but we’re stronger together, and even though we can’t always be with one another, we have more friends than we realise. Continue to stay safe and strong, South Africa, and remember that the only thing we should be spreading right now is our love for our country, one another, our families and ourselves. By Nontokozo Madonsela, Chief Marketing Officer for Momentum Metropolitan 

Paarl Dietitians

COVID-19 Immune Boosting Claims Debunked

A happy immune system is an important component of wellness. In light of the recent flu outbreak associated with the Coronavirus (COVID-19), the task associated with supporting immune health has become increasingly significant. Avoiding illness is not always possible, but there are several steps one could put in place to support immune health and reduce the risk of getting sick, as well as minimise duration and complications if they do. However, across social media we’ve heard that a variety of methods including taking large numbers of supplements and strange diets can “boost our immune system” and combat against COVID-19.  Immune supportive ingredients are actually very individual and differ from person to person. There is no blanket advice when it comes to so-called ‘immune boosting’ advice. Factors involved in supporting the immune support depends very much on an individual’s genetic composition, current diet and lifestyle e.g. stress and sleep.  This article will explain why there are no single foods or supplements that will prevent or cure COVID-19, and debunk recent diet claims related to this.   How does the immune system work? Before we dive into the details surrounding the immune system and the specific foods as well as supplements, we first need to consider how does our immune system defend our body?  People have this idea that the immune system is some kind of internal force field that can be boosted or patched up. This couldn’t be further from the truth. As the name suggests it’s not a single thing and has no central organ of control BUT is a system that involves many organs and biological functions. Their interactions defend the body against foreign invaders such as pathogens.  Each day, the body confronts an environment teeming with disease-causing organisms. The immune system is designed to implement rapid, specific, and protective responses against these organisms.  The immune system can be broadly split into two parts, the innate and the acquired response.  On detection of infection, it’s the innate response that acts first. Though fast, it lacks in finesse, and deals with an invading pathogen in much the same way that the Ghostbusters might try to remove a ghost from a haunted hotel. It gunges the halls and doorways to try to flush it out (that’s why you fill up with phlegm and snot), it yanks up the thermostat to try to boil it (why you run a fever), and it shuts down the building until the problem is solved (it makes you lethargic so you don’t go out and pick up another infection while your immune system is at work). What the innate response doesn’t do is eliminate the intruder from the body. That is the job of the acquired system, a specialised SWAT team by comparison that identifies the enemy and makes the specific weapons, or antibodies, needed to destroy it. It can takes round about 5 to 10 days for the acquired system to identify the antibodies needed and clone them up to sufficient numbers to make a meaningful attack.  DID YOU KNOW? Our immune system’s response varies over the course of 24-hours. At certain times, we may be more resilient to fighting off viruses and at other times of the day, we may be more susceptible to pathogens. For example sleep is vital for your body’s immune function the next day, so if you haven’t slept well your immune defences may be compromised.  “Immune boosting” claims are flawed The term “boosted immune system” is unscientific and is often used in headlines and marketing of diets, potions and dietary supplements. Dietary choices and supplements don’t boost the immune system; rather it can allow the immune system to function adequately and more efficiently.  According to experts the only way to ‘boost your immunity’ is through vaccination. Getting vaccinated against the flu and other diseases stimulates the immune system to protect against illness. Vaccines teach the immune system to recognise specific pathogens and prepare them to mount a defence if they are encountered. Therefore, our current goal (considering the COVID-19 pandemic) is to SUPPORT and OPTIMISE our current immune system with an overall healthy diet and lifestyle.  For example, a balanced diet provides a range of nutrients which play an important role in our immune system.  How to optimise the immune system? COVID-19 is a scary time for most individuals. Largely because we don’t have much data on the disease as it is brand new. Before we can make any reliable claims during this pandemic, we need repeated, robust, human clinical evidence.   However, until more research is available, we want to do our best in optimising our immune system. So, what can we do to keep the immune system functioning optimally? I would suggest the following: Immune supportive nutrients. A good starting point is a healthy balanced diet and to take a comprehensive, high quality multi-vitamin and mineral supplement. We should be very cautious of just taking supplements that has been touted as ‘immune boosting’. Correct nutritional deficiencies. Consider having nutrient levels checked by means of a blood tests in order to identify any deficiencies in key nutrients that are important to a healthy immune system activation. Supplementation can then take place according to underlying nutrient deficiencies. Identify and address ways to reduce inflammation. Initially we believed that anti-viral supplements were the way forward for prevention of COVID-19 and more and more evidence is emerging that the secondary focus needs to be on reducing inflammation. In fact controlling the local and systemic inflammatory response in COVID–19 may be as important as the anti-viral therapies. Taking an Omega-3 supplement is sensible since it is anti-inflammatory. Know your genes. Consider DNA testing. Knowing more about your genes can help your healthcare practitioner make positive changes through nutrition to improve and optimise cellular defence mechanisms. Immune supportive nutrients: Vitamin C There is no question that vitamin C plays a role in the immune system, however the research has found that vitamin C supplementation does not reduce the risk of the common

Parenting Hub

Beating the COVID-19 Blues

We have all been cooped up in our homes for weeks, so cabin fever is real! For most people, there is nothing better than getting together with family and friends and when these interactions are taken away, it is natural to feel off.

Parenting Hub

Tips to keep schools clean and students and teachers safe

When schools are back – albeit staggered over the rest of the year – it is critical that school management teams have plans in place to keep their staff and learners safe from the coronavirus. “They must develop this plan, implement the plan, and make sure they maintain the plan,” according to Emma Corder, Managing Director of industrial cleaning manfucaturer  Industroclean. Schools across the country have varying degrees of access to proper sanitation and other assets needed to protect learners. It might certainly be a daunting prospect for any school principal to try and prevent the spread of the coronavirus if, for example, the school does not even have access to running water. Corder says there are thankfully basic safety measures that can be implemented almost anywhere, which she recommends. The essential first step she says is to stick to the basics.  “This being hand hygiene, correct mask usage, respiratory etiquette and physical distancing.” When it comes to smaller children, it might be less easy to remind them to not share their lunch, stationery or even climbing structures, playgrounds swings and slides.” Unfortunately, the above is just the basics and schools are going to need to develop a checklist that they can abide by on a daily basis. General engineering and administrative measures need to be implemented, to ensure that all classrooms have proper ventilation e.g. cleaning of air-conditioners with correct filter installed beforehand, or during school hours all windows are opened. All schools must have a dedicated isolation room; this is needed should a pupil or staff member show any symptoms of Covid-19. “I strongly recommend that all staff and teachers be put through the correct training to make sure they understand and properly implement health measures. They will need to be intimately familiar with the basics such as the difference between cleaning and disinfecting a surface, as well as the safe disposing of any potentially hazardous medical waste,” adds Corder. But there is also a responsibility on all parents and caregivers to ensure students are fully prepared, by creating a “Covid-19 Back to School Pack”. The use of a big sized pencil box is perfect to pack two clean masks, pack of wet wipes and hand sanitizer. It’s also advised that the learners take their own water bottles so as to not fill them at the school or use public water taps, and especially to not drink directly from the mouthpiece of a tap. Remember the three best cleaning practices: Prepare for cleaning and disinfecting. Correct PPE for cleaning Use all chemicals correctly Cleaning equipment must be clean e.g. mop sleeves must be soaked in cleaning solution before being used. Disinfectants should be freshly prepared and NRCS registered. Do the Job. Top to bottom from clean to dirty. For normal cleaning use the spray and wipe method. And colour code all cleaning materials to prevent cross contamination. End of Task Dispose of dirty water and waste according to safe procedures. Wash and dry all equipment before storing it in a clean space. Dispose of all PPE wear before washing up. “If headmasters or members of staff need any assistance or have any questions about measures that are planned for a school, they must get in touch with the Departments of Health or Education immediately. Proper disinfection and preparation must be completed, before learners return,” says Corder. 

Baby's and Beyond

Do’s and Don’ts to keep the weight off this winter

Longer nights, shorter days, colder weather and decreased exercise can all contribute to winter weight gain. Add the temptation of rich comfort food and it’s easy to see why so many of us battle to keep to our health goals during winter. According to Dr Riekie Smit, an aesthetic medicine practitioner from Pretoria with a special interest in weight management, women tend to gain an average of between two and four kilograms every winter and generally only lose half of what they gained in the upcoming summer. Unless it’s stopped, this pattern will result in gaining more weight every year. We feel sorry for ourselves when it is cold outside and opt for comfort food, and then regret it when summer arrives. However, Dr Smit recommends that we should all make an effort to eat healthier food and increase our intake of vegetables, especially green ones. “This will not only keep the weight off, but also keep your immunity levels high,” she says. Dr Rosetta Guidozzi, a general practitioner from Johannesburg, says that in order to boost immunity during winter it is important to follow a healthy diet, including lots of vegetables and citrus fruits.  Foods should be enhanced with herbs such as sage, rosemary, oreganum and coriander as they have powerful antioxidant effects and are flavour enhancers, which can help you to eat less. The same applies to spices such as curry and peri-peri, which flavour foods and induce a decrease in consumption. Clinical psychologist and cognitive behavioural therapist, Dr Colinda Linde from Randburg, Johannesburg, also agrees that eating for immunity is important. “Winter tends to be when we get sick, so make sure to include immune boosting foods like citrus, garlic, herbs, mushrooms and a dose of probiotics. Winter is also a great time for ‘slow food’—casseroles, soups and stews that are easy to put together, warm and hearty to counter the cold,” she says.  Although it can be more difficult to exercise in winter, Dr Smit says that if the cold is putting you off your walk or cycle, opt rather for indoor exercise programmes, either at the gym or at home. She says that there are now multiple apps to help you with this. Dr Guidozzi reiterates that continuing exercise and eating correctly in winter is a priority. This includes the preparation of healthy stews and soups using lots of herbs and spices. “The trick is to remain motivated during winter,” she says. Even if you change the type of exercise you do during the winter months, it is important to at least continue with activity. Dr Linde says that while she would definitely recommend including exercise in winter, it is also important to be realistic about it. She recommends possibly starting the day with stretches, which warm you up and can be done on a yoga mat in your bedroom at home. She says in this way you consciously include exercise in your daily routine, with the option to also add something outside of home such as the gym, a walk or a run.  Dr Guidozzi says that winter can also trigger the “winter blues” in some people, an onset of lowered moods. “To prevent this, it is necessary to exercise and also to spend time outdoors, and absorb the sunlight when one can,” she says, and reiterates the importance of maintaining good sleeping habits. She says that sleep deprivation will lower immunity and can lead to making less favourable food choices. While healthy eating and exercise is important, so too is taking time for yourself. Dr Linde, who is launching the second edition of her book entitled Get the balance right—Coping tips for working moms, which was first published in 2005, says that winter is associated with hibernation in nature, where animals and many plants slow down, and renew themselves by spring. “We have a short winter here, only three months really, so it could become an annual stocktake, going inward by meditating quietly or journaling for a few minutes daily”, she says.  The time saved by putting a stew in the slow cooker can be used to curl up on the couch with a magazine. Another tip to remember in winter is to care for your skin, which can become dry and irritated during the winter months, leading to loss of collagen and wrinkling. Dr Smit recommends using a milk cleanser and rich moisturiser to stay hydrated. Keeping up an adequate intake of water is also essential. “In winter you could opt for hot herbal teas or hot water with lemon or mint leaves,” she suggests. Some healthcare practitioners suggest taking a supplement with added vitamin C and zinc in winter, although this should not replace a healthy diet, especially a diet which includes fruit and vegetables with adequate vitamin C.  Adding probiotics to your daily routine can also help your immunity to resist viral infections. Remember also that hand hygiene is vital to avoid germs. Instead of associating winter with comfort eating, hibernation and a bowl of creamy pasta on the couch, be proactive. Spice up your winter menu with healthy vegetable soup, download an app to start getting more active in the comfort of your home and remember that while summer bodies can be made in winter, eating healthy foods, exercising and upping your immunity can help you to enjoy a healthier winter. Whether in winter or summer, some people trying to lose weight will struggle too much with hunger, especially at the start of their weight loss journey.  These people might benefit from a prescription medication which, together with appropriate lifestyle adjustments, can help kick-start a weight loss journey, or can help someone get back on track. If you are worried about your weight, speak to your doctor for advice about how to lose or manage your weight. Visit www.ilivelite.co.za for tips, support and further information about weight loss.

Impaq

How to help a child struggling with (Corona Virus) anxiety

We’re all on edge because of the coronavirus. Our daily lives have been disrupted, we aren’t sure what tomorrow may bring, and, for many of us, the nonstop news and social media coverage are overwhelming. Therefore, it is not uncommon to feel anxious or worried during this time. If you or your children are feeling worried,  learning how to deal with anxiety in a healthy way can help the whole family be more resilient, both now and when the pandemic is finally over.  What is anxiety? Anxiety can be described as feelings of uneasiness or being worried when there is not necessarily any imminent danger present. It is often accompanied by intrusive and often unrealistic “What if” types of thoughts, experienced in the body as stress that continues even after the cause of the stress is gone.  What can parents do to support their children?  Many parents are experiencing a more difficult time dealing with COVID-19 than their children and some of the anxiety that kids are experiencing may be unintentionally passed on by worried parents. As parents, it is important to be a positive role model for your children and this includes showing them how to deal with anxiety during stressful events. You can create a positive and safe atmosphere in the home environment by doing the following:  Living in the “here and now” by focusing on, and staying in touch with, what is actually happening and not getting carried away with worst-case scenarios.  Identifying and getting help for your own anxieties first. Being smart about what you read. Make sure your information comes from trustworthy and credible sources. While it is important that we are informed about how best to keep our families safe, we should be mindful about what we are reading online to make sure it’s actually helpful and not making our anxiety worse. It is easy to get sucked into clicking on “fake news” inadvertently or forwarding social media posts to your family group without verifying them or applying common sense.  Being aware of feel-good news and sharing these stories with your children to facilitate a more positive mindset and create awareness of the “silver lining” despite the crisis. Sticking to an established routine that involves exercise, regular meals, and healthy amounts of sleep – this is crucial for regulating our moods and our worries. It can be hard to accept that our old routines are no longer possible because of COVID-19 precautions. Looking for ways to be flexible and starting new routines can help you and your family create a more productive and healthier lifestyle that can help to lower the amount of anxiety you experience. Monitor your children Parents do not always recognise signs of anxiety in their children. Identifying anxiety in your child can be tricky because it involves a pattern of behaviours that is unique to each child. The following behaviours could indicate anxiety: Reassurance-seeking (“Are we going to be okay? Is Grandpa going to be okay?”) Reluctance to separate from parents Physical symptoms like headaches or stomach aches Moodiness and irritability Tantrums or meltdowns Trouble sleeping Talk about their anxiety Younger Learners – Younger children may not always be able to express how they are feeling. For younger children, use a “feelings chart” with pictures describing emotions instead of saying “Tell me how anxious you are”. With a feelings chart, which you can find on the internet, you can ask your child to point to the feeling and/or picture representing an emotion that they are currently experiencing. They can also draw pictures about things they feel happy or sad about. Older learners – For children who are more aware of, and able to articulate, how they are feeling, it is better to ask what psychologists call “forced-choice questions.” If you ask a vague question, you’re going to get a vague answer. So instead of asking “How was your day?” which is pretty vague, maybe ask “Did your anxiety get in the way of you having a good day today?”.  Teenagers – If you have teenagers, start talking about yourself first. You can start the conversation with something like, “I saw this article today and it made me wonder about this and that. Did you experience something like that? What’s your reaction to it?”. Do not force your teenager to talk about their feelings unwillingly as this can create tension and cause them to feel hostility towards you. Wait a bit first and then attempt to discuss the matter with them at a later stage when they are calm and more willing to talk. If this still does not work, they can use a journal or art activities to express their feelings and experiences. Also read: Five tips on how to motivate your teen during lockdown  How to help your anxious child   Structure their day. As parents, we often think that setting boundaries for a child is a way to make our lives easier, but kids benefit from boundaries, too. It is easy for children to get bored or fretful if they are facing a day without structure and anxiety can thrive under those circumstances. Make sure that you are structuring their days when they are “cooped up” at home.  Alternate chores or schoolwork with more fun activities that your children enjoy and periods of free time.  As restrictions lift, be sure to incorporate safe, outdoor activities that comply with social distancing principles as well. Make sure children are still getting the chance to exercise. Encourage your child to socialise with friends via video chats and social media if they have access to these platforms. This is especially important for teenagers who thrive on social interaction with their peers. Avoid giving too much reassurance. Avoid getting into a cycle of providing too much reassurance. Children of all ages can become too reliant on reassurance and want to hear it more and more often, and when a parent isn’t able to give them complete reassurance, their anxiety can worsen. Instead, try the following: Remind kids of the things they are

Milas Meals

Nutrient Enhancers: my kind of food additives!

This is an excerpt from my book ‘Mila’s Meals: The Beginning & The Basics’ I’m talking about egg yolk, ghee, flaxseed oil, coconut oil, hemp seed oil, olive oil, sauerkraut liquid, kefir, cinnamon, nutmeg, clove, vanilla, ginger, cardamom, allspice, turmeric, broth, dulse, liver, blackstrap molasses, baobab, cacao, hemp, lucuma, maca, moringa.  It is important for me to make every mouthful of food that Mila swallows as nutritious as possible because: Good nutrition is so important at this stage of life Only a small amount of food is going to go in (at the beginning for some, or forever like with Mila) And because a lot of food is going to be turned away or spat out when the toddler emerges… So I developed a list of ‘nutrient enhancers’ – nutrient-dense foods which can be added to almost any purée or meal without significantly changing the taste, texture or appearance… because trust me… there is no greater food detective than an 18-month old! An excellent example of where nutrient enhancers shine their bright light is in the preparation of plain noodles. “Plain noodles?” I can hear you exclaim! Trust me, there will come a time when your toddler will only want to eat plain noodles, repeatedly, for months on end – and you will make them for her… because you need to choose your battles wisely, because it is the end of a long day, because you have another baby to take care of or because you are tired! So this is as plain as Mila’s plain noodles got: I cooked the gluten-free noodles in bone broth with some seaweed (wakame or kombu). Once cooked, I stirred in a raw egg yolk, some coconut oil, a pinch of sea salt and a sprinkle of dulse. Ta da! Plain noodles… that were eaten with glee! Get creative… there is no end to how sneaky you can be! Nutrient Enhancer: Why is it valuable? Eggs Eggs are a source of high-quality protein and have all the B vitamins (including vitamins B1, B2, B3, B5, B6, B12), as well as choline, biotin, folate and cholesterol, selenium, iodine, omega-3 fatty acids, vitamins A, D and E. Avoid the egg whites for your little one’s first year as these contain difficult-to-digest proteins and are what usually cause an allergic reaction. Egg yolks should be softly cooked in the beginning, but from 1 year of age you can add them in raw. They can be blended into all plant-based purées to add fat and protein. GheeFlaxseed oilCoconut oilHemp seed oilOlive oil Adding some healthy fats to your little one’s plant-based purées and meals will aid the absorption of vitamins A, D, E and K. Healthy fats are essential for your little one’s brain development Sauerkraut liquidKefir These will supply probiotics – vital friendly gut bacteria that complete the digestion process, produce vitamins, keep pathogenic (‘bad’) bacteria in check, and support the immune system. Get my sauerkraut recipe here CinnamonNutmegCloveVanillaGingerCardamomAllSpiceTurmeric Spices are a great way to develop your little one’s flavour palette. They also have medicinal qualities and are a source of nutrients. Cinnamon is a great source of manganese, fibre, calcium, potassium, iron, zinc, magnesium and vitamin A. It is known to have antioxidant, anti-diabetic, antiseptic, local anaesthetic, anti-inflammatory, warming and anti-flatulent properties. Nutmeg is a good source of potassium, calcium, iron, manganese, vitamins A, B’s and C. It is a useful remedy for: insomnia, anxiety, nausea and vomiting, indigestion (gas) and diarrhoea as well as being anti-inflammatory and antibacterial. Cloves are a great source of manganese, vitamin K, dietary fibre, iron, magnesium and calcium. They are well known for their ability to relieve tooth and gum pain, aid digestion and provide relief from asthma and bronchitis. Vanilla has antioxidant, anti-depressant and anti-inflammatory properties. Ginger is a good source of vitamin C, magnesium, potassium, copper and manganese. It is a remedy for headaches, motion sickness, nausea, indigestion, wind, colic, cold, flu, bronchitis. Ginger tea is a useful remedy for morning sickness. It boosts the immune system and protects against bacteria and fungi. Cardamom is a great source of iron, manganese, potassium, calcium, magnesium, dietary fibre, riboflavin, niacin and vitamin C. It is used as an antiseptic, antispasmodic, carminative, digestive, diuretic, expectorant, stimulant and tonic. It is a remedy for sore throats, constipation, indigestion and colic. Allspice has a good amounts of potassium, manganese, iron, copper, selenium, magnesium, vitamin A, vitamin B6, riboflavin, niacin and vitamin C. It has antiinflammatory, warming and soothing and anti-flatulent properties and is known to aid digestion. Turmeric is a powerful anti-inflammatory and antioxidant and an excellent source of iron, manganese, vitamin B6, dietary fibre, potassium, vitamin C and magnesium Broth Instead of using water to thin a purée or to cook the vegetables in, use bone broth. Bone broth: builds a healthy gut and digestion aids muscle repair and growth fights inflammation creates a balanced nervous system and a strong immune system inhibits infection caused by cold and flu viruses helps protein and mineral absorption promotes strong, healthy bones It is a source of calcium, magnesium, phosphorus, sulphur, boron, zinc, peptides (healing amino acids and natural antibiotics), collagen, omega-9s, iron, vitamin B6 and B12. All the nutrients are easily absorbed by your little one’s body (bio-available). Get the bone broth recipe here Dulse Dulse is an excellent source of calcium, potassium and vitamin B12 – making it a useful addition to any dairy-free or vegan diet. It is also a great source of protein, vitamins B6 and A, iron, phosphorus, manganese and iodine. Sprinkle dulse flakes into purées, or other meals. Liver Liver is an excellent source of high quality protein, omega-3 fatty acids, vitamin B complex (including choline, B12 and folate), a highly bio-available form of iron, vitamin D, vitamin E, pre-formed vitamin A (retinol), vitamin K2, various amino acids and trace minerals such as copper, zinc, chromium and cholesterol. A small amount (1 teaspoon) of raw liver can be grated into any purée. The liver must be frozen for 2 weeks before using it raw (fourteen days will ensure the elimination of pathogens and parasites). Alternatively add some Chicken Liver pâté into purées of other meals. Blackstrap molasses Blackstrap molasses is one way to boost your little one’s iron intake. Its other nutrients include manganese,

Paarl Dietitians

Vegan – Is it healthier?

As popular campaigns like ‘Veganuary’ fuel New Year’s pledges to cut back on meat, MANY people has been asking my opinion on vegan diets and on documentaries such as ‘The Game Changers’. If you are intrigued – keep reading.

Paarl Dietitians

Lockdown Weight Gain

Since being back at the practice and seeing patients, we found that majority of people have gained 1-3kg during the lockdown period. This weight gain occurred despite eating ‘ok’ and doing some form of exercise.

Happy Family Organics

How to incorporate yoghurt into your child’s diet by Happy Family Organics

The yoghurt section in the grocery store seems to be expanding every year, and it’s no wonder why! Yoghurt is a versatile food that can be eaten as part of a meal or snack, and can be incorporated into many recipes from dips to dressings to desserts. Yoghurt contains protein, fat and carbohydrates, as well as the nutrients calcium, potassium, phosphorus and is often enriched with vitamin D.

OneAid

Face masks in children: how safe are they?

If you follow me on social media you would have noticed me going on a lot about face masks recently. It’s very important for the public to know how to use them correctly because otherwise it’s such a wasted effort.

Parenting Hub

Infertility: Don’t wait until it’s too late!

Parenthood is undeniably one of the most universally desired goals in adulthood, and most people have life plans that include children. However, not all couples who want a pregnancy will achieve one spontaneously and a proportion will need to seek medical treatment to help resolve underlying fertility problems. It’s therefore understandable that infertility has been recognised as a public health issue worldwide by the World Health Organisation (WHO).  “Infertility is when you cannot get or stay pregnant after trying for at least a year and you are under the age of 35,” says Dr Sulaiman Heylen, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG). One in every four couples in developing countries is affected by infertility, while one in six couples worldwide experience some form of infertility problem at least once during their reproductive lifetime. The current prevalence of infertility lasting for at least 12 months is estimated to affect between 8 to 12% worldwide for women aged 20 to 44. In recent years, the number of couples seeking treatment for infertility has dramatically increased due to factors such as postponement of childbearing in women, development of newer and more successful techniques for infertility treatment, and increasing awareness of available services. This increasing participation in fertility treatment has also raised awareness and inspired investigation into the psychological ramifications of infertility. It can cause stress, depression and anxiety, which is why it is important to know that there are options available for treatment. Age is a key factor “Up to 50% of all patients who visit a fertility centre are 35 or older. We cannot stress enough how important it is for people not to wait too long when they consider having children. Young women need to be aware that there is a slow decline in fertility from their 20s until the age of 35, after which it starts to decrease rapidly until the age of 45,” says Dr Heylen. “It’s extremely important for couples to investigate fertility options and fertility preservation earlier in life, rather than leaving it too late. A woman who is not ready to have a child can choose to freeze her eggs to try to preserve her ability to have a child later,” says Dr Heylen.  It’s estimated that 20 to 30% of infertility cases are explained by physiological causes in men, 20 to 35% by physiological causes in women, and 25 to 40% of cases are because of a problem in both partners. In 10 to 20% no cause is found. Infertility is also associated with lifestyle factors such as smoking, body weight and stress. A woman’s age is one of the most important factors affecting whether she is able to conceive and give birth to a healthy child. This is due to several changes that are a natural part of ageing:  The number and quality of eggs (ovarian reserve) decreases naturally and progressively from the time a woman is born until the time she reaches menopause.  It is not only more difficult to get pregnant (conceive), but miscarriage and chromosomal abnormalities in the child (such as Down syndrome) are more common in older mothers. Fibroids, endometriosis, and tubal disease are more common and can affect fertility. Women who become pregnant at an older age have a higher risk of complications during the pregnancy, such as gestational diabetes and preeclampsia. The decrease in a man’s fertility appears to occur later in life than in a woman’s fertility. In their mid-to-late 40s, men experience changes in their sperm that can cause issues with fertility, and chromosomal or developmental problems with their children. Lifestyle and family history If you have any of the following risk factors, you may also consider seeking advice earlier: Family history (i.e., mother or sister) of early menopause (before age 51) History of cigarette smoking in either partner Previous ovarian surgery Exposure to chemotherapy or radiation to treat cancer in either partner Shortening in the time between periods Skipped or missed periods History of injury to the testicles Exposure to toxic chemicals (certain pesticides or solvents) Pregnancy is a complex process Pregnancy is the result of a process that has many steps. To get pregnant: A woman’s body must release an egg from one of her ovaries (ovulation). A man’s sperm must join with the egg along the way (fertilise). The fertilised egg must go through a fallopian tube toward the uterus. The fertilised egg must attach to the inside of the uterus (implantation). Infertility may result from a problem with any or several of these steps. For the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result. Couples, dependent on the ages of the partners, are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis. “Based on the results of the specific tests, a treatment plan will be made which can include medication, surgery or assisted reproduction,” says Dr Heylen.  Treatment options Not all couples who desire a pregnancy will achieve one spontaneously and some will need medical help to resolve underlying fertility problems. It is now estimated that more than 9 million babies have been born worldwide since the first IVF baby was born in 1978. Most assisted reproductive technology (ART) treatments take place in women aged between 30 and 39. The most common fertilisation technique is ICSI

Happy Family Organics

Baby and tot picky eater meal plan by Happy Family Organics

It seems we constantly hear about kids being picky eaters; it may feel like we are condemned to have a child who will eat nothing but chicken fingers and pizza. Is there anything you can do to raise an adventurous eater? Plenty actually, starting right now!

Bonitas – innovation, life stages and quality care

Virtual medical consultations now available 24/7

Staying healthy remains a priority for South Africans especially during the COVID-19 lockdown. However it can be a challenge to seek medical help when the Government is asking us to stay home, wear masks, wash our hands frequently and practice social distancing. The solution lies in virtual care.

STBB

Applying for a protection order against Domestic Abuse

It is not uncommon for people in South Africa to find themselves trapped in an abusive relationship. Children are often the victims of domestic violence either directly, or indirectly by being a witness to the abuse which can have a dire and lasting impact on them.

I Walk Awake

Manage Teen Burnout: Try Resilience Coaching

To break-through these struggles we need to build our motivation and self-esteem from the inside out. This means that at the beginning of each day you should take a conscious look at how you are doing. For example, you should score yourself out of 10 on physical energy, emotional wellness, mental sharpness and connection to purpose or a greater cause. Where you score lower, you can ask yourself what you need to make happen in your day ahead that will raise that score. What are you grateful for right now? What is your intention for today? What affirmation can you choose or create to frame your day ahead?

Done with compassion and genuine curiosity, this “checking in” morning practice will not only get you conscious, but will also support you in building and staying true to healthy personal habits.

Happy Family Organics

What are superfoods and why do we need them?

The term “superfood” is relatively new, but it has become extremely popular. “Superfoods” refer to foods that have exceptionally high nutritional value in the form of vitamins and minerals, and minimal calories. They are also known for being packed with antioxidants.

Bonitas – innovation, life stages and quality care

Vaccine against Streptococcus Pneumoniae

The World Health Organization (WHO) stresses that although pneumonia vaccines are not effective against COVID -19, vaccinations against respiratory illnesses are highly recommended to protect your health and lowering the risk of becoming infected with any respiratory disease during this time. WHO also states that globally more children, under the age of 5, die from pneumonia than malaria, AIDS and TB combined. In SA, flu and pneumonia rank second – after intestinal infectious disease – as the leading cause of children under 5, which doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. Bonitas Medical Fund recommends having a flu vaccine, it is the first line of defence when it comes to protecting yourself. For those who are at risk of pneumonia, a second vaccination against Streptococcus pneumouniae is also recommended. What is pneumonia? Pneumonia is inflammation of the lungs caused by an infection. Many organisms can cause lower respiratory tract infections or pneumonia. Mixed infections with multiple viral and/or bacterial infections are common. Streptococcus pneumoniae is a bacterium known to be a common cause of bacterial pneumonia in South Africa. Pneumococcal infection may cause mild disease such as a middle ear infection or more complicated infections like pneumonia or an infection of the blood called bacteraemia. In South Africa, individuals at risk of more severe or invasive pneumococcal disease include the elderly, HIV-infected individuals and individuals with chronic medical conditions (e.g. chronic lung disease). Severe disease may require hospitalisation for treatment and may result in death. These streptococcal bacteria can spread from the nose, throat and ears of infected individuals.  Pneumococcal vaccine  Two pneumococcal vaccines are registered for use in adults (over 18 years of age) in South Africa: The 23-valent polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugate vaccine (PCV13). PCV13 is also included in the South African Extended Programme of Immunisation (EPI) for childhood vaccines and is given to infants at 6 weeks, 14 weeks and 9 months.  These vaccines aim to provide immunity against the types of Streptococcus pneumoniae that are most commonly associated with severe disease. According to local clinical guidelines from the South African Thoracic Society and Federation of Infectious Diseases Societies of Southern Africa, since the introduction of the PCV13 into the EPI there has been a reduction in the number of cases of pneumococcal pneumonia caused by these types of Streptococcus pneumoniae in South Africa. Who should have the vaccination? Infants routinely receive pneumococcal conjugate vaccines (PCV13) as part of the EPI for childhood disease*. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for individuals who are at risk of developing severe disease*: individuals 65 years or older  anyone with chronic medical conditions affecting the lung, heart or kidneys HIV-infected individuals  Those with a compromised immune system due to other medical conditions (e.g. individuals with cancer) Pneumococcal vaccination during the COVID-19 pandemic The pneumococcal vaccination is not active against the novel coronavirus and will not protect you from becoming infected; it will offer protection against Streptococcus pneumoniae.  However, the National Institute of Communicable Disease (NICD) states the following, ‘any intervention to lower the risk of becoming infected with any respiratory disease at this time may be of benefit. Lowering the risk of acquiring a respiratory infection, will allow for less visits to clinics and less hospital admissions, thus decreasing the burden on the health infrastructure at this time and lowering ones’ exposure to acquiring COVID-19 in the hospitals/clinics.’ Although pneumococcal vaccination does not protect against COVID-19 mild or severe disease or COVID-19 pneumonia, it could play a role in preventing secondary pneumococcal pneumonia infections in those with underlying conditions and the elderly. When to get vaccinated?   If you think you may be within one of the groups at risk of severe pneumococcal disease, contact your pharmacy to check whether stock of the vaccine is available and schedule an appointment to be vaccinated.  Most medical aid plans offer a free flu vaccine annually to members as well as a once off –pneumococcal vaccine for those over the age of 65. As part of the preventative care benefit this is taken from risk cover so it doesn’t deplete members’ savings. Bonitas says that despite the evidence of the efficacy of both the flu and the pneumonia vaccinations, there is not enough uptake. To address this and encourage more members to get vaccinated the Scheme runs email and SMS vaccine drives targeted at the elderly, high risk/emerging risk members as well as children. It reports that this has shown an improvement in people taking the necessarily precautions, but the Fund still believes there is a long way to go.

Bonitas – innovation, life stages and quality care

Coronavirus – should you still have a flu vaccine?

The flu season is officially underway and, while Coronavirus is bringing the world to a standstill, it is important to remember that flu can be deadly too. Which is why it is important to have a flu vaccine.

RediscoverDairy

Affordable, nutrient-dense dairy is the star of tighter food budgets

As countries around the world, like South Africa, grapple with easing lock-downs and rebuilding economies, COVID-19 remains part of everyday life. Protection from the novel virus is likely to remain a high priority for the foreseeable future. Maintaining our health and supporting our immune systems has probably never been so important for our families. Many South Africans are also tightening the purse strings on their household budgets as the financial consequences of the pandemic response become starker and global recession looms.

Bonitas – innovation, life stages and quality care

Making sense of the numbers – cases, co-morbidities and costs

As the number of COVID-19 infections creeps closer to 20 000, both public and private healthcare is going to be under constant pressure. The World Health Organization (WHO) says its COVID-19 data to date suggests that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation.

Milas Meals

7 Steps to a Healthy Gut

Did you know that about 70% of our immune system is housed in our gut (or “gutter” as Mila calls it )? Well to be more precise, your gut lining houses 70% of the cells that make up your immune system. (1)

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