Jo Webber, of the NHS Confederation, accepts that a spate of extremely cold weather could make matters worse, although she believes the NHS will cope with whatever is thrown at it.

BBC: Can the NHS cope with winter?

Mr Maharaj said there were still some South Africans who "sit with their dogs in front in a van or truck with a worker at the back in pouring rain or extremely cold weather".

BBC: South Africa's Jacob Zuma in dog ownership row

After the severe weather, a cold-weather system could bring snow and freezing rain to the Midwest, beginning Wednesday, and the threat of extremely cold weather in the northern Plains states and Upper Midwest, particularly on Thursday.

CNN: STORY HIGHLIGHTS