With South Africa counting down the hours until the first 1 million doses of Covid-19 vaccine land at OR Tambo International Airport from India tomorrow, the question we’re mulling over is: When will we begin to feel things shift in the country?
The answer isn’t simple.
The country’s 1.25 million healthcare workers are set to be first in line to receive the Oxford-AstraZeneca jabs – produced and brought in from the Serum Institute of India under the trade name Covishield. On arrival tomorrow, the shipment will undergo quarantine, quality assurance testing and a reconciliation process for 10 to 14 days.
Once that is done, the vaccine will be distributed across the country.
The national health department has set an ambitious target of vaccinating 40 million adults this year in an effort to achieve herd immunity.
While immunising healthcare workers is an all-important first step, it will be a long while still before the true impact of the three-phase vaccination strategy is realised.
“We can’t expect to see an impact on community transmission of Covid-19 from the immunisation of healthcare workers alone. Immunisation of healthcare workers is a first step. The second step is the immunisation of the elderly, which should decrease the number of anticipated deaths,” Dr Melinda Suchard told City Press this week. Suchard is the head of the Centre for Vaccines and Immunology at the National Institute for Communicable Diseases (NICD).
“Herd immunity won’t apply when we talk about health workers only because health workers interact with patients and community members who won’t yet be immunised in phase 1.”
However, she said, “immunising them will be important for their individual protection from occupational exposure and for the prevention of transmission to other patients in healthcare settings”.
Despite the spread of the reportedly more transmissible new variant of the virus, Sars-CoV-2 501Y.V2 – which has recently been shown to be prevalent in the Eastern Cape, the Western Cape and KwaZulu-Natal – and the confirmation by scientists on Thursday that the UK variant B.1.1.7 (501Y.V1) was also in circulation in South Africa, infection numbers continued to steadily decline this week.
According to NICD surveillance records, the positivity rate declined from 19% last week to 17.62% this week.
Hospital admissions for Covid-19-related illness in both public and private hospitals have also shown a decline, according to records from 638 facilities.
But South Africa is not out of the deadly Covid-19 woods yet.
“We can expect Covid-19 to be with us for many months to come, even years,” Suchard stated matter-of-factly.
“But as more people come through vaccination and through circulating infection, the number of people at risk will decrease, meaning the disease will circulate more slowly rather than cause such large outbreaks.”
The vaccines, she added, would “be a tremendous help” to get a large portion of the population immune in a short space of time – approximately six months.
While Suchard said they were optimistic that South Africa had passed the peak of the second wave, it remains to be seen whether the country – like others across the world – will go through further surges, which remains a strong possibility.
During a press briefing about the country’s phase 1 inoculation plan, Health Minister Zweli Mkhize said the threat of a third surge was a real concern.
“We need to really make sure that if we’ve got the vaccines, we drive as much as possible [to vaccinate as many people as possible] so that more people are on the safer side. The targeted 40 million remains realistic. It’s a tall order, but we’ll have to push,” he said.
Not only will the rate of vaccination be a factor when it comes to the impact the programme will have on the pandemic, it will also determine the effectiveness of the jabs and the rate of viral transmission.
Last week, an article in the scientific journal Nature showed how Israel had been among the first countries to report the impact of vaccines administered to people outside of vaccine trials.
In preliminary analysis of the 200 000 people aged 60 and older who got the Pfizer-BioNTech two-dose vaccine, researchers found that it lowered the chances of testing positive for Covid-19 by 33%.
Even more impressive results came out of Israel this week, with the country reporting that, of the 700 000 people who got vaccinated, only 300 later contracted the virus and only 16 required hospitalisation. Israel leads the pack in vaccination reach worldwide.
The research also suggests that the Pfizer-BioNTech vaccine protects against the South African and UK variants. On Wednesday, the drug makers announced that the vaccine did indeed protect against the variants.
Professor Barry Schoub, chair of the ministerial advisory committee on Covid-19 vaccines, this week said: “We’ve seen in the roll-out programmes overseas, for instance in Israel and the UK, where, for example, in the elderly, once a certain [number of vaccinations] is reached, then one starts seeing declines in various parameters such as hospital admissions and ventilator usage.
“So I think at each phase as one reaches herd immunity, we’ll start seeing those effects. But in terms of the whole population, it’s going to depend on when we reach the stage of herd immunity [after vaccinating 67% of the adult population] to see the impact on the whole population. Until such a time, as we’ve seen even in overseas countries, we won’t really see an impact. We’ll still see the waves and we’ll still see [a] significant [amount of] infections.”
In the meantime, Schoub urged people to remain on high alert, wash their hands, maintain a physical distance when around other people and wear their masks.