SA’s Covid-19 vaccine roll-out strategy unlikely to delay third wave, says UCT professor

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  • A third wave of Covid-19 infections is expected to hit South Africa soon, experts warn
  • This, as the government continues to inoculate its frontline healthcare workers 
  • It's unlikely that SA will reach population immunity in time, but we can better prepare for a third wave

Experts have warned that a third wave of Covid-19 is inevitable and will reach South Africa in the upcoming cooler months. According to Professor Marc Mendelson, head of the Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital, University of Cape Town (UCT), SA’s vaccine roll-out programme may not delay the arrival of the third wave.

“There are never watertight answers when dealing with this pandemic, but to get to population immunity through natural infection plus vaccination-induced immunity will require that millions of the population be vaccinated in a relatively short timeframe,” Mendelson said in a UCT news release.

As of Thursday, more than 157 000 frontline healthcare workers have been inoculated with the Johnson & Johnson Covid jab. A News24 editorial notes that the South African government has admitted that the country is likely to miss vaccination targets.

For Mendelson, “predicting the third wave [is] fraught with problems”.

Instead, he explained that there are several aspects that may come into play and impact the resulting force of infection. 

These include further mutations in the virus, the speed of the country’s vaccination roll-out programme, non-compliance with public health interventions such as physical distancing, and the possibility of other unforeseen drivers that we are yet to learn about.

The new 501Y.V2 coronavirus variant, first detected in late 2020 in SA, caused a huge spike of cases during the country’s second wave. The variant carries a mutation, called N501Y, that has made it more contagious than the original variant. It has already spread to more than 30 other countries worldwide.

Mendelson added that further mutations of SARS-CoV-2 will occur, but it is not yet certain whether they will give the virus an evolutionary advantage. 

The only way of reducing the emergence of another variant, he advised, is to reduce transmission and boost immunity by rolling out vaccines fast. If a new variant does not occur this time round, then we should see a less impactful third wave, he said.

“In truth, however, with the current tools in our box, we won’t eradicate SARS-CoV-2,” he added. Instead, what we will experience is something other scientists have also pointed out: that the virus is likely to become endemic, like influenza (the flu), where we will have better control of it.

Lessons learned

There were also some valuable lessons that stemmed from SA’s second wave, said Mendelson, and advised on how we can better prepare for a potential third wave.

Apart from the highly infectious 501Y.V2 variant that caused an even-worse second wave of infections, it was "super-spreader events" which took place at social gatherings that compounded transmission of this more infectious virus. The relaxation of these interventions, he believed, played a significant role in helping to propagate the second wave.

Therefore, it is important that we learn from the second wave and not repeat mistakes made, said Mendelson, and added that maintaining a ban on mass gatherings and focusing on super-spreader events in poorly ventilated indoor spaces is critical. 

Careful assessment of how healthcare workers were deployed on the Covid-19 frontline is also needed, he said. “Despite the need to keep as many non-Covid-19 services running at an appropriate level, the whole-of-hospital human resource model that was ultimately achieved in the first wave, but diluted in the second, should be reinstated. 

“This would go a long way to providing the physical and psychosocial support to the relative minority of doctors who bore the brunt of the second wave.”

Looking ahead

“While international travel continues, we know that importing novel variants of SARS-CoV-2 into South Africa is always going to be possible,” said Mendelson. 

This is why it is important to continue surveillance for new variants through sequencing virus genomes from people infected with Covid disease. In doing so, scientists and officials can react swiftly to changes in circulation of these variants, he explained. 

South Africa’s network of genomic surveillance, led by KRISP, allows scientists to track any new changes in the virus on a weekly basis. 

“Then of course vaccinate, vaccinate, vaccinate. And maintain all public health prevention measures – those measures are absolutely critical as we look ahead,” said Mendelson.

READ | Covid then vs Covid now: The emergence of variants and how the virus has evolved

READ | SA's AstraZeneca study ‘rude awakening, turning point’ in Covid vaccine development – Shabir Madhi

READ | Another coronavirus variant detected in SA, but no reason to panic, says KRISP director

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