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Wits University professor of vaccination, Professor Shabir Madhi, left, and Maverick Citizen editor Mark Heywood. (Photos: Supplied | Leila Dougan)
Up to 40% of the people living in the densely populated areas of South Africa had likely been infected by the coronavirus, said vaccinologist and Ministerial Advisory Committee member Professor Shabir Madhi during a Daily Maverick webinar on Sunday.
Between 35% and 40% of people living in densely populated areas in South Africa had likely been infected with the coronavirus, the latest figures available for the Western Cape and Gauteng show.
The number of infected people far exceeded the confirmed figure of 650,000; “It’s more in the region of 15 million to 20 million,” Madhi said. “No one could have predicted what would happen in South Africa.”
Madhi said that initial infection models estimated that about 25% of the population would be infected. However, she said the high prevalence of infections does not translate into high rates of hospitalizations and deaths.
About half of the confirmed number of cases in South Africa had been confirmed by private sector laboratories, but the private sector does not cover 50% of the country’s population. He added that the asymptomatic and mildly symptomatic were also not tested.
“The numbers [35% to 40%] they are based on antibody tests, ”he said.
He added that at the peak of the outbreak the country was reporting some 14,000 cases a day, but new models show that there were between 60,000 and 80,000 new cases a day.
“While the number of deaths is probably an underestimate… we have not seen the infection rate translate into hospitalizations and deaths. It didn’t happen to the extent that the modelers predicted. ”
He said using the Western Cape as a benchmark, while there were around 15,000 confirmed deaths caused by Covid-19 in South Africa, the actual number is likely to be around 30,000.
“Not everyone who has died has been screened for Covid-19. We must recognize that there have been many deaths outside of hospitals. If we use the Western Cape as a benchmark and use the same setting, we think about 30,000 instead of 15,000. “
Madhi said the theory he favors is that South Africans have “fundamental immunity, probably due to exposure to the common cold coronaviruses,” and provided reasons why hospitalizations and deaths were relatively low for a country that had a low number of so high of infections. She said this would have offered cross-protective immunity against the virus that caused Covid-19.
Other theories, Madhi said, are based on the relative youth of South Africa’s population and preventive measures, such as confinement and the use of masks, that may have offered some protection.
“We do not know which of these reasons contributed to our not experiencing [the number of] deaths and hospitalizations [that were expected]. ”
Madhi warned that the country was not yet out of the woods. “We have reached a threshold [of infections to create] group immunity. “He cautioned that these levels were not high enough to allow the removal of all restrictions and non-pharmaceutical interventions, such as the use of masks, physical distancing and hand washing.
“It will be premature to return to an open society.”
He said that all indications currently showed that the country is on a downward trajectory, in terms of new cases, hospitalizations and the number of confirmed deaths. He added that he still advised against mass gatherings as they could cause new outbreaks.
“[Mass gatherings] they are exactly what will allow for super propagation. We will see a much faster resurgence … a lot of infections in a short period of time. “
But, Madhi added, there was no longer a medical reason to keep SA’s borders closed.
“Having a few visitors is not going to generate massive outbreaks in the future. Visitors will not be the motive if they adhere to non-pharmaceutical interventions. We are not trying to contain viral transmission in South Africa, which is when we need to close the borders. “
He said he did not believe that the quarantine of foreign visitors was necessary. “We do not quarantine close contacts of South Africans who tested positive. There is almost no reason to quarantine incoming visitors. Right now it’s a waste of money. “
He said that if the country lowered its adherence levels to non-pharmaceutical interventions, there would likely be a resurgence. “But it will be less severe this time.”
While this was difficult to predict as it depended on how complacent people became with masks, handwashing, physical distancing, and mass gatherings, Madhi said emerging patterns in European countries showed an increase in infections after summer break.
“We could see less compliance in December, which means that in January and February we could see a resurgence.”
He added: “The reality is that people are re-infected. There is nothing unusual about it. The reason he recovered the first time was that he developed an immune response. One of the challenges with this virus is that we don’t know how long this immunity will last. “
On Wednesday, South Africa halted its trial of the vaccine developed by the University of Oxford and AstraZeneca after a participant in the United Kingdom fell ill, but Madhi said on Sunday the suspension had been lifted.
“We have concluded that the adverse event was unlikely to be related to the vaccine.”
He said the South African part of the trial will resume after a review by an ethics committee and the South African Health Products Regulation Authority.
That’s where we are. We have registered 1,800 of the 2,000 we are targeting. We would have completed [the enrollment] last week if we don’t stop vaccinations. “
He said that when the vaccine is shown to be effective, it could be recommended for use under an emergency waiver that allows the introduction of vaccines before obtaining a license from a regulatory authority.
At best, the country will have 10 million doses of the vaccine by June next year, but this will require a significant commitment from the government.
“I think the government is raising its hand and buying the concept,” he said.
However, the virus was unlikely to ever be eradicated, Madhi added.
“The best scenario for us is that it becomes a seasonal virus with sporadic outbreaks. It is very unlikely that we will reach elimination. Some of these respiratory viruses have been circulating since the 1960s. Segments of the population will always be vulnerable. We don’t know how long the immunity will last. ”
He said the health consequences of the lockdown also need to be addressed with great urgency, explaining that around 12,000 excess deaths due to natural causes recorded this year were the result of strict lockdown rules.
“Deaths due to decreased management of tuberculosis and HIV will carry over to the next year or the next year,” he said.
“We have seen a 25% decrease in vaccines. We will have to figure out how to reverse this. The blockade had a cost. ” DM / MC
