Category: COVID

Categories : COVIDTags :

South Africa Mulls AstraZeneca Again in Light of Delta Protection

On By ModernMedia
Photo by Mika Baumeister on Unsplash

Four months after selling off one million AstraZeneca vaccine doses, South Africa is considering buying more of them to contain the spread of the Delta variant.

The Delta variant is much more transmissible than previous strains, including the beta variant. However, the government presented data on 26 June showing a 70% efficacy against it with the AstraZeneca vaccine. The vaccine, which of June 2021 comprises over 90% of all doses supplied through COVAX globally, will have a significant impact as the Delta variants spread.

The government may approach the Serum Institute of India for the shots, deputy health minister Joe Phaahla told lawmakers on Wednesday.
This would add to supplies as the health regulator considers approving Russia’s Sputnik V and China’s Sinovac inoculations, he said, adding that he hoped to secure these doses from India’s Serum Institute.

In March, also facing expiry on the doses, the government sold off its doses to the African Union after research showed the then dominant Beta variant was resistant.

In February, University of the Witwatersrand Professor of Vaccinology Shabir Madhi said the AstraZeneca vaccine had a roughly 20% efficacy in preventing mild disease from the Beta variant.

“We don’t want to go back to the original argument of whether its limited efficacy on the Beta variant was correct, to dispose of it, to sell it to other countries,” Phaahla said. “With the current information that it is quite efficacious when it comes to the Delta, it is already registered.”

A study by the University of Oxford,demonstrates that AstraZeneca’s COVID vaccine, will provide protection against the Delta and Kappa variants; formerly the ‘Indian’ variants. The study investigated the ability of monoclonal antibodies from recovered or vaccinated people to neutralise the Delta and Kappa variants. 

Neutralisation against the Delta and Kappa variants was comparable with that seen against the Alpha and Gamma variants, with no evidence of widespread antibody escape as seen with the Beta variant. These results indicate that the vaccines could be effective in real-world settings. The Phase III COV002 trial in the UK showed vaccine efficacy of 70.4% at preventing symptomatic COVID against the Alpha variant, when measured more than 14 days after a second dose.

Furthermore, a recent analysis by Public Health England showed early evidence of real-world data that two doses of AstraZeneca’s COVID vaccine are effective against the Delta variant, with similar levels of protection achieved as those seen against the Alpha variant.

Sources: BusinessTech, AstraZeneca

Categories : COVID General InterestTags :

Month-long COVID Coma Left Ambulance Worker ‘Scarred’

On By ModernMedia
Photo by Ian Taylor on Unsplash

A UK ambulance worker who contracted COVID and was in an induced coma for over a month says his family is psychologically scarred by what happened.

Paul Clements, 59, had major organ failure as well as several infections, leaving him in intensive care at Bristol Royal Infirmary. Doctors told him he was lucky to survive the 33-day induced coma. Speaking to the BBC, Mr Clements said that the time passed “in the blink of an eye”.

“The last thing I remember is being handed a cup of tea by my daughter,” said Mr Clements. He was agitated, complaining that the tea tasted awful, prompting concern from his family.

“I put it down, and then I blinked. I then found myself lying on a bed looking at a nurse,” he recalled. “I told her that I’d put my tea down somewhere.”

He said the nurse laughed in response, and then explained to him that he “had been unconscious for 33 days.”

On 19 March 2020, Mr Celements began to have COVID symptoms. Five days later, he was rushed into hospital.

“They tried three times to wake me up. The doctors told me I had pneumonia, a chest infection, an abdominal infection, kidney failure and liver failure – all wrapped up in COVID.” Up to a third of hospitalised COVID patients in the UK’s first wave had ‘do not resuscitate’ orders, recorded on or just before their admission.

He says that “Trying to get my head around that was almost impossible. Even now they have no idea why I survived.”

At the time, his family weren’t allowed to visit the Bristol Royal Infirmary where he was due to COVID restrictions.

“It was hell, absolute hell,” said Paul’s wife, Kerri. “Every time the phone rings you’re on edge thinking this is a call we don’t want. Listening out for his breathing every night, if he coughs I’m on edge, if he says he doesn’t feel well we’re back on edge.”

Mr Clements spent a total of three months in hospital before being leaving the ward to applause by the staff.

He returned to his work as an emergency care assistant six months later, with South Western Ambulance Service where has been for the past 38 years. He acknowledges the close call he had. “Unfortunately in my job I’ve put people in body bags and taken them to the mortuary,” he said.

“I spent some time in hospital trying to get my head around it and realised that could’ve been me, and the reality of it is so scary.”

Source: BBC News

Categories : COVIDTags :

Male and High BMI not Linked to COVID ICU Mortality

On By ModernMedia
Photo by Mufid Majnun on Unsplash

A new meta-analysis shows that, contrary to some previous research, being male and increasing body mass index (BMI) are not associated with increased mortality in COVID patients in intensive care units (ICU).

However, the study by Dr Bruce Biccard (Groote Schuur Hospital and University of Cape Town) and colleagues found that there were a wide range of factors linked to death from COVID in ICU. An August 2020 study of ICU COVID patients in Europe showed an association for age but not male sex.

The meta-analysis, which includes 58 studies and 44 305 patients published in the journal Anaesthesia, showed that, compared to patients without these risk factors, ICU COVID patients had a 40% greater mortality risk with smoking history, 54% higher with hypertension, 41% higher with diabetes, 75% higher with respiratory disease, around twice as high with cardiovascular disease or cancer, and 2.4 times higher with kidney disease. Other factors associated with an increased risk of death were the severity of organ failure, needing mechanical ventilation (a factor of 2.5 over non-ICU), as well as increased white blood cell counts and other inflammation markers.

The authors believe that age may effectively represent frailty in COVID patients which impacts on a person’s physiological reserve to overcome a critical illness. Hypertension, smoking and respiratory disease may be linked by their association with angiotensin-converting enzyme (ACE) receptors in the body, since there is increased expression of ACE-2 receptors amongst smokers and patients with chronic obstructive pulmonary disease. The link between hypertension and cardiovascular disease and increased mortality may be associated with the risk of cardiac injury which occurs with the systemic inflammatory response to COVID infection.

The authors said: “The findings confirm the association between diabetes, cardiovascular and respiratory comorbidities with mortality in COVID patients. However, the reported associations between male sex and increasing BMI worsening outcomes are not supported by this meta-analysis of patients admitted to ICU. This meta-analysis provides a large sample size with respect to these risk factors and is a robust estimate of risk associated with male sex and BMI.”

Source: EurekAlert!

Journal information: Anaesthesia, doi.org/10.1111/anae.15532

Categories : COVID HospitalsTags : 1 Comment

Upgrade to FFP3 Face Mask Dramatically Cuts Infections

On By ModernMedia
Photo by Artem Podrez from Pexels

Upgrading face masks to filtering face piece (FFP3) respirators for healthcare workers on COVID wards produced a dramatic reduction in hospital acquired SARS-CoV-2 infections, according to a preliminary study published in the BMJ.

For most of 2020, Cambridge University Hospitals NHS Foundation Trust followed national guidance that healthcare workers should use fluid resistant surgical masks as respiratory protective equipment unless aerosol generating procedures (AGPs) were being carried out when FFP3 respirators were advised.

From the pandemic’s outset, the trust has been regularly screening its healthcare workers for SARS-CoV-2 even when asymptomatic. They found that healthcare workers on “red” COVID wards had a greater infection risk than staff on “green” wards, even with protective equipment. So in December 2020 the trust implemented a change in policy so that staff on red wards wore FFP3 masks instead of fluid resistant surgical masks. The FFP3 standard requires that masks filter 99% of all particles measuring up to 0.6 μm.

The study was carried out at Addenbrooke’s Hospital in Cambridge. Before the change in policy, cases among staff were higher on COVID versus non-COVID wards in seven out of eight weeks analysed. Following the change in protective equipment the incidence of infection on the two types of ward was similar. Of 609 positive results over the eight week study period, 169 were included in the study. Healthcare workers who were not ward based or worked between different wards were excluded, as were, non-clinical staff, and staff working in critical care areas.

The researchers developed a simple mathematical model to quantify the risk of infection for healthcare workers. This found that the risk of direct infection from working on a red ward prior to the policy change was 47 times greater than the corresponding risk from working on a green ward. While almost all cases on green wards were likely caused by community-acquired infection, cases on red wards at the beginning the study period were attributed mainly to direct, ward-based exposure.

The model also suggested that the introduction of FFP3 respirators provided 100% protection (confidence interval 31.3%, 100%) protection against direct, ward based covid infection.

Study author Chris Illingworth, from the MRC Biostatistics Unit at the University of Cambridge, said: “Before the face masks were upgraded, the majority of infections among healthcare workers on the COVID wards were likely because of direct exposure to patients with COVID. Once FFP3 respirators were introduced, the number of cases attributed to exposure on COVID wards dropped dramatically—in fact, our model suggests that FFP3 respirators may have cut ward based infection to zero.”

Michael Weekes from the department of medicine at the University of Cambridge added: “Our data suggest there’s an urgent need to look at the PPE offered to healthcare workers on the frontline. Upgrading the equipment so that FFP3 masks are offered to all healthcare workers caring for patients with COVID could reduce the number of infections, keep more hospital staff safe, and remove some of the burden on already stretched healthcare services caused by absence of key staff because of illness.”

Source: The BMJ

Journal information: BMJ 2021;373:n1663

Categories : COVID Injury & TraumaTags :

Trauma Patients with COVID at Great Risk

On By ModernMedia
Photo by Nate Isaac on Unsplash

The COVID pandemic has placed a great strain on healthcare resources, with a number of indirect impacts ranging from increased incidence of heart attacks to decreased cancer screenings, but also increased the risk of complications and death among trauma patients with COVID. 

The study revealed that the risk of death for COVID-positive patients in trauma centres across the US state of Pennsylvania was six times higher than non-COVID-negative patients with similar injuries. Complication risk in COVID-positive patients was doubled for venous thromboembolism, renal failure, need for intubation, and unplanned ICU admission, and was five times greater for pulmonary complications. In patients over age 65, the risks were even higher. The findings were recently published in The Journal of Trauma and Acute Surgery.  

“COVID had the largest impact on patients whose injuries were relatively minor, and who we would have otherwise expected to do well,” said lead author Elinore Kaufman, MD, MSHP, an assistant professor in the Division of Trauma, Surgical Critical Care and Emergency Surgery at Penn Medicine. “Our findings underscore how important it is for hospitals to consistently test admitted patients, so that providers can be aware of this additional risk and treat patients with extra care and vigilance.”

Researchers conducted a retrospective study of 15 550 patients admitted to Pennsylvania trauma centers from March 21, 2020, (when non-essential businesses statewide were ordered close) to July 31, 2020. Of the 15 550 patients, 8170 were tested for the virus, and 219 tested positive. During this period, the researchers evaluated length of stay, complications, and overall outcomes for patients who tested positive for COVID, compared to patients who did not have the virus. They found that rates of testing increased over time, from 34% in April 2020 to 56% in July. Centres had a great variability in testing, a median of 56.2% of the time with a range of 0 to 96.4%.

“First, we need to investigate how to best care for these high-risk patients, and establish standard protocols to minimise risks,” said senior author Niels D Martin, MD, chief of Surgical Critical Care and an associate professor in the division of Trauma, Surgical Critical Care and Emergency Surgery. “Second, we need more data on the risks associated with patients who present symptoms of COVID, versus those who are asymptomatic, so we can administer proven treatments appropriately and increase the likelihood of survival with minimal complications.”

Source: University of Pennsylvania

Categories : COVIDTags :

Lockdown Level 4; Third Wave Driven by Delta Variant

On By ModernMedia


In response to the third wave driven by the delta variant, President Cyril Ramaphosa instituted a two-week Level 4 lockdown during a ‘family meeting’ address to the nation.

He warned that the healthcare system was facing a dire situation. “Our health facilities are stretched to the limit… ICU beds are in short supply,” he said. 

In a press briefing on Friday, the head of the World Health Organization said the COVID Delta variant, first seen in India, is “the most transmissible of the variants identified so far,” and warned it is now spreading in at least 85 countries.

“We are in the exponential phase of the pandemic with the numbers just growing very, very, extremely fast and (they) will keep growing in the next weeks,” said Tulio de Oliveira, a leading virologist in the country.

The Delta variant first seen in India now appears to be “dominating infections in South Africa,” de Oliveira of the Network for Genomic Surveillance in South Africa told a virtual briefing.

The Delta variant has emerged as dominant in South Africa. Source: Department of Science & Technology

Koleka Mlisana, the head of a government ministerial advisory committee on COVID, told the same briefing that there is “evidence that the Delta variant may actually be taking over”.

Acting Minister of Health, Mmamoloko Kubayi-Ngubane said that due to the prevalence of the Delta variant, infection numbers “are likely to surpass the second wave peak” in January.

Only about 2.4 million people have been immunised since February. Thousands of EFF activists rallied in Pretoria on Friday to demand a faster coronavirus vaccination rollout, including expedited approvals for the Sinovac vaccine from China and Russia’s Sputnik V.

Source: Medical Xpress

Categories : COVIDTags :

Preliminary Study Explains Why Delta Variant is So Infectious

On By ModernMedia
Colorized scanning electron micrograph of an apoptotic cell (purple) heavily infected with SARS-COV-2 virus particles (yellow), isolated from a patient sample. Image captured at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAID

A preliminary study has possibly determined why the SARS-CoV-2 Delta variant is more infectious and pathogenic than its ancestor.

Through a series of in vitro experiments, researchers have discovered that variant’s enhanced ability to induce cell-to-cell fusion (syncytia) and reduced susceptibility to vaccine and infection-induced antibodies together help make the Delta variant more infectious than previously circulating variants. The study, which is yet to be peer reviewed, is currently available on the bioRxiv preprint server.

The SARS-CoV-2 virus has undergone more than 12 000 mutations since it was first detected in December 2019, most of which are neutral and do not contribute to viral evolution. However, the acquisition of specific mutations in structural and non-structural proteins has caused the emergence of novel, more virulent SARS-CoV-2 variants.

Spike protein mutations are particularly concerning as they can significantly influence viral infectivity, virulence, and immune evasion ability.

The B.1.617 lineage drove a massive surge in new COVID cases in India. This lineage is further divided into three sub-lineages, namely B.1.617.1, B.1.617.2, and B.1.617.3. Although these emerged first in India, the B.1.617.2 or Delta variant or soon became dominant in many countries, including South Africa where it has driven a new surge of infections, particularly in Gauteng Province. The World Health Organization (WHO) has designated the Delta variant as a ‘Variant of Concern’ (VOC) due to its significantly increased infectivity and pathogenicity.

In the current study, the scientists have evaluated the susceptibility of the Delta variant to neutralisation by vaccine or natural infection-induced antibodies.

Delta variant mutations 

The Delta variant’s spike protein contains nine mutations in the S1 subunit and one mutation in the S2 subunit. In the S1 subunit, five mutations are present in the N-terminal domain containing binding sites (epitopes) for neutralising antibodies. In addition, two mutations are present in the receptor-binding domain of the S1 subunit, which is known to influence antibody-mediated neutralisation and infectivity. Among the three remaining mutations, two are known to increase angiotensin-converting enzyme 2 (ACE2) binding, viral replication, and spike protein cleavage at the S1/S2 site.    

Delta variant host cell entry

Using African green monkey and human cells, the researchers found that Delta can enter kidney cells of both species with similar efficacy as the wild-type SARS-CoV-2. However, for human colon and lung cells, Delta showed 1.5-fold and 2-fold higher invading ability, respectively, compared to the wild-type virus. Since the Delta variant spike protein did not exhibit increased ACE2 binding, the scientists suggest that increased entry of B.1.617.2 into colon and lung cells is not mediated by enhanced ACE2 binding.

Besides inducing fusion between the viral envelope and host cell membrane, the spike protein triggers the fusion of infected cells with nearby cells to form large multinucleated cells, known as syncytia. Given the fact that spike-induced syncytia formation contributes to COVID pathogenesis, the scientists investigated whether Delta variant infection is associated with increased syncytia formation.

By conducting in vitro experiments on human lung cells expressing high levels of ACE2, they found that Delta spike expression leads to 2.5-fold higher and larger syncytia formation than the wild-type spike expression.

Delta variant’s immune evasion ability less than Beta?

The scientists tested the ability of four therapeutic monoclonal antibodies to neutralise the Delta variant, of which only Bamlanivimab failed. The other three antibodies exhibited similar efficacy in neutralising both wild-type virus and Delta variant.

Antibodies derived from COVID recovered patients, and BNT162b2-vaccinated individuals showed only slightly reduced efficacy in neutralising the Delta variant as compared to the wild-type virus. In contrast, the B.1.315 or Beta variant, first detected in South Africa, showed a significantly higher ability to evade infection- and vaccination-induced immunity.

In summary

The study showed that Delta’s increased ability to invade lung cells may enhance infectivity and pathogenicity. Though it has lower susceptibility to antibody-mediated neutralisation, it is possible that Delta may be effectively controlled by immunity developed in response to natural infection or vaccination.

Source: News-Medical.Net

Journal information: Arora P. 2021. Increased lung cell entry of B.1.617.2 and evasion of antibodies induced by infection and BNT162b2 vaccination. bioRxiv. https://www.biorxiv.org/content/10.1101/2021.06.23.449568v1

Categories : COVIDTags :

The Origin Mystery of SARS-CoV-2 Deepens

On By ModernMedia
SARS-CoV-2 viruses emerging from a human cell. Credit: NIAID

Australian researchers studying SARS-CoV-2 have discovered that the virus is most ideally adapted to infect human cells — instead of bat or pangolin cells, prompting renewed questions about its origin.

The scientists, from Flinders University and La Trobe University, described how they used high-performance computer modelling of SARS-CoV-2’s structure at the beginning of the pandemic to predict its ability to infect humans and a range of 12 domestic and exotic animals.

They were hoping to identify an intermediate animal vector that may have played a role in transmitting a bat virus to humans, and to understand any risk posed by the susceptibilities of pets and livestock.

Using genomic data from 12 animal species, the researchers painstakingly built computer models of the key ACE2 protein receptors for each species. These models were then used to calculate how strongly the SARS-CoV-2 spike protein bound to each species’ ACE2 receptor.

Surprisingly, the results showed that SARS-CoV-2 bound to ACE2 on human cells more tightly than any of the tested animal species, including bats and pangolins. If one of the animal species tested was the origin, it would normally be expected to show the highest binding to the virus.

“Humans showed the strongest spike binding, consistent with the high susceptibility to the virus, but very surprising if an animal was the initial source of the infection in humans,” said Professor David Winkler at La Trobe University.

The findings, originally released on the ArXiv preprint server, have now been peer reviewed and published in Scientific Reports.

“The computer modelling found the virus’s ability to bind to the bat ACE2 protein was poor relative to its ability to bind human cells. This argues against the virus being transmitted directly from bats to humans. Hence, if the virus has a natural source, it could only have come to humans via an intermediary species which has yet to be found,” says Flinders affiliated Professor Nikolai Petrovsky.

The team’s computer modelling also showed fairly strong binding of SARS-CoV-2 to ACE2 from pangolins, which are occasionally used as food or in traditional medicines. Professor Winkler noted that pangolins displayed the highest spike binding energy of all the animals in the study – significantly higher than bats, monkeys and snakes.

“While it was incorrectly suggested early in the pandemic by some scientists that they had found SARS-CoV-2 in pangolins, this was due to a misunderstanding and this claim was rapidly retracted as the pangolin coronavirus they described had less than 90% genetic similarity to SARS-CoV-2 and hence could not be its ancestor,” Prof Petrovsky said.

Similarity in spike proteins

As shown in this and other studies, the specific part of the pangolin coronavirus spike protein that binds to ACE2 was almost identical to its SARS-CoV-2 counterpart.

“This sharing of the almost identical spike protein almost certainly explains why SARS-CoV-2 binds so well to pangolin ACE2. Pangolin and SARS-CoV-2 spike proteins may have evolved similarities through a process of convergent evolution, genetic recombination between viruses, or through genetic engineering, with no current way to distinguish between these possibilities,” Prof Petrovsky said.

“Overall, putting aside the intriguing pangolin ACE2 results, our study showed that the COVID-19 virus was very well adapted to infect humans.”

“We also deduced that some domesticated animals like cats, dogs and cows are likely to be susceptible to SARS-CoV-2 infection too,” Prof Winkler added.

The question of how the virus came to infect humans currently has two main explanations. The virus may have jumped to humans from bats through an intermediary animal which remains to be identified. The other explanation making headlines in the media is an accidental release from a virology lab, where it perhaps was created in ‘gain of function‘ tests, which are carried out around the world to better understand pathogens. A number of organisations and governments, including the World Health Organization and the United States have urged further investigation to find out which of these is correct — though a definitive answer may take years.
How and where the SARS-CoV-2 virus adapted to become such an effective human pathogen remains a mystery, the researchers concluded, adding that finding the origins of the disease will help efforts to protect humanity against future coronavirus pandemics.

Source: EurekAlert!

Journal information: Sakshi Piplani et al, In silico comparison of SARS-CoV-2 spike protein-ACE2 binding affinities across species and implications for virus origin, Scientific Reports (2021). DOI: 10.1038/s41598-021-92388-5

Categories : COVIDTags :

Positivity Rate at 25% as Lockdown Upgrades Expected

On By ModernMedia

President Cyril Ramaphosa is expected to meet with the National Coronavirus Command Council (NCCC) to discuss the government’s response to the third COVID wave, which includes the possibility of new restrictions. 

Several bodies have strongly urged upgrading to a harder lockdown, including the South African Medical Association, the Gauteng Provincial Government, medical professionals, and now the Ministerial Advisory Committee on Covid-19.

Earlier this week Ramaphosa indicated that the government will have to increase its COVID containmant measure – especially in Gauteng province. He noted that the country’s first hard lockdown in March 2020, one of the strictest in the world, did help cut infection rates at the start of the pandemic.

South Africa recorded 17 493 new cases, a new daily high for the third wave, of which 10 806 were in Gauteng. Case positivity rate increased to 24.92%. A report released on Wednesday by the South African Medical Research Council showed that 1349 excess deaths in Gauteng for the week ending 13 June, of which 431 were due to COVID/

Warnings and failure to act

In an interview with The Money Show with Bruce Whitfield this Monday, Netcare CEO Richard Friedland had warned that the numbers of Covid-19 patients “are overwhelming facilities at the moment”.

Since Wednesday last week, Gauteng’s hospitals had been battling with a “mass casualty situation” , not unlike the aftermath of a train accident, or the collapse of a sports stadium, with “injuries on a massive scale”. But, with COVID, he said, the crisis is not over in a couple of hours, but remains ongoing.

With no evidence of a peak in case numbers, Friedland said that, “I’m afraid that these numbers are demonstrating that [without] a Level 5 lockdown in Gauteng, we may not see the end of this surge for some time.”

Professor Koleka Mlisana, co-chairperson of the Ministerial Advisory Committee on Covid-19, says that tighter restrictions are likely needed to help curb infections.

Prof Mlisana said that the other major crisis is making sure that there are sufficient hospital beds in Gauteng. This includes additional facilities, staffing members and beds to ensure the system is not overwhelmed, she said.

Prof Mlisana said that this was down to a lack of preparation by the government, despite warnings from the advisory committees. 

Source: BusinessTech

Categories : COVIDTags :

WHO Urges Equitable Travel Requirements

On By ModernMedia
Photo by Tim Gouw on Unsplash

The WHO has urged that as air travel is restored, vaccinations should not be a prerequisite for travellers, potentially locking out those in poorer regions, especially Africa.

In a virtual press briefing on Thursday, Dr Matshidiso Moeti, World Health Organization Regional Director for Africa said that the WHO believes that schemes to remove quarantine and entry restrictions for travellers that have been vaccinated, are discriminatory and could deepen already existing inequalities even further.

Meanwhile, she warned that Africa’s third wave, already underway in 12 countries, with cases rising in another 14, threatens to be the worst yet with 5.3 million cases across the continent. It is projected that in three weeks the third wave will surpass the previous wave’s peak.

Public fatigue and new variants are driving this surge across Africa, with Delta the variant  detected in 14 countries. She stated that Africa can “blunt this third wave” but “the window of opportunity is closing”.

The WHO aims to strengthen variant surveillance in Africa by reinforcing the regional laboratory hub have a 8 to 10 fold increase in next 6 months for genome sequencing

Though vaccination rates remain low in Africa, there is nevertheless a great demand for vaccines, with 18 countries having used over 80% of the vaccines received through COVAX. Fortunately only mild side effects from the vaccines have been seen in African communities, she said.

Mr Kamil Alawadi, Regional Vice President for Africa and Middle East, International Air Transport Association (IATA) said that inconsistent requirements added additional complications in travel, increasing cost for the passenger and the airline. For travellers, PCR testing can range from $100 up to $400 for a single, one direction trip.

The key requirement for the recovery of the airline industry is the lifting of restrictions, said Alwadi, citing a survey that showed that 84% of passengers will not fly if there were quarantines in place. However, demand still existed for air travel, as evidenced by travel bookings spiking as soon as governments relaxed their border restrictions.

Alawadi said that the IATA agreed with the WHO that only lifting quarantine requirements for vaccine individuals was inequitable, and that “a robust and flexible testing system” was needed in place of quarantine, using systematic testing at the point of departure such as rapid antigen tests which are cheaper, faster and more accessible.

Graphic from Skyscanner.net showing countries with major travel restrictions from South Africa (red, 83 countries), moderate (orange, 29) and low restrictions (green, 42)

The situation was urgent for the African aviation industry as it had lost USD7.8 billion in 2020, with eight airlines filing for bankruptcy, he noted. This was against a background of USD430 billion global loss for the industry, though he noted that some countries are seeing a rebound to 2019 numbers for domestic travel. However, it is projected that losses will only stop by 2023 and return to profit by 2024.

The IATA has developed protocols in concert with the  International Civil Aviation Organization (ICAO) and WHO that will be non-discriminatory not require vaccinations, said Alwadi. However the aviation industry is sinking very rapidly without governmental support.