Although new COVID cases have not yet shown an upward surge, the fact that the test positivity rate had climbed past 10% is cause for concern.
According to health minister Dr Zweli Mkhize, the 2383 new infections recorded in the past 24 hours came from 23 352 tests at a positivity rate of 10.2%. Yesterday the positivity rate stood at 9.86%, and in the days beforehand had been gradually creeping upward.
The government has previously expressed concern when the positivity rate (the percentage of COVID tests that return positive) reaches the 10% and 12% marks. In late November, ahead of the second wave, the case positivity rate was 14.5%. Some provinces of South Africa are reporting rates well in excess of this, particularly the Northern Cape which last week had a reported positivity rate of 24.1%.
Dr Mkhize also reported that there were 72 Covid-19 related deaths in the past 24 hours. The health minister also reported that across SA there were now 171 860 people who had received their first shot of the two-dose Pfizer vaccine.
With these latest figures, there are now 1 637 848 cumulative cases and 55 874 cumulative fatalities since the outbreak of the coronavirus in SA in March last year. However, the true toll may be much higher, as South Africa’s ‘excess deaths’, those which are above the average rate of deaths from all causes, were up to 2.67 times higher than the official toll. A report from a team at the SA Medical Research Council and University of Cape Town believed that around 85% of those excess deaths were due to COVID.
Doctors in India have hit out against yoga guru Baba Ramdev over his controversial statements against modern medicine and mocking of COVID patients.
Recently, the controversial guru said that tens of thousands died of COVID after taking modern medicines, and also mocked patients for trying to get oxygen cylinders.
The guru subsequently withdrew his statement after being criticised by the country’s health minister. But on Monday he again took a swipe at modern medicine for not having a cure for some diseases.
Despite India’s modern allopathic healthcare system, alternative therapies like ayurveda and homoeopathy are hugely popular in India. This has helped many gurus to launch successful businesses with sales of herbal medicines and products. India also has a Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (Ayush) that promotes traditional medicine systems.
The Indian Medical Association (IMA), which represents allopathy doctors in India, has criticised the guru for his “insensitive” remarks in the middle of the pandemic. Such statements from a guru with millions of followers were “irresponsible and demoralising”, said doctors spoken to by the BBC. The country has been grappling with a surge of infections caused by a ‘double mutant’ SARS-CoV-2 variant as well as prematurely relaxed social distancing rules.
The controversy A video of Baba Ramdev mocking patients for trying to find oxygen went viral earlier this month, making references to oxygen shortages in several cities in April and May.
“God has given us free oxygen, why don’t we breathe that? How can there be a shortage when God has filled the atmosphere with oxygen? Fools are looking for oxygen cylinders. Just breathe the free oxygen. Why are you complaining about shortage of oxygen and beds and crematoriums?” he said.
The statement drew sharp criticism from doctors and families of COVID patients who demanded an apology.
Just two weeks later, another video surfaced in which he criticises doctors, blaming COVID deaths on them. Many doctors expressed their anger over Twitter, some went so far as to demand his arrest. In the face of mounting pressures, India’s Health Minister Dr Harsh Vardhan issued a statement asking the guru to withdraw his remarks.
“Allopathy and the doctors attached to it have given new lives to millions of people. It’s very unfortunate for you to say that people died from consuming allopathic medicines.
“We should not forget that this battle can only be won through united efforts. In this war, our doctors, nurses and other health workers are risking their lives to save people’s lives. Their dedication towards serving mankind in this crisis is unparalleled and exemplary,” Dr Vardhan said.
Baba Ramdev withdrew his controversial statement in a Sunday tweet — only to issue a letter the next day asking the IMA why modern medicine had no cure for 25 diseases, including diabetes and hypertension.
This has again infuriated doctors. Prominent pulmonologist Dr A Fathahudeen, who has treated thousands of COVID patients, told the BBC that such statements cause lasting damage.
“For more than a year, healthcare workers like me have been in a war-like situation. We have saved tens of thousand of lives. It’s really unfortunate, insulting and hurtful to read such statements,” he said.
Dr Fathahudeen added that modern medicine had evolved over the years with constant research and studies. “We follow evidence-based practice. At any given time, thousands of researchers are working to come up with cures. Look at the progress we have made in cancer treatment. We have to constantly evolve and learn. It’s hard to trust any branch of medicine that offers absolute cure for every disease.”
Dr Fathahudeen also said that such statements manifest doubts in the minds of people when trust in medicines and vaccines is most needed in the middle of a raging pandemic.
Baba Ramdev’s rise to fame Televised yoga classes were Baba Ramdev’s ticket to fame; he had a following of millions and he received worldwide praise for promoting yoga and healthy living.
He successfully leveraged his fame to create a business empire. In 2006, he helped launch a company called Patanjali Ayurveda to sell herbal medicines and a few years later, the business expanded to sell almost any product. Since last year, the company has been selling a product called Coronil that it has made a number of false claims over, including that it was a WHO-approved COVID treatment.
As reported by the Wall Street Journal, US intelligence learned three doctors at Wuhan Institute of Virology became sick with COVID-like symptoms in November 2019 and sought out hospital care. This, along with an open letter in the journal Science has prompted new calls to find out whether COVID started at that facility.
A State Department report was issued during the last days of former President Donald Trump’s administration but officials familiar with the report did not agree on the strength of the evidence found, the Journal reported. However this new report adds more detail, and comes on the eve of a World Health Organization meeting, which will no doubt include COVID.
In March, virologist Marion Koopmans told NBC News that the illness of lab workers could be due to normal seasonal illnesses.
Earlier this year, a team from the WHO spent a month in Wuhan investigating the origin of the virus, and produced a report concluding that the virus most likely jumped from bats to people, rating a lab leak as “extremely unlikely”.
The WHO however also said it also did not have access to all the necessary information – a situation has prompted some experts to be wary of the findings and demand more investigations into the virus’s origin, including the possibility that it in fact was leaked from a lab.
November 2019 is also in line with when experts believe COVID began circulating.
For its own part, China has consistently denied that the coronavirus escaped from a lab. However, the lab has not made available its raw data or records on its work with coronaviruses in bats.
A spokeswoman for the National Security Council told the Wall Street Journal that the Biden administration has questions about the virus’, but plausible theories should be investigated by WHO.
“We’re not going to make pronouncements that prejudge an ongoing WHO study into the source of SARS-CoV-2,” the spokeswoman said. “As a matter of policy we never comment on intelligence issues.”
The Western Cape provincial government has said it is actively preparing for a resurgence of COVID cases while three other provinces have now declared they are in a third wave.
The province’s premier Alan Winde said in a statement on Sunday that based on current trajectories, the province is likely to officially enter its third wave two to three weeks from now.
Gauteng premier David Makhura confirmed that his province officially entered into a third wave more than a week ago. This was followed by similar declarations in the Free State and the Eastern Cape.
“The Western Cape is currently facing a resurgence as it has seen increases in its case numbers every day, over the past 12 days. While this is not yet a third wave, it is the first sign that we are moving towards one,” Winde said.
“Our guiding principle remains that no person will be denied access to life-saving medical treatment. We must make sure we have enough beds, staff and oxygen to respond effectively in the month ahead.”
He added that in the meantime South Africans should continue to follow the level 1 lockdown restrictions, adhering to social distancing and avoid social gatherings to help flatten this curve. But health experts have warned that the rise in cases could require further lockdown restrictions.
Head of the Western Cape Health Department Dr Keith Cloete told EWN that it is a national competency to put lockdown restrictions in place, but they are highly likely to appear given that the number of cases is on the increase countrywide.
Health minister Dr Zweli Mkhize has likewise warned of likely additional restrictions in South Africa due to rising COVID numbers.
He said that the government has discussed the rising numbers. “At some point we are going to have to start looking at additional restrictions,” he said.
“We are going to be recommending that there should be more focus on the size of gatherings, and look at the focus on some of the measures that were actually released when we thought the situation was much more improved.”
He highlighted the importance of trying to maintain a balance to ensure that people continue to be able to work. “We do need to send a strong message still, that people can’t be complacent.”
As of 23 May, there were 2894 new cases in South Africa and the COVID test positive rate stood at 9.86%. Data collected up to 15 May showed the highest positive rate was in the Northern Cape (24.1%), Free State (17.5%) and North West (15.1%) provinces. The percentage testing positive was <10% in all other provinces. (Source: NICD PDF, note this is a 10 MB size)
Transport minister Fikile Mbalula said that South Africa will seek to join a digital ‘vaccine passport’ scheme being tested by a number of airlines.
Presenting his departmental budget speech on Friday, Mbalula said that South Africa must ensure that it joins the growing number of countries that accepts the International Air Transport Association’s (IATA) mobile travel pass for COVID vaccination.
This particular initiative was tested successfully by Singapore Airlines, and more than 20 carriers, the minister said.
“In recent months, Singapore has announced that it will accept visitors who use a mobile travel passes containing digital certificates for Covid-19 tests and vaccines,” Mbalula said.
“This makes Singapore one of the first countries to adopt this initiative. Singapore will accept the IATA mobile travel pass for pre-departure checks, where travellers can get clearance to fly to and enter Singapore by showing a smartphone application containing their data from accredited laboratories.”
The IATA’s app allows travellers to store digital information from certified labs. It will be available for download later this month. IATA aims to bring in additional changes such as QR code scanning by immigration officers.
Vaccine passports have been the subjects of debates over equitability, access and potential for abuse. However, vaccine passports are not only permissible under international health regulations, they already exist. The World Health Organization endorses certificates confirming vaccination against yellow fever for entry into certain countries. They also incentivise vaccination, a public good.
Currently, South Africa has 62 ‘major restrictions’ from other countries in place, with suspended travel, stringent requirements for entry or outright bans. Meanwhile there are 92 moderate restrictions in place on South Africa, where travel is possible subject to measures such as COVID tests on arrival.
A second generation viral vector COVID vaccine candidate from ImmunityBio Inc is being considered as a booster shot in a study involving nearly 500 000 South African health workers already innoculated with the Johnson & Johnson vaccine.
The health workers, who are the first outside of much smaller studies to receive vaccinations in South Africa, will need a booster, Glenda Gray, the co-lead of the South African studies, said in an interview Wednesday.
“It could be the universal boost that we are looking for,” she said. “Hopefully we will start in a couple of weeks.”
ImmunityBio’s second generation COVID vaccine candidate uses an hAd5 virus as vector. It induces both short term and long term immunity, and besides targeting the coronavirus’ spike proteins like first generation vaccines, it also targets the nucleocapsid protein, which has a lower rate of mutations. Additionally, this hAd5 vector virus provokes an anti-SARS-CoV-2 response, even in individuals with adenovirus immunity.
The magnitude of this T cell response was equivalent to those seen for spike and nucleocapsid T cell responses from previously infected convalescent SARS-CoV-2 patients.
The robust T cell response to both proteins could make it more effective against strains such as the B.1.351 ‘South African’ variant , ImmunityBio said in a statement earlier this year.
The vaccine is also being assessed to determine the safety and effectiveness of oral, sublingual and subcutaneous administration routes.
ImmunityBio’s vaccine is currently in phase I trials in Cape Town, and the company has signed an agreement with South Africa’s BioVac Institute to produce the inoculation in the country should it win approval.
Despite controversial claims, the SARS-CoV-2 virus likely does not integrate its genetic material into the genes of humans, according to a study published in the Journal of Virology.
A prior study reported the virus’s genetic material was found to have integrated into human DNA in cells in petri dishes, though the scientists conducting the newer research now say this was resulted from genetic artefacts in the testing.
Study co-lead author Majid Kazemian, a Purdue University assistant professor of biochemistry and computer science, said that this finding has two important implications.
“Relatively little is known about why some individuals persistently test positive for the virus even long after clearing the infection,” he explained. “This is important because it’s not clear whether such individuals have been re-infected or whether they continue to be infectious to others. So-called ‘human genome invasion’ by SARS-CoV-2 has been suggested as an explanation for this observation, but our data do not support this case.
“If the virus was able to integrate its genetic material into the human genome, that could have meant that any other mRNA could do the same. But because we have shown that this is not supported by current data, this should allay any concerns about the safety of mRNA vaccines,” he concluded.
It is indeed possible for virus genetic material to be incorporated into the DNA of humans and other animals, which are referred to as ‘chimeric events’. These have happened over many millions of years; human DNA contains approximately 100 000 pieces of ‘fossil DNA’ from viruses that have been accumulated throughout our evolution, accounting for nearly 10% of the genetic material in our cells. Some viral fragments even play a role in diseases such as cancer.
Recent scientific journal articles have raised controversy by claiming that the SARS-CoV-2 virus can also cause these chimeric events. Even before this study demonstrated it was not the case, the researchers suspected it was unlikely, said co-lead author Dr Ben Afzali, an Earl Stadtman Investigator of the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases.
“While an earlier study suggested that, in cells infected with SARS-CoV-2, genetic material from the virus copied and pasted itself into human DNA, our group thought this seemed unlikely,” Dr Afzali said. “SARS-CoV-2, like HIV, has its genetic material in the form of RNA but, unlike HIV, does not have the machinery to convert the RNA into DNA. SARS-CoV-2 is unlikely to paste itself into the genome and coronaviruses, in general, does not go near human DNA. As our study shows, we find it highly improbable that SARS-CoV-2 could integrate into the human genome.”
Christiane Wobus, associate professor of microbiology and immunology at the University of Michigan Medical School, another co-lead author on the study, said that the collective understanding of RNA viruses is that SARS-CoV-2 integrating into the human genome was extremely unlikely, it was still worth asking the question.
“Unexpected findings in science—when confirmed independently—lead to paradigm shifts and propel fields forward. Therefore, it is good to be open-minded and examine unexpected results carefully, which I believe we did in our study,” she said. “However, we did not find conclusive evidence for SARS-CoV-2 integration, but instead showed that during the RNA sequencing methodology, chimeras are produced at a very low level as an artifact of the laboratory technique.”
To examine any possible integration event, the researchers came up with a novel technique involving extraction the genetic material from infected cells and then boosting the amount of the genetic material 30-fold. With any chimeric events in the host cell DNA, these bits of genetic material from SARS-CoV-2 would have also increased those by 30. The data did not show this.
“We found the frequency of host-virus chimeric events was, in fact, not greater than background noise,” Kazemian stated. “When we enriched the SARS-CoV-2 sequences from the bulk RNA of infected cells, we found that the chimeric events are, in all likelihood, artifacts. Our work does not support the claim that SARS-CoV-2 fuses or integrates into human genomes.”
Journal information: Bingyu Yan et al, Host-virus chimeric events in SARS-CoV2 infected cells are infrequent and artifactual, Journal of Virology (2021). DOI: 10.1128/JVI.00294-21
As South Africa awaits an impending third wave, twenty-eight schools in the Northern Cape have had to close as a result of COVID cases this month, while all school contact sports are being suspended.
While infections are on the rise in most provinces, Northern Cape has 314 patients in hospital with COVID, according to information from the National Institute for Communicable diseases.
“Since 1 May we can report that 28 schools in the Province have been directly affected due to COVID-19 cases,” the department said in a statement on Wednesday.
The department said that those schools were closed for disinfecting and those who were infected with COVID were isolated.
“To date, 13 schools still remain closed and will reopen once it is safe to do so. The department also recorded from 1 May to date, 124 positive cases that were reported at schools thus impacting on valuable learning and teaching time being lost.”
Four schools in the small town of Calvinia were also closed earlier this year to contain rapidly spreading COVID infections.
The provincial education department’s Geoffrey van der Merwe called on communities to be even more vigilant and follow COVID safety protocols.
“District offices developed recovery plans for these schools to ensure that the academic performance of learners are not negatively affected,” he said.
Since the second phase of the programme kicked off this week, a mere 329 people in the province have so far received a COVID vaccine shot. So far approximately 9500 healthcare workers in the Northern Cape have been vaccinated.
This was decided on by the Council of Education Ministers in a virtual meeting held on Wednesday morning .
However, the Department of Basic Education said non-contact sport training in schools could continue, on the condition that all social distancing, hygiene and safety measures would be adhered to and that there was no physical contact between participants during training.
Two Indian states have decided to distribute the controversial anti-parasitic drug ivermectin as a preventative measure, MedPage Today reports.
Goa, on the west coast, and Uttarakhand, a northern state in the Himalayas, will give the anti-parasitic to wide swaths of their population as a preventative measure in hopes of preventing future outbreaks.
Leaders of both states insisted that their recommendations were evidence-based. “An expert medical panel has recommended this,” Om Prakash, chief secretary of Uttarakhand, told Reuters. Vishwajit Rane, health minister of Goa, also said an expert panel from Europe found the drug shortened recovery time and reduced the risk of death, the news agency reported.
Yet no large randomised controlled trial has proven the drug’s efficacy against COVID, and no prominent health group — the NIH and the WHO among them — has recommended the drug in treatment or prophylaxis.
The use of ivermectin for COVID has been the subject of bitter debate in South Africa, and human administration of ivermectin was approved for compassionate use with guidelines released in January. Following a court order, pharmacists and doctors in South Africa are allowed to make up small batches of medicines containing Ivermectin on prescription by a doctor and in small quantities, and can be used.
Madhu Pai, MD, PhD, professor of epidemiology and global health at McGill University in Montreal, tweeted a link to guidelines developed by collaborators in the UK and India, led by Cochrane and Christian Medical College Vellore in the southern state of Tamil Nadu.
On May 15, the group updated their guidance to state that it recommends “against using ivermectin for treatment of patients with any severity of COVID-19. Ivermectin should only be used in the context of a randomized controlled trial.”
Officials in Goa said the state will give ivermectin tablets to anyone aged 18 or over. Through most of the recent COVID surge, the popular tourist destination has remained open to holidaymakers, only imposing a 15-day lockdown last week.
Meanwhile, Uttarakhand plans to distribute the drug even more widely, giving it to anyone over age 2, with the exception of pregnant and lactating women, according. The state has been struggling with high caseloads, which rose from under 300 a day in early April to more than 7000 a day last week, Reuters reported.
The state recently hosted Kumbh Mela, a huge festival which drew millions of people from across the country for a two week long celebration including bathing in the river Ganges. Reports indicated many people did not wear masks and were closely packed. This became a massive superspreader event, with cases all over India being traced to it. Some districts of Madhya Pradesh reported that 20% of cases were festival returnees.
Goa and Uttarakhand’s moves have not gone unnoticed by ivermectin advocates. The Front Line COVID-19 Critical Care Alliance, a long time champion of the drug, paid scant attention to the difference between causation and correlation in a recent tweet on the issue: “Case counts and deaths are falling in India! A close look … shows that the declines occurred as the Health Ministry [sic] began its widespread distribution of #ivermectin.”
Coming just days after a third wave was officially declared in Gauteng, and months of delays, frustration and confusion, South Africa’s COVID vaccination programme is at last rolling out on Monday.
The vaccination programme will start off mostly on old age homes, at 87 sites across 9 provinces.
Fanned out across nine provinces and 87 sites, healthcare workers and those licensed to administer vaccines will start the mammoth task, which will kick off mostly at old age homes.
Those who are registered and eligible will receive a vaccination date and site to visit where they will either receive the once-off Johnson and Johnson vaccination – or the first dose of the Pfizer vaccine with another to be taken a fortnight later.
A vaccine site such as a pharmacy may charge up to R354.75 per dose of Pfizer, and R330 for a dose of Johnson and Johnson, according to a memo released by the department of health.
Additionally, a R70 fee for administering the vaccine will be billed to the recipient’s health insurance company or the government if uninsured.
The programme will also cover the hundreds of thousands of healthcare workers who have not yet received their vaccinations.
Health Minister Zweli Mkhize, health MECs and other representatives described their plans for the nation on Sunday night.
Dr Mkhize is under no illusion about what lies ahead and what it will take to get it all done.
“Five million senior citizens are targeted to be completed by the end of June, provided that the supply of vaccines flow as anticipated.”
To put this into context, that’s just 44 days for this target to be met and given some of the setbacks experienced during the Sisonke implementation study, the government will face many sceptics.
“We know that everyone has been very anxious to know what will happen and how we will start to vaccinate our most vulnerable citizens and then move onto vaccinating the general population,” Dr Mkhize said.
According to the minister, over 1.2 million senior citizens have registered to be inoculated thus far. Officials are also hoping to vaccinate an additional 700 000 health workers during this time.
Text messages are being sent out to citizens aged 60 years and over, to get help them prepare.
As the campaign begins, there should be over 975 000 doses of Pfizer vaccines in stock, which have stringent, ultra-cold storage requirements.
Dr Mkhize emphasised that Monday or this week is not open to all senior citizens 60 year and above, rather that old age homes will be the priority.
“We recommend that as many people as possible register beforehand. We will not accommodate people walking into the vaccination sites, the program has been designed to avoid long queues, that’s why we want to keep people on going in based on the message inviting them for vaccination.”
However, some provinces with smaller populations,such as Mpumalanga and the North West, have stated they would try to accommodate senior citizens who would have travelled long distances to vaccination sites.
Dr Mkhize underscored the difficulty of conducting such a programme.
“This is just to know how many vaccines you will get out of a vial and how you draw out the requisite amount, to allow us a few days to iron out teething problems and we expect there will be many teething problems so we are expected to start slow.”
