Tag: South Africa

Categories : COVID Expert OpinionTags :

UCT Expert Talks COVID and Warns of Third Wave

On By ModernMedia

If South Africa does not pursue a rapid vaccination programme to achieve herd immunity, it may face a third wave as a consequence, warned a leading local expert.

Professor Marc Mendelson of UCT’s Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital made these statements while speaking during a virtual Summer School lecture on Saturday, titled “COVID-19 Insights and Lessons”.

“Without rapid vaccination of at least two thirds of the population, we [South Africa] are not going to get to population immunity, and without that, we will see another wave,” Mendelson warned.

However, he emphasised that much had been accomplished in the battle against COVID. “It is associated with a scientific endeavour that we have never seen before. We’re definitely better off a year down the line, but there are a huge number of things that we need to answer. As a country we still face deep problems with severe issues around vaccine strategy, and we haven’t even talked about vaccine denial,” he said.

Criticism has been directed at the South African government because of its failure to start a vaccination programme, despite its huge case load and status as Africa’s most wealthy nation. A leaked phone call from a Pfizer executive has only added to this, as it was revealed that for months SA health officials had not been responding to requests for vaccine discussions.

Regarding COVID transmission, he said that the virus resided in the upper respiratory tract as well as the lungs, and that it could be expelled in aerosol droplets. The clinical and epidemiological evidence suggested that larger, heavier droplets carried the virus.

“The household infection rates were high. A very large number of cases, the vast majority [in fact], were within families in close proximity [to one another]. This, epidemiologically, suggests that large droplets play a role in transmission.

“If you want to reduce transmission from large droplets, then you need to increase the distance you are from someone. Also, because droplets drop onto surfaces … you will need to clean surfaces and wash your hands well. This is the science behind the use of masks, handwashing, social distancing and ventilation.”

However, he added that a number of studies had found the virus in remote corners of hospitals at a distance from patients, suggesting that it had been carried there by smaller, aerosolised particles.

“If you want to reduce aerosols, one way of doing that is to improve ventilation. The more the air is changed, the [quicker] it will dilute small droplets,” he said.

Source: University of Cape Town

Categories : COVIDTags :

SA Experts Confirm That COVID Variant is More Contagious

On By ModernMedia

A panel of South African experts confirmed on Monday that the SA strain of COVID is 50% more transmissible than previous strains.

Collecting data from the main infection clusters around the country, the experts came to the conclusion that while more contagious, the new variant is not more lethal. 

“There is no evidence the new COVID variant is more severe than the original variant,” said epidemiologist Professor Salim Abdool Karim, co-chair of the Ministry of Health’s scientific committee.

However, the SA healthy system has been strained by the sheer number of cases. Concerns over more transmissible variants have prompted the UK government to switch to administering the first dose of two-dose vaccines such as the one from Pfizer, and leaving an extended period before a second dose is administered, even though protection will wane over time.

Another panel member, Dr Waasila Jassat, said that although hospital admissions had increased, the overall death rate had not, supporting the case for the variant not being more lethal.

The spread of the variant in December prompted the government to reinstate its lockdown. It also resulted in many countries banning flights from South Africa in a bid to stem the variant. Prof Karim said that it was not yet known if current vaccines would protect against the SA variant, although studies were underway.

Another panel member, virologist Professor Alex Sigal stated: “The world has underestimated this virus.” He added that it was evolving and adapting to humans.

The experts also urged that it should not be referred to as the “South African variant”. The variant could have turned up anywhere in the world, and it was only thanks to the country’s excellent genomic surveillance that it was picked up at all, they said.

Source: Medical Xpress

Categories : COVID UncategorizedTags :

SA Government Aims for a Corruption-free Vaccine Programme

On By ModernMedia

In the past week, President Cyril Ramaphosa and health minister Zweli Mkhize have undertaken a publicity drive to demonstrate how the government is working to ensure a tightly controlled vaccine drive that is not plagued by corruption. This is to avoid a repeat of the corruption in PPE acquisition last year, with some R10.5 billion being investigated for looting, with an Auditor-General report finding some items being purchased at five times the going price.

These efforts include centralised transactions which involve the auditor-general looking out for any discrepancies. Vaccine acquisition and roll-out planning will be handled by the government, with the private sector being tapped for storage and distribution. “What we have done is to get the Treasury and the Department of Health’s office of the chief procurement officer to oversee any form of transaction that is going to happen.

“Right now the procurement of the vaccines is within government. It makes it easier because it’s a tight-knit set of people, the prices are known, the manufacturers are known, the deviation is specific and it’s not the same as what we had in PPE where there were so many vendors, suppliers and so many different prices,” he said.

Furthermore, there will be consultation with the Attorney General. “We are going to say [to the AG]… these are the risks we have identified and ask them to analyse our plans and see if there are further risks we must be aware of and how we can work together to prevent any risk of looting,” Mkhize said.

Medical aid schemes have voiced concerns over the process, having sourced vaccines for their members as well as contributing to the vaccination costs of those not covered by any medical aid scheme.

President Ramaphosa said that South Africa would have pre-paid like other countries to secure vaccines, even given the risks of them failing, if it had the funds to do so.

However, he affirmed that there are funds available to buy the vaccination scheme, saying: “we are going to have the money, it will come from Treasury. There is just no way we can say, when it comes to saving the lives of South Africans, that we don’t have the money. The money will be there. It has to be there to save the lives of South Africans. That one will be my bottom line.”

The Covax programme will provide a vaccine for 10% of the population in the second quarter of 2021, for which a deposit of R283 million has been paid. A further 1.5-million vaccine doses have been secured from AstraZeneca and 9-million from Johnson & Johnson (J&J). The J&J vaccine only requires a single dose to confer immunity, so should be able to cover 9 million people.

“J&J will be producing through Aspen here at home, and we are hoping to get the bulk of our supply from there, once the production starts,” said Ramaphosa.

Source: Times Live

Categories : COVIDTags :

Stellenbosch Doctors Urge Patience on Ivermectin

On By ModernMedia

The South African public should be patient and wait for data on Ivermectin’s effectiveness against COVID, according to Stellenbosch doctors, who urge patience. The doctors wrote an article published in the South African Medical Journal explaining that further studies need to be completed before ivermectin can be authorised for use.

A veterinarian parasiticide that may have relevant antiviral and anti-inflammatory properties, ivermectin has gathered considerable attention for possible use in COVID prophylaxis and treatment since a number of small trials appeared to show effectiveness. However, close examination shows that they are very weak. Doubts have been raised over whether the necessary concentrations used in vitro can be achieved in vivo.

In their article, the doctors noted that several large randomised controlled trials are underway, and the results of these will allow the possible effectiveness of ivermectin to be gauged. “Data for Ivermectin from larger RCTs are expected in early 2021,” the doctors wrote. “These data are very promising, showing large treatment effects and acceptable adverse effect profiles for ivermectin against Covid-19, especially when combined in meta-analyses.”

They pointed out that the hoped-for effectiveness of other medications had not been borne out. “As a recent example, the widely proclaimed benefits of hydroxychloroquine and chloroquine from observational studies proved to be unfounded in larger RCTs,” they wrote.

Ivermectin use has been banned by the government, to considerable resistance. A number of organisations have already demanded that ivermectin be administered as a COVID treatment, including Black First Land First, the New Economic Rights Alliance and AfriForum. Afriforum is contemplating legal action to have ivermectin authorised. These calls have come despite the South African Health Products Regulatory Authority (SAHPRA) repeatedly counselled against the use of ivermectin.

The doctors cautioned that although the data trends indicated a possible efficacy for ivermectin, the optimal dosage if effective still needed to be determined: “Higher than standard Ivermectin doses appear to be safe in humans, but at the time of writing there is still much uncertainty regarding the human dose required to achieve antiviral activity and a favourable benefit-to-risk balance.”

Source: IOL

Categories : COVIDTags :

Gauteng Doctors’ Struggle in COVID “Fever Tents”

On By ModernMedia

Angry doctors have opened up concerning recent images of severely ill patients at Steve Biko Academic Hospital (SBAH) being treated in tents amid pouring rain. These images came as David Makhura and MEC for Health Dr Nomathemba Mokgethi visited the hospital on Monday.

Speaking on condition of anonymity, two doctors at SBAH spoke to Daily Maverick about the reality of the situation. The doctors described a desperate situation of overwhelmed facilities, with patients possibly dying as much from the cold and rain as from untreated COVID – or indeed, a condition that presents similarly to COVID.

The image presented to the public by the government is “smoke and mirrors”, said Dr Felicia (not her real name). “This is a show. They [health officials] are lying to you people. They are lying. They are covering it up,” she said.”Fever tents” have been set up outside the Emergency Department, where patients remain while they are being screened for COVID. If they test negative, they are admitted to SBAH If they test positive, they are sent to Tshwane District Hospital.”

According to Dr Felicia, conditions in the tents are abysmal. “There is no nursing, there is no oxygen or beds in these tents. There is no oxygen in the tanks, we actually just do 10 minutes of CPR and many times we don’t have PPE to do it in.”

As infections continue to rise in South Africa, approaching 250 000 active cases, hospitals are buckling under the pressure, and doctors are expecting the worst to come.

Dr Monica (not her real name) spoke of her feelings of the situation. “I don’t feel like I am being protected by our hospital right now. I am running around like a chicken without a head. I feel very hopeless. I feel like I should not care anymore. Caring is actually just hurting me and the patients because instead of me doing what I said I was going to do when I left medicine, I am treating these people like numbers. Someone dies and you have to shrug your shoulders and move on to the next. There is not even a minute to mourn a person or to figure out what went wrong. I feel completely hopeless,” she said.

Dr Monica said people need to stop politicising the pandemic, and get the hospitals the resources they need. She also implored the reporters to convey their message. “Tell the people out there, this is serious. They must wear masks, they must social distance,” she said, breaking off and running to attend to a patient.

Source: Daily Maverick

Categories : COVIDTags :

COVID Cases Surge in Africa

On By ModernMedia

Over the past month, Africa has recorded the highest growth in new infections, with a 13% growth over the last week. With only two million cases and 45 000 deaths, Sub-Saharan Africa still only has a small part of the caseload of other regions. 

Dr John Nkengasong, who heads the African Centres for Disease Control (CDC), said: “I think this is serious, the second wave is extremely aggressive.”  The latest surge is thought to be driven by the more transmissible South African variant, known as 501Y.V2. President Cyril Ramaphosa said this variant, found in 90% of new cases, was likely responsible for the country’s latest surge, which has caused morgues to fill up and hospitals to run short of staff and critical resources such as oxygen.  North of the border, Zimbabwe this week started a month-long lockdown to curb a rise in new cases and protect its own overburdened health care system. Nearly two million Zimbabweans live in SA and regularly travel and forth, potentially spreading the virus.

Rashida Ferrand, a London School of Hygiene and Tropical Medicine professor working at the Parirenyatwa Group of Hospitals in the Zimbabwean capital Harare told Reuters that there was “a pretty high likelihood” that the new SA strain of the virus identified could be circulating in Zimbabwe.

Lockdowns may now not be enough to control the spread of the new variant – certain studies of the similar, highly transmissible UK variant suggests that it may now spread too fast for its R (reproduction) value to be brought below 1, or otherwise cause a much slower decline in infections. Fortunately, it seems that lockdown measures in the UK are having some effect. 
Meanwhile, there are concerns that the SA variant may also be able to evade the protection of current vaccines, according to new research – but that has not been peer reviewed yet. Research in SA on the question is expected to provide answers. Meanwhile, 12 gene sequencing laboratories are being geared up around Africa to track the spread of the virus variants, and some genome sequencing work has been done since December, but not enough to paint a clear picture.

Source: The Telegraph

Categories : UncategorizedTags :

SA Scientists Warn Local COVID Variant May Resist Vaccine

On By ModernMedia

South African scientists have said that there is a “reasonable concern” that the South African strain of SARS-CoV-2 may have greater resistance to current vaccines, and underscored the need for global vaccination.

Speaking to the BBC,  Prof Shabir Madhi, who has led vaccine trials in South Africa, explained, “It’s a theoretical concern. A reasonable concern… that the South African variant might be more resistant.” 

The South African variant has mutated far more than the UK variant, raising the possibility that it may be able to evade the antibodies that typically fight coronavirus.

Prof Helen Rees, a vaccine expert at Wits University, said, “Fortunately, should further modifications of the vaccine be required to address the new variants, some of the vaccine technologies under development could allow this to be done relatively rapidly.”

South African scientists recently pushed back against the notions that the SA variant was more transmissible than the UK one, or that it is more deadly. Explaining the reason for the flight restrictions from South Africa, UK Health Secretary Matt Hancock has stated that he believed it was more infectious than the UK variant, saying “This is a very, very significant problem […] and it’s even more of a problem than the UK new variant.”
The UK variant has a “transmission advantage” of 0.4 to 0.7, leading to reproduction numbers of 1.4 to 1.8.Prof Madhi said laboratory tests would determine whether current vaccines would be effective against this variant in a few weeks.

Source: BBC News 

Categories : UncategorizedTags :

New Year Sees SA Hospitals Battling for Resources Amid COVID Surge

On By ModernMedia

As the new year begins, South African hospitals are struggling as unprecedented numbers of COVID cases in the second wave are pushing resources to the limit. Hospitals are having to cope with the situation even as their own workers are off sick or self-isolating.

Last week, at least one province was reported to have reached out to the army to request additional personnel to help cope with the additional burden. Wester Cape premier Alan Winde said the province was recruiting an additional 1 300 health care workers (HCWs)In a weekly media briefing, KwaZulu-Natal premier Sihle Zikalala stated on Sunday that a total of 8 723 public sector HCWs had been infected with COVID since the start of the pandemic.

“Of the total infected, 98 have sadly succumbed to the disease. The majority of the infected health-care workers are nurses,” he said. HCWs are also struggling with burnout and illness.  Experts had long been predicting the impact the second wave would have on South Africa’s already weakened health infrastructure. As of Sunday, 3rd January, there were a total of 167 492 active cases in the country.  

Dr Kams Govender, who works west of Durban, said: “What we are experiencing now is just the tremor, the tsunami is yet to come in mid January. It’s hit us hard and it’s going to hit us even harder then. We are physically and emotionally exhausted, and worse, losing our health-care colleagues every single day. But still we push on and show up and pray for better days where there is more light than darkness.”

The hospital at Prince Mshiyeni Memorial Hospital (PMMH) in Umlazi, KZN, was reported to be full and bodies had to be taken to funeral homes within 48 hours.

One nurse at PMMH said, “The hospital is full, the Covid wards are full, the normal wards are full. There are no beds for our outpatients, they lie in the passage on stretchers waiting for beds. The Covid patients will be placed with one another in a consultation room. We try to separate them but it’s not a proper place for patients to be in because there are no beds, just the stretchers. We are running out of oxygen points because there are so many patients that need oxygen. We tend to prioritise who needs it more, but right now everyone needs it.”
Source: Sowetan Live

Categories : UncategorizedTags :

Impact of COVID Lockdown on Soweto Residents’ Mental Health

On By ModernMedia

A new study reported by Health-e has revealed the mental health toll that COVID and the lockdown to control it took on residents of Soweto, with 957 participants interviewed before the lockdown and then six weeks into the lockdown.

The interviews revealed that some 14% of those surveyed were at risk of depression, which was worsened by factors such as childhood trauma as well as their level of knowledge about COVID. Feeling unable to take precautions against the virus caused anxiety levels to skyrocket. 

“While participants believed that the pandemic did not affect their mental health or their ‘mind,’ the strong relationship between perceived risk and depressive symptoms raises the concern that they may not be aware of the potential threats to their mental health during Covid-19,” said Dr Andrew Wooyoung Kim, co-director of the study. “This discrepancy may be due to different ideas of mental health, including mental health stigma.”

Kim acknowledges that the challenging South African environment of poverty and poor services may also have had significant impacts.
“Our study re-emphasises the importance of prioritising and provisioning accessible mental health resources for resource-limited communities in Soweto and across South Africa,” Kim added. 

Categories : UncategorizedTags :

New COVID Lineages Found in SA

On By ModernMedia

To study the spread of COVID in South Africa, an interdisciplinary team called the Network for Genomics Surveillance in South Africa (NGS-SA) was formed with members from SA, the UK and Brazil. Analysing 1365 genomes of the SARS-CoV-2 virus, the researchers found 16 new COVID lineages which emerged in SA, which account for 42% of the country’s infections.

As could be expected, the bulk of introductions occurred before the advent of the lockdown and travel bans. Whether these new COVID lineages have any superior attributes relative to the original strains is as yet unknown, although the infectivity appears the same.

The study shows that, despite the lockdown, new strains emerged in localised outbreaks. Nosocomial outbreaks were also studied; in one case an outbreak in a hospital in KZN which went on to infect 16% of the population was brought under control, partly as a result of the investigation.

Source: News-Medical.Net