New Covid-19 variants which have been detected in South Africa and concerns of a big third wave have prompted calls for stricter lockdown rules.
The National Institute for Communicable Diseases (NICD) has recently confirmed that four South Africans have tested positive for the COVID-19 B.1.617.2 variant.
This is the variant is more contagious and is fuelling the spike in Covid-19 cases and deaths in India. There is also speculation that it may bypass vaccine protections.
Another variant that is currently dominating Covid-19 infections in Europe and North America, B.1.1.7 has also been detected in South Africa.
Eleven cases of B.1.1.7 have been confirmed – eight in the Western Cape, two in Gauteng, and one in KwaZulu-Natal.
The detection of these new Covid-19 variants comes amidst a rise in infections in South Africa and concerns about a third wave.
Health Minister, Zweli Mkhize has expressed concern over the increase of Covid-19 cases in the country in the past two weeks.
Mkhize said the Free State, Gauteng, Northern Cape, and North West provinces are of particular concern.
Numerous districts in these provinces have been flagged by the NICD and have been placed “under observation” due to an appreciable rise in the 14-day average percent change.
The Free State Health Department has already announced that the province is officially experiencing a third wave.
Departmental spokesperson Mondli Mvambi said last week they have seen a “shocking rise of infections”.
“Our current ability to treat people may not last if unnecessarily stretched to the limit by non-adherence to Covid-19 measures,” he said.
There has also been a rise in case in Gauteng which Professor Adrian Puren from the NICD said could be a sign of a third wave.
Predictive modelling by the NICD showed Gauteng is at the highest risk of having a particularly devastating third wave.
This is because of its higher concentration of working-age adults and people with co-morbidities in the province and the lower estimates of seroprevalence.
On the back of the increase in Covid-19 cases and concerns around the new variants, experts are now calling for stricter lockdown rules.
At the end of April, Bloomberg reported that the South African government was considering introducing additional measures to stave off a third wave.
“We have received an advisory from the ministerial advisory council that we have to consider some restrictions and we are now going through that,” Health Minister Zweli Mkhize said.
Professor Alex van den Heever from the Wits School of Governance echoed Mkhize’s concerns in a Cape Talk interview in March.
He explained the problem is that people’s behaviour might go back to what it was in October and November last year, which will result in another surge.
He said the country is nowhere close to dealing with the problem and that not enough people will be vaccinated in South Africa this year to reach herd immunity.
To vaccinate the majority of the population by the end of the year, South Africa has to vaccinate around 200,000 people per day. This is not happening.
Speaking to Business Day TV this week, Van den Heever said there is a high probability of a third wave which will be driven by people’s behaviour.
He said there should be a strong focus on limiting large gatherings. “If we can address gatherings, we will reduce the possibility of a third wave,” he said.
Winter periods make it difficult to contain the virus, which means that even with restrictions it is challenging to avoid another wave.
“It is not the variants which are going to cause a third wave, but the variants will be part of a wave,” he said.
“If we have super-spreader events which involve one of those variants, it may become the dominant variant which we experience.”
He said the delay in South Africa’s vaccination programme means it will not be in time to help with a third wave.
“We will have to face this wave with restrictions – the way we have done in the past,” Van den Heever said.
He said South Africa may have to consider restrictions “pretty soon” in Gauteng and the Free State if we continue to see infections rise.
The Actuarial Society of South Africa (ASSA) said while the country is unlikely to escape a third Covid-19 wave, the severity in terms of confirmed cases, hospital admissions and deaths will depend on its timing.
ASSA working group member Adam Lowe said evidence from around the world indicate that the quicker the third wave follows the second wave, the less severe it is likely to be.
According to Lowe, South Africa could experience one of three scenarios:
- An early third wave in May (most likely) – an early third wave is expected to be less severe than the second wave and is most likely to materialise in May 2021. Not only does historical precedent set by the Spanish Flu pandemic in 1918 and 1919 support this scenario, but it is also a realistic expectation given the public holidays and school holidays in April.
- A delayed third wave (less likely, but not impossible) – a third wave of similar magnitude to the second wave becomes more likely the longer the peak is delayed. A more severe third wave would be likely to peak in late winter (July/August) at the earliest.
- Worst case scenario (very unlikely) – a large and sudden third wave could be possible if available patterns and interpretations of patterns prove to be flawed.
The worst-case scenario can occur if the number of people infected in the first two waves was over-estimated, or through a series of super spreader events.
The super-spreader events can be a result of reduced vigilance on the part of a population which has been locked down for over a year, Lowe said.