SA has reached a turning point in the coronavirus pandemic, as vaccination and high levels of natural immunity from prior infection are likely to protect most people from severe illness and death in future waves, just as they did during the recent Omicron-driven surge, say leading local researchers.
Three quarters of Gauteng’s population surveyed before SA’s fourth wave in December had coronavirus antibodies, which helps explain why an unprecedented surge in cases was not accompanied by a commensurate rise in hospitalisations and deaths, according to a peer-reviewed study published this week in the New England Journal of Medicine.
The Omicron wave accounted for just 10% of Gauteng’s Covid-19 hospitalisations and 3% of its Covid-19 deaths. This is in sharp contrast to the July 2021 Delta wave, which was responsible for 44% of the province’s Covid-19 hospitalisations and 50% of its Covid-19 deaths, said the paper’s lead author, Wits vaccinologist Shabir Madhi.
The decoupling of the incidence in new cases from the incidence of hospitalisation and death heralded a turning point in the epidemic, if the main goal was to protect people from severe illness and death rather than infection, Madhi said.
The researchers analysed blood samples from 7,010 participants, of whom 1,319 (18.8%) had been vaccinated against Covid-19. They found 73.3% of participants had antibodies to the SARS-CoV-2 virus, with sero-prevalence ranging from 56.2% in children under the age of 12 to 79.9% in people over the age of 50. Sero-positivity varied across the province and was as high as 85% in crowded parts of inner city Johannesburg.
The results indicate it was time for the government to adjust its response to the pandemic, which appeared to be at its tail end, and tackle Covid-19 in a similar way to other infectious diseases, said Madhi. The government should focus its vaccination drive on reaching more people over the age of 50, who were at greatest risk of severe illness or death from Covid-19, rather than pushing to immunise young adults and children, he said. At least 90% of people aged over 50 should be inoculated, he said.
However, government figures show one-third of people aged 50 and older have yet to be vaccinated, more than six months after shots became available to this cohort.
Responding to Madhi’s criticism of the government’s vaccination strategy, Health Minister Joe Paahla said: “Our approach is not either-or. We seek to protect the South African population.”
Young people were also at risk from severe Covid-19, generally more mobile than older adults, and were more likely to spread the virus if they were unvaccinated, Paahla said.
It was in the interests of the country as a whole to vaccinate younger adults, as there were 17.7-million people aged between 18 and 34, almost half the adult population, he added.
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