Cape Town - The predicted rise in Covid-19 cases over the winter period, or the third wave, is dependent on population immunity, ongoing viral evolution, and the willingness of South Africans to abide to public-health measures.
Health and social security systems specialist, Alex van den Heever says while the magnitude of the third wave would be difficult to predict, it is impacted by human behaviour and the residual susceptible population.
“Even through a lot more people are likely to have been infected than publicly reported, the majority of the population in most provinces have not. A third wave could therefore still prove problematic. I think the health system is slightly better prepared than for the second wave, but it has been shown that we can’t really cope with dramatic surges in infections,” he said.
Van den Heever said the some of the key contingency measures needed to manage the third wave were ;
– Restrictions on large gatherings
– Restrictions on indoor gatherings
– Restrictions on religious gatherings
– Stricter curfews
– Restrictions on public transport
– Tighter enforcement of regulations
“We need these contingent measures in place. I don’t think we need an alcohol ban but more importantly we need better enforcement of the regulations. The regulations must be clear from government,” said van den Heever.
Meanwhile, a pulmonologist from Melomed Gatesville, Dr Bilal Abdool Gafoor said South Africa could mirror similar statistics to other countries around the world.
“Most countries have had a persistent incidence during the second wave with ebbs and tides. A third wave is expected by May or June,” he said.
While several experts have said the healthcare system could be better prepared for this third wave, Gafoor said the challenges and limitations of medication, staff and ventilators remain.
“I don’t think the health sector will be fully prepared to handle the sheer magnitude of patients during a pandemic. We will certainly be better able to cope from a logistic perspective as we will understand how to direct resources more efficiently. There are also no miracle breakthroughs in treatment and hence it is expected there will be a surge of bogus treatment fuelled by social media and the public,” he said.
Clinical epidemiologist Dr Harry Moultrie said while there is considerable uncertainty about exactly when the third wave will hit its magnitude, another resurgence of Covid-19 cases appears likely.
“The likelihood of a third wave occurring in South Africa is dependent on a large number of factors including population immunity, cross-protection provided by the original strain to the 501Y.V2 variant, ongoing viral evolution, vaccination coverage and efficacy, population behaviour and adherence to non-pharmaceutical interventions. Predicting the timing and scale of future resurgences is however difficult,” he said.
The predicted timing of the third wave coincides with the annual winter respiratory flu season, which could be a double whammy that will affect South Africa and its health system.
Moultrie said if a substantial Covid-19 resurgence does coincide with a normal influenza season in 2021 it would place the health system under severe pressure.
“The maintenance of good hand hygiene and avoiding crowded poorly-ventilated indoor spaces will assist in limiting the transmission of both influenza and Covid-19,” he said.
From the frontline, Gafoor says the flu season was markedly low due to the precautions taken in social distancing and barrier protection.
“The influenza virus is less lethal and we expect that as lockdown measures elevate it is unlikely that the influenza virus will be a significant contributor. Indeed we have experienced the predominance of Covid-19 over influenza already in its spread and virility,” he said.
IOL