Johannesburg - On the green palisade fence that rings the St James Presbyterian Church in Bedford Gardens, ribbons flutter in honour of South Africa’s Covid dead.
Every morning for nearly two years Silva Cossa and Leonard Makuyo have tied ribbons. At first a white single ribbon tied to the fence represented one death.
Some mornings their work is quick, when the death toll is low. On other days when the virus is riding a wave, the work can be long as they tie hundreds of ribbons to the fence.
The numbers of dead have kept climbing, claiming more of the space on the fence. It is because of this that the church now places blue ribbons on the fence, each representing 10 of the dead.
Very soon, probably close to the second anniversary of when South Africa went into lock down to fight the virus, the country will reach a grim milestone. This will be when officially 100 000 South Africans will have died from the disease.
Two years in, and it appears that the world and South Africa have seen the worst of the Covid-19 virus. The Omicron variant is not as deadly and transmission rates are falling.
But epidemiologist Professor Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa (Caprisa), warns that the pandemic is not over and that the nation should expect even more challenges in the future.
“We must understand that we are living in the midst of a pandemic and that it's not over and we only have to look to Hong Kong to see evidence of that,” he explained.
The Asian island has over the last month seen soaring infection rates, with its hospitals battling to cope. The number of deaths have risen particularly among the elderly and unvaccinated.
As South Africa closes in on the second anniversary of the lockdown, Karim this week told the Saturday Star how those two years had changed him.
“I can probably describe the past two years in just two words: tiring but also an amazing educational opportunity.
“I would say it's tiring, because everything about this virus is so fast, there is no time to recover. Things move at a very fast pace and I feel as though I have lived through 10 years during these two years,” he admitted.
“But secondly, I would also say that this pandemic offered me incredible educational possibilities, because I have learnt so much. But it has also taught me that even though we think we know so much, there is even more to learn.”
There was a time when the well-known epidemiologist admits he got scared and that was when he heard of a new deadly variant.
This was the Beta variant of the novel coronavirus, which would go on to wreak havoc, resulting in widespread infections, record-high hospitalisations and thousands of people losing their lives.
“I remember the day I got really worried about the pandemic was at the end of November 2020 when my colleague, Professor Tulio de Oliveira, showed me the new sequence of the virus and from this information I could see how the virus mutated to what we now refer to as the Beta variant,” Karim explained.
“This variant made a critical change that caused us great concern as it was able to escape immunity. I remember thinking then that everything we were worried about had happened.”
For Professor Nancy Phaswana-Mafuya, of the Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, her scary moment during the pandemic was seeing the growth of vaccine hesitancy spurred on by myths and misinformation.
“The response to Covid19 would have been better if our health system was adequately equipped and if current health inequalities and inequities had been addressed.”
She said future pandemic preparedness is absolutely critical. “The world was not adequately ready. Increasing capacities for handling pandemics, multi-disciplinary and trans-disciplinary approaches, multi-sectoral approach… no single agency can handle a pandemic on its own," said Phaswana-Mafuya.
But while South Africa got some things wrong in the fight against the virus, deputy vice-chancellor for research and innovation at North-West University and member of the Ministerial Advisory Committee on Vaccines, Professor Jeffrey Mphahlele, gave the response by the country seven out of ten.
“At a political level there was the feeling that our leaders took the pandemic seriously. That was a good sign for me. Although we know that everything cannot be perfect in times of crises, I did feel that the communication could have been better.
“There should have been more targeted communications and social mobilising for certain population groups. For me, the tailored messaging was missing.”
Mphahlele said the moments that scared him the most were the arrival of the second wave accompanied by the Beta variant, and the arrival of the third wave with the Delta variant.
“I realised that this virus was still changing and mutating. We didn’t know the impact and I feared that we would have perpetual cycles of lockdown. At these stages I was really very scared,” he said.
Mphahlele added that vaccine hoarding by richer nations did nothing to alleviate his fears and he feared for the worst for developing countries.
But while the anniversary might provide a time to reflect, the daily death toll is a reminder that the virus remains with us. There are likely to be more waves.
“In terms of the pandemic itself: I fully expect to see a fifth wave, and a sixth, and a seventh, as new and perhaps more contagious variants evolve and spread,” said Professor Benjamin Smart, of the University of Johannesburg, who is an expert in public health and medical philosophy.
“On a positive note, many more people are now vaccinated, and many more have natural immunity from previous infection. While I expect new waves of infections, with a bit of luck (and help from scientists producing effective vaccines), the number of deaths from Covid-19 will continue to drop, and the virus will become an endemic disease much like the seasonal flu,” he said.
And while there are signs that the pandemic is waning, many believe it is now time to take stock and start the process of healing a nation that has experienced terrible trauma.
Gavin Lock is the reverend for St James Presbyterian Church. Over the last two years he has attended to 200 burials, a higher than usual number, thanks to Covid-19.
“I hear politicians speak and they are saying it is time to open up the economy, and it's almost as though the psychological suffering has been forgotten now that things are looking better.
“And it's good that life just carries on, but for many folks, it's not carrying on because someone didn't make it,” he said. One family in his congregation lost four members to Covid-19. A ribbon on the fence is for Lock’s father who died from the virus.
“I do think they are the silent sections of society that continue to suffer the post traumatic stress from the pandemic, where the world is trying to get started again.” he said.
Studies have shown that doctors and nurses are experiencing depression having spent so much time on the front line in the fight against the virus.
Professor Shabir Madhi, the dean of the Faculty of Health Sciences and Professor of Vaccinology at the University of the Witwatersrand, Johannesburg, South Africa said the past two years had been a whirlwind of events on the work, mental and personal front.
“Any semblance of normality has been eroded. As a scientist it’s been unparalleled in being able to be part of a global initiative on what is often not even a once in a lifetime experience.
"Although that has been highly gratifying, it has some with a downside of not having any reasonable off time as well as inadvertently neglect of family.
"The scariest bit was in the initial few months of the pandemic when it was uncertain as to what the outcomes of people infected with the virus would be. As is the case for all health care workers, knowing that you will be exposed on a daily basis to the virus and risk being infected – without any available cure – was mentally draining.“
Madhi said SA’s response to the pandemic had been a mixed bag of success and failure.
"There are many lessons to be learnt. Had government actually followed the science, we might have been in a different space with infections, deaths and the economy and livelihoods of people," Madhi said.
At St James, groups are now allowed to gather, and the economic fortunes of many of the congregation have improved in recent months.
And for Cossa and Makuyo, there are not that many ribbons to tie at the moment. It means that perhaps in the near future Lock is going to have to make a decision.
“At some stage we will have to cut the ribbons off and I have been toying with the idea of inviting the community to come and cut a ribbon off, if they have lost a loved one. But then how do we know when this is over.”