Scientists warn of a new Covid-19 variant that carries an “extremely high number” of mutations as South Africa’s fourth wave approaches.
The new variant B.1.1529 may drive further waves of disease by evading the body’s defences.
At least 10 cases have been identified in three countries and has raised concern among some researchers because a number of the mutations may help the virus evade immunity.
The variant was first found in Botswana, where three cases have now been sequenced. Six more have been confirmed in South Africa, and one in Hong Kong in a traveller returning from South Africa.
Dr Tom Peacock, a virologist at Imperial College London, posted details of the new variant on a genome-sharing website, noting that the “incredibly high amount of spike mutations suggest this could be of real concern”.
Peacock in a series of Tweets said it “very, very much should be monitored due to that horrific spike profile”, but added he hope it may be an “odd cluster” that is not very transmissible.
Meanwhile, a preliminary analysis by World Health Organization (WHO) shows that only 27% of health workers in Africa have been fully vaccinated against Covid-19, leaving the bulk of the workforce on the frontlines against the pandemic unprotected.
Analysis of data reported from 25 countries finds that since March, 1.3 million health workers were fully vaccinated, with six countries reaching more than 90%, while nine countries have fully vaccinated less than 40%. In sharp contrast, a recent WHO global study of 22 mostly high-income countries reported that above 80% of their health and care workers are fully vaccinated.
“The majority of Africa’s health workers are still missing out on vaccines and remain dangerously exposed to severe Covid-19 infection. Unless our doctors, nurses and other frontline workers get full protection we risk a blowback in the efforts to curb this disease. We must ensure our health facilities are safe working environments,” said Dr Matshidiso Moeti, WHO regional director for Africa.
It is important to have high vaccine coverage among health workers not only for their own protection but also for their patients and to ensure health care systems keep operating during a time of extreme need.
Africa’s shortage of health workers is acute and profound, with only one country in the region having the required health workers (10.9 per 1000 population) to deliver essential health services. Sixteen countries in the region have less than one health worker per 1000 population. Any loss of these essential workers to Covid-19 due to illness or death therefore heavily impacts on service provision capacity.
Based on data reported to WHO by countries in the African Region, since March 2020, there have been more than 150 400 Covid-19 infections in health workers, accounting for 2.5% of all confirmed cases and 2.6% of the total health work force in the region. Five countries account for about 70% of all the Covid-19 infections reported in health workers: Algeria, Ghana, Kenya, South Africa and Zimbabwe.
After almost four months of a sustained decline, Covid-19 cases in the general population in Africa have plateaued. For the first time since the third wave peak in August, cases in Southern Africa have increased, jumping 48% in the week ending on November 21 compared with the previous week.
The risk of health worker infection rises whenever cases surge. This is a pattern that has been observed during the previous three waves of the pandemic. With a fourth wave likely to hit after the end-of-year travel season, health workers will again face risks amid low vaccination coverage.
To date, more than 227 million vaccine doses have been administered in Africa. In 39 countries which provided data, 3.9 million doses have been given to health workers.
“With a new surge in cases looming over Africa following the end-of-year festive season, countries must urgently speed up the rollout of vaccines to health care workers,” said Dr Moeti.
Vaccine shipments have been on the rise over the past three months. Africa has received 330 million doses from the COVAX Facility, the African Vaccine Acquisition Task Team and bilateral agreements since February 2021. Of these 83% have been delivered since August alone. As vaccine supply picks up, addressing uptake bottlenecks and accelerating rollout become more critical.
All countries in Africa have prioritized health workers in their vaccination plans. The low coverage is likely due to the availability of vaccination services, especially in rural areas, as well as vaccine hesitancy. Recent studies found that only around 40% of health workers intended to receive a Covid-19 vaccine in Ghana and less than 50% in Ethiopia. Concerns over vaccine safety and the adverse side effects of the vaccines have been identified as the main reasons for their hesitancy. Health workers are key sources of information for the general population and their attitudes can influence vaccine uptake.
“The Covid-19 vaccine stands among humanity’s extraordinary scientific feats. In Africa, we’re gradually overcoming supply constraints. Now is not the time to stumble over vaccine mistrust,” said Dr Moeti.
Supporting national efforts to drive up health worker vaccination, WHO is coordinating trainings and dialogue on vaccine safety and efficacy to help address doubts or misconceptions around the Covid-19 vaccine as well as advocating open and honest communication about the benefits and side effects of vaccination.