Covid-19: Experts warn against complacency in preventing 'second wave'

Even though the decline in Covid-19 cases is a promising sign for SA, there are concerns about a second surge.

This was the opinion of the three experts who took part in a webinar presented by the University of the Free State (UFS) on Thursday.

The panellists included Prof Salim Abdool Karim, director: Centre for the Aids Programme of Research in SA (Caprisa) and chair: South African Ministerial Advisory Committee on Covid-19; Prof Glenda Gray, president and CEO: South African Medical Research Council (SAMRC); and the UFS’s Prof Felicity Burt, NRF-DST South African research chair in vector-borne and zoonotic pathogens research.

Prof Abdool Karim said the downward decline is consistent and the number of patients presenting at hospitals is also declining.

“What we are seeing is a promising trend, and it looks like we are on the decline. A question that I am often asked is — is the worst over? The answer is not clear cut. We are concerned about the risk of a second surge. If anything — what really concerns me at this stage is a second surge, as I think about how the pandemic may play out in the next few weeks,” said Abdool Karim.

He referred to other countries, such as the US, Spain, New Zealand, Vietnam and South Korea, which are now facing a second surge.

“We need to be very careful; this is not the time for complacency. We need to maintain all our efforts. If we look at one of the key drivers, it is the need for our economy to restart. We need to get people back to work,” said Abdool Karim.

According to him, we have to look at Covid-19 not as a sprint, but as a marathon. “As we learn to coexist with this virus, aim for containment; we need to plan for the long term. Even if we get a vaccine, it is unlikely we will be able to vaccinate a substantial part of our population before the end of next year.

“We need to transition from being scared to a situation where we can control our risk; when we know that we can control the risk and then influence the risk, we influence the risk of everyone around us. Part of the new normal is the strategy of mitigation with prevention, plus preventing outbreaks.”

Prof Gray spoke about whether schools should be open and the role children play in transmission, how to avoid the second wave, how to adjust testing, and the exciting news concerning vaccine development.

As a paediatrician and a parent, Gray said she believed schools should open. “Children have a different immune response to Covid-19 and probably have less viral load copies, causing them to have a milder form of the disease. They are lucky to have been spared the symptomatic or severe form of the disease,” said Gray.

She said schools need to be de-risked as much as possible, with children and teachers wearing masks, washing hands, making sure that there is good ventilation in the school, and that windows are wide open.

“We also need to know about the comorbidity and ages of teachers, so that we can keep the sick and older teachers out of direct contact. The younger teachers with no comorbidities should be teaching.”

“We also know from our experiences with health workers that transmissions happen in the tea room where teachers take off their masks and talk. We need to minimise the transmissions in tea rooms and protect teachers and parents who are old and have comorbidities.”

Gray said from data she has seen, schools play a very small role in the transmission of Covid-19; a lot more transmissions happen in the community, through commuting and in overcrowded taxis.

Gray agreed with Abdool Karim that SA should be concerned about a second wave, and that we need to ensure that community transmissions are minimised.

Gray said a global race was on to find a vaccine. “The more vaccines the better, we want more vaccines to work. The more vaccines, the more affordable they are, and the more doses are available.”

During her presentation, Burt said the current response to outbreaks is largely reactive rather than proactive, and “if we have more of a one-health approach, with forecasting, early detection, and a more rapid respond, we could have an affect on public health in the future”.