This pandemic is a long way from over, Covid-19 experts agree

South African experts have called for a reality check: Covid-19 is an airborne disease, so it's not going away.

Vaccines will reduce hospitalisations and deaths but not eliminate them. Far from the pandemic being in retreat, the world recently experienced its highest number of infections in a single week.

Wits vaccinology professor Shabir Madhi told the Sunday Times this week: "Getting rid of the virus is not going to happen under any circumstances. The goal now is to stop severe disease and death. Nobody is totally protected, and ongoing circulation means people remain at risk of dying.

"If we can get into the same space as seasonal influenza, which kills 11,000 South Africans every year, we should call it a success story."

Madhi was surprised anyone would take the recorded number of deaths as the real number. He said that if one "conservatively assumes" 70% of excess deaths are due to Covid, we then have 182 deaths per 100,000 - and that places us among the top 10 countries with most Covid deaths per capita.

The only way is "substantial immunity through nature or vaccination, but the former comes at a huge toll".

Tedros Adhanom Ghebreyesus, head of the World Health Organisation, told a press conference, "This pandemic is a long way from over", and that it was getting worse.

"In January and February this year, the world saw six consecutive weeks of declining cases but we have now seen seven consecutive weeks of increasing cases and four weeks of increasing deaths, and last week was the world's highest number of cases in a single week so far."

This is despite about 780-million doses of vaccines administered globally.

"In some countries, despite continuing transmissions, we see restaurants, nightclubs and markets ... open, full of people taking few to no precautions," said Adhanom.

According to National Institute for Communicable Diseases public health expert Kerrigan McCarthy, "in South Africa we are experiencing caseloads as low as, or lower than, the inter-wave levels seen in August-October last year. However, we have seen a number of localised outbreaks in congregate settings including schools and university residences. These are concerning, as they may herald a new wave of infections." She said that "Covid fatigue is a global phenomenon but Covid is here to stay" and "we should not let our guard down".

Madhi said it had come as a "real blow to the entire control system" when it emerged that contaminated surfaces and direct infection were not the biggest problem.

"Once we realised it was truly a respiratory pathogen, that changed the game almost completely," he said. "It becomes much more difficult to contain, and mass gatherings are especially dangerous because of this when there isn't enough population immunity.

"Anyone who understands respiratory viruses will know that unlike other viruses that are not airborne, it is going to spread quickly, and once it seeds widely, it's almost impossible that it is just going to disappear."

Learning to live with an airborne virus that won't go away is taking its toll, according to a historian at the Wits Institute for Social and Economic Research, Professor Hlonipha Mokoena. "We are just at the tip of the iceberg of the mental fallout and people are presenting with depression and other mental health challenges," she said, "But none of us can control where the virus is going and this will put extra strain on an already stretched health system."

According to professor Quarraisha Abdool Karim, an infectious disease expert at the Centre for the Aids Programme of Research in SA, "when we are faced with something new and unknown, the anxiety and fear kick in at the same time that governments are trying to implement measures".

This means "individual liberties" are constrained, but it is important for governments not to "abuse power".

On the upside, she said, "we are doing well in terms of containment and deaths".

Professor Francois Venter of Wits University said it was "hard to predict" the third wave "but most places that have seen a classic first and second wave have seen a third, so I sadly suspect we will have another".

He said a "quick and efficient" vaccine rollout could break the back of the pandemic, but, "sadly, this is not happening".

Professor Glenda Gray, president of the South African Medical Research Council, expects a third wave "if our pandemic mimics the north and their pandemic and other parts of Africa".