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Variants, the fourth wave, vaccines and the unlikelihood of herd immunity: What might happen in South Africa?

Screen Shot 2021-08-16 at 3.39.17 PM

By The Scientists Collective, Maverick Citizen, 15 August 2021, photo credit: Bakertilly

The rise of the scary-sounding variants, a South African third Covid-19 wave that was much worse than the first or second for most of the country, and the introduction of multiple vaccines has confused many of us. Uncertainty about the future is always frightening. This is especially so when scientists don’t explain things clearly, or where there is disagreement around ideas like ‘herd immunity’, whether the new variant makes you sicker than the previous ones, and speculation about how the virus will evolve further.

First, some key points in our article (below) about SARS-CoV-2 (the virus)/Covid-19 (the disease) in South Africa:

  • South Africa, like much of the African region, has experienced a devastating third wave, made worse by the very small number of people who were vaccinated when the super-infectious Delta variant arrived.
  • The phrase “herd immunity” is used incorrectly by senior advisers to government, and unfortunately has entered popular vocabulary among politicians, commentators and the media, when it is extremely unlikely to occur.
  • Ongoing mention about vaccinating to reach herd immunity threatens to undermine messaging on the actual value of vaccines, which is primarily to prevent severe disease and death.  
  • Our immune system seems unable to stop SARS-CoV-2 infection in everyone, even after vaccination or previous infection.
  • However, the vaccines (and immunity produced by a previous infection) seem excellent (not 100%, but very close) at stopping severe illness — the kind that puts you in hospital and kills you.
  • Understanding that the primary role of Covid-19 vaccines is to protect against severe disease and death helps us to decide how best to use current vaccines, future possible combinations or “boosters”.
  • A better understanding will also better inform how we use masks, and apply social distancing and lockdowns, to get our society, schools and other institutions back to normal as quickly and responsibly as possible.
  • Experts are cautious about firmly forecasting the future of the Covid-19 pandemic as there are many uncertainties. But we know if a fourth wave arrives towards the end of the year (as previous waves have been roughly five to six months apart), vaccinations for as many people as possible are our #1 priority, as well as preparing and stocking health facilities, and ensuring safeguards against rapid spread are in place in places where people gather in large numbers. Lessons need to be learnt from the experience of the first three waves.
  • In the short term, it is impossible to over-emphasise how important it is to get the vast majority (90% or more) of vulnerable people (those over 60, and those with comorbidities) vaccinated before November 2021.
  • Deal with it! Masks and physical distancing are here to stay until there is high penetration of Covid-19 vaccines among the groups most vulnerable for severe Covid-19.
  • If we get the majority of adults vaccinated, (like the 88% of adults in the UK), especially the most vulnerable, there is a future (maybe a year away) where we may be able to get back to a normal lifestyle and start regarding this virus like the seasonal influenza virus — something that we have to live with and manage.
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