First published in GroundUp
I heard someone say recently: “This variant is really catchy.” My family can bear testimony to this. We have just had a markedly quiet Christmas and New Year, all of us holed up with positive Covid-19 results.
This came as an unwelcome surprise – no doubt as it has to the more than 1 million South Africans who have been infected by the novel coronavirus. We are infectious disease researchers. We’ve walked the long HIV and tuberculosis roads – we have grappled with pathogens and epidemics in the past. A number of thoughts arise from this recent too personal encounter with SARS-CoV-2.
It is a really catchy virus. We have been careful. Damn it, we are the outspoken protagonists on the importance of good ventilation to prevent TB. While getting our research sites open again to ensure HIV, TB and Covid research could safely continue, we have really tried to model good behaviour. We have sheltered in place whenever possible and avoided crowds, closed environments and all close encounters. We’ve been reading all the reviews and published data.
But it’s been a brutal year for many, not least for the matric Class of 2020. They have lost so much of what makes the final year of school memorable – everything from tours to balls to first-team seasons. Our 18-year-old hasn’t hung out in bars or beaches. He hasn’t gone to raves. A single matric cocktail party on an open field without a buffet and with symptom screening may have been our undoing — or maybe not? Maybe it was a quick stop at the supermarket despite masks and physical distancing?
The point is we have observed the non-pharmaceutical intervention code and still have caught this catchy virus. The result: symptoms that together with positive nasal swab results spelt the end of holiday celebrations.
Ten days later, we are still battling an array of symptoms but we are incredibly fortunate. We haven’t had to seek the assistance of our courageous clinical colleagues or take up a valuable hospital bed. We are not among the at least 29,000 South Africans who are no longer with us due to this virus.
For us, the non-pharmaceutical interventions have not been infallible – and we have a spacious home, a small family and provisions. How much more inadequate have interventions been in crowded environments, where need has necessitated work and exposure? How easy to blame those who have struggled to adhere to regulations and non-pharmaceutical interventions as the purveyors of contagion, to stigmatise the young whose natural drive is to socialise and congregate?
Just as shaming individuals to adopt safer sex behaviours to prevent HIV acquisition did little but increase stigma around HIV, calling out individuals who may have few options or little inclination to adopt non-pharmaceutical precautions will do little to contain the pandemic.
We have, it seems, lost the overall Covid plot. The short-term emergency strategy in adopting non-pharmaceutical interventions was just that, a short-term intervention to bridge to the rollout of a viable preventive vaccine. How soon the “safe and effective vaccine” would take to be found was a gamble, how quickly that vaccine can be rolled out should have been less of a gamble.
We are 30 years into the quest to find a vaccine against HIV and we are still hunting. What amazing innovation and good fortune that the Covid virus has proved amenable to an effective vaccine and so quickly. I’m so very glad that we were able to employ much of the machinery and technical know-how generated in the HIV field to expedite the development for not one but a few effective Covid vaccines. What a wonderful triumph for science.
Now the political will to ensure the efficient and rapid rollout of vaccines across the world is the challenge of the day. In South Africa, as the second wave takes hold with a vengeance, it would seem at the very least we should do all we can with whatever means at our disposal to find sufficient doses of a safe and viable vaccine to protect our frontline healthcare force. They are exhausted and depleted. They worked through the first wave and the holiday period. They have continuously put their lives on the line and once again have no choice but to put themselves in the firing line.
Protecting them now that we know this is possible should be the highest government priority. Without health workers, there is no health. This is the first and most urgent priority and quite obviously the first critical vaccine queue.
The next queue, hopefully not too far behind, will be the elderly and infirm. Until then, we can continue to inform and educate the elderly and the infirm on what they can try to do to protect themselves through shielding and isolation.
With the “catchiness” of this virus, there is little doubt that anything short of scale-up and rollout of a safe and effective vaccine is very unlikely to bring the epidemic under control. A safe and effective Covid vaccine is not only a silver bullet — it’s our only silver bullet. DM
Professor Linda-Gail Bekker is the director of the Desmond Tutu HIV Centre. She leads clinical research on the prevention and treatment of HIV and TB.
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