The Western Cape government has enough Covid-19 vaccines to inoculate all 70,000 healthcare workers before 17 May and will be ready to begin phase 2 thereafter, according to Dr Keith Cloete. The head of the province’s Health Department was speaking to Judge Dennis Davis in an interview on Friday, 7 May 2021.

The national government has officially said a third wave of Covid-19 infections has begun in two provinces – the Free State and the Northern Cape. This is according to data and analysis by the National Institute for Communicable Diseases (NICD) which tracks Covid-19 data, said Cloete.

The other seven provinces were on “high alert” and keeping a close eye on daily data. The Western Cape, for instance, constantly surveys for small clusters and how they are interconnected, he explained.

The province was averaging “only” 120 cases per day, as well as about 25 Covid-19 hospital admissions and three deaths daily. This meant the province was “solidly between waves”. However, at this point there are some small markers that the province might be seeing an increase in infections, Cloete added. 

This is of particular concern in the Cape Town metro where an increasing proportion of private-sector testing done in “affluent suburbs” is coming back positive, he explained. Covid-19 infection had been more prevalent in the metro’s townships during the first and second waves.

Social behaviour is likely to be the single most influential factor in when the third wave begins in South Africa and how large it will become, Cloete said. A collective of researchers from the NICD and Stellenbosch, Cape Town and Wits universities had crunched the numbers and taken into account the impact variants, immunity, seasons and social behaviour might have on the third wave’s trajectory.

If people limited the size and frequency of gatherings, wore masks, washed hands and ensured effective ventilation, the onset and size of the wave would be pushed back. This would allow more time to vaccinate and save lives before the third wave.

Davis said the public has been told “all manner of things” about vaccines by politicians and uncertainty is rife. When Davis asked if phase 2 of the roll-out would begin on 17 May, Cloete confirmed it would.

Phase 1 – the vaccination of healthcare workers – is being finalised, he added.

Davis pointed out that the national government said there were 1.5 million healthcare workers to be vaccinated across the country, yet only 382,480 have had the jab so far.

Cloete explained that the Western Cape estimated there were 134,000 healthcare workers in the province. Of these, more than 65,000 had been vaccinated so far. The balance needed to be done in the next two weeks.

The province was in the process of “verifying” all healthcare workers who had registered to have the vaccine but had not yet had it. This would determine how many had registered and how many still needed to be vaccinated. Cloete estimated that more than 70% of the 35,000 healthcare workers employed by the province have been vaccinated against Covid-19.

The verification programme extended to undertakers, traditional healers and those working in health for non-governmental organisations, old-age homes and social development. This covered the public and private sectors. 

The province had 90,000 doses of Johnson & Johnson vaccine on hand to do this. If all healthcare workers were vaccinated there would be about 25,000 J&J doses “left over”.

The province “has just been told” that there were an additional 4,000 doses coming and would receive 34,000 Pfizer vaccine shots on 15 May and every week thereafter. 

On 17 May, the province will start administering about 20,000 Pfizer jabd to those over 60, Cloete said, and on 28 May, another 200,000 J&J doses will arrive in the province.

Davis pointed out that there are 10 days to go before vaccination of over-60s starts, yet no one knows where they will be vaccinated, by whom and when.

Cloete explained that more than 180,000 people over 60 in the province had registered by 6 May. He assured that they will receive a follow-up SMS with a date and time for their vaccination. More than 200 public-sector sites had been identified by the department – each geographical area would have a “base” site, which would be based on existing sites for healthcare workers. There would be private-sector sites at retail and community pharmacies, hospitals and GPs. 

There would also be a “mass site” in the City of Cape Town as well as workplace vaccination sites. There were 2,000 trained vaccinators “ready to be deployed” to these sites. 

Cloete went on to say that old-age homes will be prioritised from 17 May and not everyone will be contacted before and on 17 May. There would be an “incremental, slow uptake” and it would take time to take off.

He said access to the EVDS system has helped the province to pinpoint where registration is low – the central Karoo has a registration rate of only 4% compared with 40% in the Overberg district. The metro is 22%.

The province hoped registration would pick up before 17 May because it is now possible through WhatsApp and the USSD notification platform. In addition, it would launch registration drives in the areas where the data says registration has been low. It would rely on schools, community healthcare workers and neighbourhood organisations to drive the messages home.

The province had also asked the national government to adjust the EVDs to allow for “block registration” to allow old-age homes to register all of their residents. 

The province wants to have completed vaccination of over-60s by the end of July 2021, Cloete said. This would depend on increasing vaccinations over time to reach 26,000 a day. This would be possible because the province already administered 3,000 Covid-19 vaccines a day at nine sites. The sites, vaccinators and vaccines were in place to achieve this.

It is an “ethical and moral imperative” that the vaccine should be available to all, which is why there is such a focus on public sites, he added. 

There are more than 400 private old-age homes on the system and more than 200 private pharmacies, he said, explaining that the private sector has to work on a national level, therefore coordinating with them on a provincial level is more challenging – although this is well on its way. 

Cloete committed that by 17 May the province will tell the public where the vaccination sites in their geographical area will be.

People would not be able to choose whether they get a J&J or Pfizer shot. The province’s Covid-19 advisory committee of scientists had recommended this since they were both safe and effective.

The Western Cape had contracted a courier company to transport Pfizer vaccines at the necessary -70 degrees Celsius to different sites. This vaccine was preferable at high-volume sites because it had to be used within six hours of opening. 

Davis commented that while the province could be regarded as a “case study” in how to prepare for the vaccinations, new variants may throw off these careful plans.

Cloete explained that scientists at Tygerberg and Groote Schuur hospitals are keeping track of the variants in the province. Their research showed that the dominant variant remains B1.3.5.1 – first detected in Nelson Mandela Bay. As a result, the province continued to assume it would remain dominant during the third wave. DM/MC