Last year’s weapons to fight this year’s wars – or virus variants – are not going to cut it anymore.

Experts tracking the virus and the public health protocols say things have changed and it’s time for a review and clearer communication of what works and what doesn’t. There are also clanging bells in the distance; it’s a wake-up call that as government mandates and guidelines slip to the background, individuals will have to take greater personal responsibility and get used to personal risk assessment. 

The fast changing nature of the virus – its latest mutations as delta and now omicron – is one reality but there have been game-changers with a bolstered response arsenal in the form of general population vaccination and boosters on the horizon. 

It’s a backdrop change that shifts the focus from battling the coronavirus to better use of evolving tools and better judgment to arrive at the point of living with the virus. 

Professor Alex van den Heever, chair in the field of Social Security Systems Administration and Management Studies at the Wits School of Governance, points out what is no longer effective: Symptom screening, temperature checks and patchy sanitising of hands and surfaces top his list. “People who are asymptomatic or who only have mild symptoms won’t even have a temperature. Screening also doesn’t single out people who are positive – it singles out who is ill and who is more severely ill.” 

Sanitising hands or surfaces fall into the same category of low effectiveness, he says and contact tracing when infection rates are surging simply overwhelmed tracing systems. As people fall through the cracks, contact tracing becomes “quite pointless”. 

Even rapid antigen testing, so-called lateral flow tests, adopted in countries like Switzerland where vaccinated people are issued free home test kits, and testing in general including PCR and antibody tests, he says have limits in preventing the spread of infection. In his example, friends from different households could rapidly test before meeting up and all be negative but become infected en route to their gathering. The same applies to people being tested before a flight then becoming infected during a flight and only showing symptoms days later.  

“The main issue then is that if you’re worried about higher levels of transmission and the potential for people to develop severe illness then the best strategy is to control group settings – that’s about it,” Van den Heever says. 

In assessing the past three waves, he says the big questions revolve around understanding the factors that have reduced the effectiveness of public health safety protocols. 

“We locked down some sectors of society and not others” he says, but pointing out that data from private and public hospital admissions during the first three waves along with factoring excess death numbers showed that the virus impacted indiscriminately and in spite of some of the lockdown restrictions. 

Van den Heever adds: “Conditions are changing with people being vaccinated or even having been infected multiple times, so there’s considerable immunity distributed in the community now. And if there is a lower risk of developing severe illness then going forward getting infected is basically just another immune boost.” 

Van den Heever admits it’s not the moment to throw all caution to the wind. But a turning point when “we will have to let the virus rip” is coming. 

“We still have to be safe – because what we know statistical data only remains a statistic till it’s your grandmother,” he says. His point is about better personal choices and better risk assessment and knowing that our decisions have a down the line impact on those in society who are most vulnerable.

On this score he says some established guidelines hold: vaccination, ventilation, limiting numbers at social gatherings especially when people are going to let their guard down and masking up with an N95 mask over a surgical mask if you are not physically distanced – like being on a plane or a taxi. 

For Shabir Madhi, dean of the Faculty of Health Sciences and professor of vaccinology, the immediate strategy is to start the campaign of booster doses for people over 60 and those who are immuno-compromised.

“There is good medical evidence that we should not wait any longer to give boosters,” he says. The first cohort of over-60s who completed their second dose of Pfizer in July this year will have anyway clocked up six months by January next year. 

Madhi says aligned to a booster vaccination drive should still be ventilation, masking and limiting numbers for indoor gathering – “everything else is window dressing”, he says. 

He adds that once the omicron wave ebbs the hospitalisation and death data will give scientists and researchers clearer understanding of the severity of the variant and the impact of vaccination. Omicron has proved to be highly transmissible, with a new national infection number on 15 December standing at just under 27,000 and 54 deaths and a total 191,596 active cases. If symptoms remain mild enough not to require hospitalisation it will be the push for public safety guidelines to be eased accordingly. 

Ultimately, Madhi says it’s about a mindset shift now. “We need to stop believing that we can stop infections taking place. The main focus is about minimising numbers of people dying or people in hospital because of severe symptoms. We will have to learn to live with this virus.”

How society navigates a changed world of viruses even with fewer government public health directives will come down to personal choice but understanding that this comes with the responsibility of community-wide impact.  

For UCT Emeritus Professor Crain Soudien who was previously CEO at the Human Sciences Research Council this presents clear tension points. But he says it can also be a moment to reset day-to-day human interactions that have become marked by casual crudeness, entitlement to offend or call out and retreat to angry laagers and bubbles of confirmation bias. It makes having conversations about tough topics tougher.

Soudien says new lines of division are being drawn out in a time of virus. It’s the likes of the pro-vaccination versus anti-vaccination debates or the pro- restrictions versus the anti-restrictions debates. His point though is they should be debates, not stances that end relationships, make family members police each in suspicion or cause friendship fallouts.  

Soudien says: “These issues are producing new kinds of fractures and new kinds of boundaries, so it’s important to recognise this because they are not going to go away. But we have to always be learning about how to be managing these new and very inventive forms of divisions among us – to know that this is how othering happens and this is how power works.”

He adds too that conversations and debates must extend beyond middle-class framing to recognise our unequal societies that mean socio-economic pressures often stand in as default choices for the poor and those on the margins.     

“There is no formula other than looking to multiple ways and inventive ways to get a message across about how best we protect ourselves and each other. And we have to insist that we have the capacity to be able to speak to these things to have hard conversations without being offensive, judgemental and even as we’ve become such a soundbite civilization right now”. DM/MC