In the absence of a mass vaccination rollout, experts have advised that tighter lockdown restrictions be implemented to avoid a vicious Covid-19 third wave propelled by new variants.
The Free State health department announced last week that the province was already in a third wave. The Gauteng provincial government said it was likely to hit the province in the next few weeks.
The recent confirmation that two variants of concern – the B.1.617.2 and the B.1.1.7 – were circulating locally had made experts worry about a potentially devastating third wave, especially with low vaccination rates.
The B.1.617.2 was first detected in India, and the B.1.1.7 in the UK.
Last week, the National Institute of Communicable Diseases predicted that a third wave was likely to be less severe than the other waves – if a new variant was not detected.
Dr Asmal Dasoo, convenor of the Progressive Health Forum, said without mass vaccination, the country should move to a stricter lockdown level that would further limit gatherings.
The country's currently on the adjusted level 1.
Dasoo said: There are no other tools left. We certainly don't have any vaccines; we are pretty much where we were with the other two previous waves. We are in the same place we were over 12 months ago.
The sentiment was echoed by Wits University health and security expert Professor Alex van der Heever. He said: "If the current trends continue, we will need to introduce restrictions targeted at gatherings. In the absence of a vaccine rollout, there will be no other option."
Dasoo said the most important thing would be to prepare the health system for the increase in caseloads.
"We need to prepare the health system for inevitable increases. People know they have to wear their masks and sanitise. All we have to do now is block all gatherings of more than ten people. Once you have more than ten people, the spread becomes more exponential. No one in South Africa should be comfortable being in a group of more than ten people unless those people are part of their household."
VACCINATION IS THE ONLY WAY OUT
He said while there was concern over the B.1.617.2 and B.1.1.7 variants, they were likely circulating in the country for much longer than the official confirmation.
He said that banning travellers from India and the UK would not make much of a difference.
"Even before the first cases of the variant arising in India were confirmed, it must have been in circulation already. The virus respects nothing that we can do. All that we can do is to protect ourselves, and the only way to do that is to get immunity."
The best way to get immunity, Dasoo said, was to get people vaccinated as soon as possible.
There has to be a reckoning; we are so far behind in terms of vaccination, and even our peer countries are far ahead of us. We've had a combination of bad luck but also some wrong decisions. The same vaccine that we said was not good enough for us is being distributed in countries with the variant that emerged in South Africa.
Earlier this year, South Africa sold the AstraZeneca vaccine doses to the African Union after it was found the drug was not effective against the 501Y.V2 variant – which was first detected locally – that was dominant in the country.
The country had, so far, only vaccinated healthcare workers as part of the Johnson & Johnson Sisonke implementation study. The study – which aimed to vaccinate 500 000 healthcare workers – was expected to be concluded this week.
The vaccination of people aged 60 and above was expected to start next week on 17 May.
Dasoo said it might be time for the Ministerial Advisory Committee (MAC) on Covid-19 and the health department to admit that they had failed with their Covid-19 response.
"Maybe it is time the MAC and the health department come clean with people and say we screwed up, mea culpa. Only the president can do that. And he has been engaged in this other melodrama in the ANC and leaving this [Covid-19 response] behind. We have a top leadership that is not quite focused on what this pandemic is, partly because they are not badly affected themselves. I don't know what it will take for them to take it seriously."