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Third wave is on its way, if rapid vaccine roll out falters

South Africa is currently riding the second wave of Covid-19 infections, driven by 501.V2 - a particularly virulent strain of the virus, and "without rapid vaccination of at least two thirds of the population, we are not going to get to population immunity in the country, and without that, we will see another wave", said Professor Marc Mendelson, head of the University of Cape Town's (UCT) Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital.
Professor Marc Mendelson
“Globally, this pandemic has been the greatest challenge to the public health system that we’ve ever seen, and it’s associated with a scientific endeavour that we have never seen before. We’re definitely better off a year down the line, but there are a huge number of things that we need to answer. As a country we still face deep problems with severe issues around vaccine strategy, and we haven’t even talked about vaccine denial, he said, at the virtual Summer School lecture titled Covid-19 insights and lessons.

The new variant

Mendelson said that scientists detected a new strain of Covid-19 in parts of the country in September 2020. Now, “pretty much all infections” in the country are dominated by the new variant.

The new strain contains a large number of mutations, and the viruses that scientists continue to genotype have emerged with the same mutations. These mutations, he explained, sit in the area of the spike protein of SARS-CoV-2, which “antibodies generally recognise”.

“Antibodies and T-cell immunity recognise the same areas, and these recognition sites are critical in our fight against the virus. If the genetic material protein changes and the spike protein changes in this variant, there is a possibility that our immune system won’t work as well.”

Mendelson said that scientists have many unanswered questions about the new strain, including whether current vaccines will offer protection against the new variant, and whether people previously infected with a different strain will have immunity against the new variant.

“Scientific evidence is rapidly being worked on by a research consortium across South Africa to find out exactly what’s happening and what the answers will be.”

Government’s vaccine roll-out plan

Government’s vaccine roll-out plan will be divided into three categories: phase one will focus on frontline healthcare workers; phase two will focus on essential workers, the elderly and persons with comorbidities; and phase three will focus on other people 18 years and older.

“The bottom line is that our response has been slow, even though it is now accelerating. We’ve been promised by the president that 67% of the population is going to be vaccinated by the end of the year. Remember, kids under 16 don’t get vaccinated, so we are talking about 40 million people who need to be vaccinated," he said.

While Mendelson said he’s not able to describe exactly what it will look like and what its effects will be, without rapid vaccination to achieve population immunity, a third wave is definitely on the cards.

Read more: vaccine, Marc Mendelson



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