“Even once vaccines are rolled out successfully in a given country, unless the global community is vaccinated no one is safe, especially as variants have been shown to disperse fairly rapidly including possibly eventually to countries where there is a high level of vaccination. As a result, Covid-19 is not going to simply disappear. In fact, I believe it will be with us for the rest of our lifetimes.
“Covid-19’s rate of mutation caught many scientists by surprise; they weren’t expecting such rapid mutations especially not in key components of the virus that we’re targeting with vaccines," he said.
Right now, there is another variant that has been identified in Tanzania, which seems to be even more problematic than the SA variant in terms of additional mutations that will probably confer even greater resistance to the vaccines. San Francisco has also identified variants that are relatively vaccine resistant.
It is about controlling the magnitude of severe disease and the number of people that die. Between 10,000-11,000 people die from seasonal flu each year in South Africa and Madhi said that if we get to the point where the number of people who die each year from Covid-19 is around the same level, that will be a positive scenario.
Madhi said currently the Covid-19 death rate is about three times the official figure.
Most South Africans probably think our death rate from Covid-19 is around 50,000 people. But it is likely triple this amount based on South African Medical Research Council modelling.
Even if one assumes that only 70% of our excess mortality is due to Covid-19, which would be conservative, South Africa still ranks 11th globally with a mortality rate that is higher than Spain, Italy, the UK and even the US. “This shows how potent the virus is, and how unsuccessful our efforts to contain it have been,” Madhi said.
Speaking about the pause in the Johnson & Johnson (J&J) vaccine rollout due to an extremely rare blood clotting disorder, he said the AstraZeneca and Pfizer probably have had similar rates of the described side effects.
Those affected range from four to five individuals per million. Mortality rates since the pandemic began in South Africa are at 1,800 of every million assuming only 70% of excess mortality is due to Covid-19. The risk of dying from Covid-19 is nowhere near the risks of the rare occurrence of blood clots from the vaccines. “In South Africa, we unfortunately don’t have the same luxuries as countries like the US, who can afford to pause a vaccine while another one fills the gap. The lesson here is to truly consider the benefit/risk ratio before taking such a decision.”