UPDATE | Government response to third wave of Covid-19 pandemic

Due to a lacklustre response to stricter measures intended to curb the spread of Covid-19, coupled with rising numbers of hospital admissions in Gauteng, the government has been forced to rope in the military.

After meeting President Cyril Ramaphosa and defence and military veterans minister Nosiviwe Mapisa-Nqakula on Thursday, acting health minister Mmamoloko Kubayi-Ngubane announced on Friday that the military health services would be deployed in the province.

“After the conversation with the president and the minister of defence and military veterans, we have requested additional capacity to assist Gauteng in terms of military health personnel who have moved into the province to help us swiftly,” said Kubayi-Ngubane.  

The acting health minister, who was speaking during a webinar with a panel of experts on progress made by the government in its fight against Covid-19, said this would help ease pressure on Gauteng’s burdened health system.

“They will assist us in terms of moving into hospitals and in areas where we need healthcare practitioners to help us manage the pandemic.”

The deployment of military health services was scheduled to start on Friday “so we can start the process of ensuring we ease the burden in Gauteng where healthcare workers are facing serious pressure”.

Kubayi-Ngubane also had talks with public service and administration minister Senzo Mchunu about assisting with capacity.

The acting health minister said additional pressure was caused by a lack of beds after Charlotte Maxeke Academic Hospital was evacuated.

“I can confirm that by next week the oncology side [of the hospital] will be handed over to start operating. The other issue that needed to be dealt with was around the fire doors, and they have been installed. We are not going to relax. We will get Charlotte Maxeke on track.”

By the end of Thursday, the health department said two million South Africans had been vaccinated.

However, Kubayi-Ngubane cautioned the nation: “Just because you are vaccinated does not mean people should lower their guard.”

The latest on the vaccine rollout

Elaborating on the vaccination rollout, Dr Nicholas Crisp said it began with the vaccination of 479,000 healthcare workers under the Johnson & Johnson (J&J) Sisonke trial.

“If we want to get closer to the people, we need more sites and more vaccines. We fortunately have received the 300,000 doses we have been looking for to bridge the J&J conundrum we had when the US Food and Drug Administration (FDA) locked up the vaccines and we will immediately start rolling out two programmes,” said Crisp.

The department is aiming to vaccinate 582,000 people in the public and private education sector within 10 working days.

“Many of these people would have already been vaccinated because they are over the age of 60 and work as psychologists and healthcare workers, but most still need to be vaccinated.”

Crisp said the 300,000 doses would not be enough to cover the entire sector but the next consignment of vaccines, from a similar source in the US with a short expiry date, was expected to arrive next week.

The second programme, which is at an advance stage of planning and will commence after the vaccination of teachers, is the security cluster, starting with the police.

Crisp said another programme is under way for the military and correctional services.

“Besides the Pfizer vaccine, which we already have in the country, we will have an additional two million doses in the short term and the J&J deliveries will continue so we can continue with the programme.”

Speaking about the vaccination of workers, Dr Barry Kistnasamy said phase 2 aimed to vaccinate the general population (60 years and over) and then the rest of the workforce (40 years and over).

The country has 15 million workers in the formal economy and seven million in the informal economy.

“We are starting with age-based sequencing in the workplace with 60 and above and 40 and above. In terms of phase 2a, we have 416,000 workers and phase 2b consists of 4.8 million workers.”

There is a plan in place to reimburse people who use their medical aid funds for vaccination, and the health department is investigating why there is hesitancy to be vaccinated among workers.

Registration difficulties

The government’s online registration portal, the electronic vaccine data system (EVDS), has been plagued by delays but the department said it was working on troubleshooting the system.   

Project manager Milani Wolmarans said information collected from the system allowed the department to do an analysis, provide daily updates and assist with decision-making processes.

“We are always working on improving the system because we want to make sure there is access to the people. The system shouldn’t prevent people from getting the vaccine,” said Wolmarans.

Vaccine trials continue

Providing an update on the Sisonke trial study, SA Medical Research Council president Prof Glenda Grey said some of the side-effects discovered were similar to those found in other parts of the world.

“These vaccines, whether it is the J&J or the Pfizer, will reduce your risk of severe disease. They may not protect you from infection but they will protect or reduce the risk of similar disease.”

Grey said follow-ups were being conducted on healthcare workers who had breakthrough infections (adverse reactions).

“We are busy adjudicating them to determine whether they are mild or severe. We are seeing only a handful of severe reactions. Most have been mild,” she said.

Studies are also being conducted to see how HIV-positive, pregnant and breastfeeding mothers and healthcare workers with comorbidities responded to the vaccine to ensure the response was comparable with cases around the world.

While workers will be protected after getting the jab, Grey said they must continue to use personal protective equipment and follow Covid-19 protocols.

She said investigations were ongoing into new coronavirus variants discovered around the world to acquire the right vaccines.

Prof Helen Rees from the SA Health Products Regulatory Authority (Sahpra) said the organisation had prioritised the regulation of Covid-19 vaccines.

“So far the vaccines that have been approved by Sahpra for emergency use are AstraZeneca, Pfizer and J&J. The vaccines we have in the pipeline are the Sputnik vaccine and Sinovac vaccine.”

Rees said some of the other vaccines — including Novavax, Sinopharm and the Cuban vaccines — which the public were asking about were not under review because there were no applications.

“It is not taking time to review the Sputnik and Sinovac vaccines. For the Sputnik vaccine, there are two applicants and they are doing a rolling review. As they get data, they are submitting it to the regulator and the regulator is reviewing those processes on a continuous basis,” she said.

The applicants are submitting information so the regulator does not have all the required information to complete its work.

With Sinovac, Rees said when the first application was submitted the regulator requested more data.

“We are in continuous dialogue with the Sinovac and Sputnik applicants. The Sinovac applicants have submitted to the regulator the same information they submitted to the World Health Organisation (WHO). They gave an emergency use listing for Sinovac so we work with Sahpra and the WHO.”

The organisation is studying an embargoed dossier from the WHO on Sinovac.

More importantly, Rees said the public should note that not all vaccines were effective. “None are 100% effective and none were developed to be effective against the Beta variant. They were developed to deal with the original variant.”

Together with the department, the regulator was monitoring how the public responded to the vaccines to ensure safety.

In terms of political pressure, Rees said Sahpra felt the same pressure the country was experiencing “so it cannot be business as usual under Covid-19. However, at no stage have we experienced political pressure and I can say that with absolute certainty.”

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