Western Cape is planning for 3rd wave; personal responsibility remains key
For nearly a year now, the Western Cape Government has been responding to the Covid-19 pandemic, in order to save lives and provide the appropriate care for those who are sick. This response has always been data-driven and evidence-led. While this data currently shows us that we have overcome a significant and serious second wave, our work is not done. We must prepare ourselves for a third wave, to save lives and limit the impact of Covid-19 on the livelihoods of our residents.
During my SOPA, I outlined our four-pronged response to Covid-19. Rolling out vaccines effectively, procuring our own vaccines, preparing for a third wave and supporting our scientists researching therapeutics, are key in responding to this pandemic in the coming weeks and months.
Preparation for a third wave:
Our Western Cape epidemiologists are part of the MAC technical working group who are preparing a response to a possible third wave. While we know that a third wave is likely, we cannot predict the timing, location or magnitude of a resurgence. We do however know that it could be driven by six key factors:
Changes in viral transmissibility which could be brought about by changes in the weather and seasonal changes in behaviour such as the Easter weekend and funeral attendance.
Behavioural changes among the population such as the changes in restrictions and adherence to quarantine and isolation protocols.
Changes in interactions between connected subpopulations such as movements between provinces and movement between urban and rural areas.
Changing immunity/reinfection risk, as there is some evidence to show immunity post infection. However, this may wane over time.
Viral evolution, as new variants like 501Y.V2 could affect viral transmissibility.
Speed, impact and uptake of vaccinations will also impact severity of third wave.
Containment and mitigation:
Between peaks, our focus must be on containment, and ensuring that clusters of cases, related to a specific place or event, do not result in widespread community transmission. Once community transmission has been established, containment efforts become ineffective and the focus must then shift to mitigation measures, to reduce the numbers of deaths, ensure that our healthcare system does not become overwhelmed and protect our healthcare workers.
Our containment response must focus on prevention behaviour and increased testing and surveillance, while our mitigation measures include retaining our core field hospital capacity and making use of the additional infrastructure put in place during the first two waves.To contain infections, community behaviour remains key to preventing Covid-19. A surveillance and outbreak response is also important to ensure we are able to closely track and respond appropriately.
The Western Cape's surveillance strategy focuses on three key areas:
Determining the proportion of and places where previous infections have occurred through seroprevalence testing. The Western Cape has conducted seroprevalence testing among people accessing our services for HIV treatment and antenatal services following the first wave. In February, residual samples from people accessing diabetic, Paediatric and HIV treatment were taken which will, in the next few weeks, be able to give us a picture of infections in communities following the second wave.
Tracking the rate, areas and the molecular characteristics of new infections. Our waste-water testing system is an excellent early warning system which we continue to use. Scientists across the country and around the world are also constantly working to identify new variants which may have an impact on the third wave.
Tracking individual new cases allows us to trace contacts, advise them to isolate or quarantine and contain cluster outbreaks around cases. In the Western Cape, we will be using screening, and PCT or rapid antigen tests for these purposes.
A vaccination campaign is also an important aspect of a containment strategy. The Western Cape is on track in its rollout of the J&J Sisonke implementation study, to vaccinate healthcare workers. We have completed our first tranche of just over 13 000 vaccines, and the second tranche is currently being rolled out. Today, the first healthcare workers outside of the metro started receiving their vaccinations in George, and vaccination in Worcester and in Paarl will begin soon.
In this tranche, 64% of vaccines will be allocated to the public sector, with 36% going to the private sector and we have scaled up from four vaccination sites to a total of 8 to be brought online by 15 March.
Vaccines in this study will be rolled out in four tranches over an eight-week period, covering approximately 40% of the province's healthcare workers.
Phase 2 vaccinations:
The general population will begin to receive vaccinations in phase two of the rollout. It is important that we urgently vaccinate priority categories within the next three months in order to mitigate the impact of a third wave. As phase 2 includes many of our most vulnerable including those over 60 years old, and with serious co-morbidities, this phase is important in reducing deaths, and protecting our health system from becoming overwhelmed.
In order to do this, we are working to develop an efficient delivery system which will roll out vaccines to as many people, as quickly as possible.
At this stage, the only vaccines currently available in the country are those being used as part of the J&J Sisonke study. Given this limitation of availability, contingency plans to procure vaccines for the country and the province must be explored urgently.
Over the past six weeks, the Western Cape has recorded significant declines in the number of Covid-19 infections in the province. While we are in this space between peaks and waves, it is imperative that we all take personal responsibility to ensure that we remain safe.
The country has just moved to Level 1, allowing for more movement and congregation and in the coming weeks, public holidays, and the Easter weekend will see more people moving around and congregating, increasing the risk of infections. It is imperative that we are all acting more responsibly than ever before.
We must ensure that we are all wearing our masks, washing our hands and keeping our distance. Avoiding crowds, confined spaces and close contact also remain important in infection prevention. Businesses, faith-based organisations and all civil society groupings must also do everything possible to ensure that their spaces and activities are safe for all who use them.
A third wave is likely, but how we act now, in our response as a government, and our behaviour as individuals can help to reduce its impact and save lives.