Warning signs of Covid–19 fourth wave in South Africa


There are early warning signs from laboratory data that the fourth wave of Covid–19 may be starting in Gauteng, KRISP director at the University of KwaZulu-Natal Tulio de Oliveira has told the Sunday Times.

De Oliveira highlighted increases in positivity rate and the reproduction number as signs that the epidemic is growing again in South Africa.

According to one estimate, the reproduction number in Gauteng surged to over 2.1 during the past two weeks — higher than even Gauteng’s ruinous third wave.

The reproduction number is an indication of how fast an infectious disease spreads.

Gauteng’s reproduction number essentially says that every person with Covid–19 in the province is infecting two others.

Covid-19 reproduction number in Gauteng
Estimate of people currently infectious with Covid-19 in Gauteng

While this massive rise in the reproduction number is cause for concern, epidemiologists told the Sunday Times that South Africa as a whole is not in the early stages of a fourth wave.

They said that the faster South Africa could roll out vaccinations, the less likely it would be for slight upticks in infections to turn into an overwhelming wave.

However, unvaccinated South Africans could put hospitals under pressure, similar to last December.

Another sign that the fourth wave may be starting is that scientists have detected fragments of the virus that causes Covid–19 in Gauteng’s wastewater.

“We have seen an uptick in numbers over the last ten days or so, but it is too early to tell… This is here in Gauteng and also in the Western Cape,” the paper quoted Nomathemba Chandiwana as saying.

Chandiwana is a senior research clinician in the Wits Ezintsha research group.

She said that South Africa is especially vulnerable because 60% of the population was still unvaccinated.

Combined with relaxed safety protocols and the coming festive season, you have a recipe for a recurrent wave.

Nomathemba Chandiwana, Senior Research Clinician in the Wits Ezintsha research group

Scientists are tracking two new variants that could impact the severity of South Africa’s next wave of Covid–19 infections.

De Olivera said they are looking at an even more transmissible sub-lineage of Delta (AY.4.2) and a variant that could reduce vaccine efficacy (B.1.640).

He said they are “alerted but not concerned” about the new variants and assured that the Delta sub-lineage is found at very minimal prevalence in South Africa.

However, South African scientists are keeping an eye on it, he said.

The UK and Europe are worried about AY.4.2. Its prevalence increased about 15% in the UK, and it is estimated to be 10%–20% more transmissible than the original Delta variant.

Delta tore through countries like India and South Africa, bringing India’s healthcare system to its knees and South Africa’s to the brink.

Therefore, a more transmissible variant of Delta is a major cause for concern, especially with South Africa hoping to welcome thousands of UK tourists these holidays.

Experts have warned since July that South Africa should expect a fourth wave to hit in early December.

Salim Abdool Karim, former chairman of the government’s ministerial advisory committee on Covid–19, expected the fourth wave to start on 2 December and last about 75 days.

Government assumed that the wave would follow a similar pattern to that of the third wave and that there would be a new variant by then, Abdool Karim said.

Salim Abdool Karim, former chairman of the government’s ministerial advisory committee on Covid–19

Karim’s prediction follows a warning from Francois Venter, the director of Ezintsha at Wits health sciences, who said that South Africa could see a fourth outbreak of Covid–19 as early as November.

Venter told the Sunday Times that he hopes the Gauteng fourth wave will be milder than last December’s overwhelming surge.

“We suspect many people have already been infected, and a third are vaccinated, so they are very unlikely to be hospitalised, and Gauteng empties out over December,” he said.

Health minister Joe Phaahla previously said that the fourth wave is inevitable — that the festive season coupled with the movement of people would trigger another wave of infections.

“This makes it more urgent that more and more people come forward to be vaccinated because we want everybody in our country to be protected from this inevitable fourth wave.

“If we all vaccinate, we can have a safe and enjoyable festive season,” Phaahla stated.

According to Media Hack’s vaccination tracker on The Outlier, 13,867,595 people in South Africa have been fully vaccinated (34.6% of adults).

An average of 96,603 vaccinations per day were administered over the past week.

At this rate, the soonest South Africa could hope to vaccinate 67% of South Africans is in nine months.

Now read: South Africa’s fourth wave of Covid–19 will be mild — unless this happens


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