Business calls for the elderly to get their jabs first

Business for SA (B4SA) has urged the government to review plans for the coronavirus vaccine second phase and inoculate the elderly before essential workers to protect the most vulnerable as soon as possible.

SA faces a vaccine supply crunch between April and June, raising the prospect of many of the most vulnerable people not being covered before the next surge, which many experts expect as soon as May. Age raises the risk of severe Covid-19 and the risk of underlying conditions, such as diabetes and hypertension, associated with a poorer Covid patient outcome.

“We are advancing a case that age should be the predominant factor in determining the hierarchical rollout of the vaccine in phase 2,” said B4SA’s Stavros Nicolaou, head of strategic trade at Aspen Pharmacare. B4SA is a voluntary association of businesses supporting the government’s response to the coronavirus pandemic.

“The short-term aim should be denting the mortality curve and keeping people out of hospital. In the absence of sufficient vaccines in quarter two, there is a case to be made for tweaking phase two to enable the elderly to be vaccinated first, and as you build up volume revert to essential workers.”

That SA has not settled on what an essential worker is “makes it all the more compelling to start with the elderly”, he said. B4SA estimated the government would have landed only enough vaccines to cover about 6-million people by the end of June, far short of the targets set for phase one and two.

Nicolaou said B4SA was concerned about queue-jumping in phase two. Using age as the criteria for inclusion would help reduce fraud. The early access programme under way has seen some health-care workers game the system and get shots ahead of people with roles that put them at higher risk.

Phase one of the vaccine strategy prioritises SA’s estimated 1.25-million health-care workers, and began on February 18 with a phase 3b study using Johnson & Johnson’s shot.

Phase two will cover people older than 60, adults with comorbidities that raise their risk of severe Covid-19, essential workers and people in congregated settings such as care homes and prisons, an estimated 16.6-million people. Phase three will target everyone over 18, about 22.5-million.

Health department deputy director-general Anban Pillay said on Friday that the government expected the second phase to begin in May, and that all the groups would run in parallel. He told a virtual event hosted by B4SA that the government would release the definition of essential workers “within the next week or so” with subcategories detailing which essential workers would be first in line.

“It is important that those at highest risk and those that play an essential role in keeping the wheels of the country turning first, are ”identified he said. and vaccinated

Cosatu said it would be ideal to secure more vaccines and not reduce target groups.

Friday marked the first of a few unhappy anniversaries with regards to the country’s encounter with Covid-19. It was on March 5 that the first case was detected in SA. Three weeks later the country was in total lockdown.

On the economic and health front, the impact has been devastating. On Saturday, the number of confirmed cases stood at about 1.5-million, with more than 50,000 people having died.

But official figures for deaths from Covid-19, as in many other countries, underestimate the true toll of the disease, and the Medical Research Council estimates SA has recorded more than 145,000 excess deaths during the pandemic, reflecting deaths directly caused by the virus and collateral deaths due to restricted access to health services.

The economic devastation has been all there to see, with the fourth-quarter Stats SA data out in February showing that the number of people without jobs jumped almost 1.4-million from a year earlier, pushing the joblessness rate to a record 32.5%.

On the medical front, the situation could have also been a lot worse. What happened after Covid-19 ceased being an isolated incident in China but a pandemic that closed down much of the global economy was nothing short of miraculous. Global pharmaceutical companies embarked on a race to develop a vaccine, and within 12 months the vaccine made by Pfizer was being rolled out in the UK, marking the fastest vaccine development.

Governments — here and in European nations — have rightly come in for criticism for a slow rollout of vaccines. But that sense of despair should be tempered by the fact that 12 months ago it would have been unthinkable that by now SA health workers would be getting vaccinated.

To think that about three months ago government officials were lecturing South Africans that vaccines were no “silver bullet”. Which was of course nonsense.

Getting as many people as possible inoculated as soon as possible is our best hope against a damaging cycle of illness, death and lockdowns.

SA’s new infections might have dropped enough for the government to return the country to level 1 of the lockdown, but this is no time to be complacent. Soon people will start gathering for the Easter holidays. While we welcome the decision to open up more of the economy, allowing indoor gatherings of up to 100 people is baffling. We noted the same in December, before the arrival of a second wave and much tighter restrictions as the country headed towards Christmas.

After the Easter period, we will then start the countdown to the winter months, when the country will be more vulnerable as people congregate more indoors. It’s worrying that the government hasn’t come up with any sort of road plan about how to protect the wider population ahead of this eventuality.

It still hasn’t said who will be eligible for the second phase of vaccinations after it has decided it has covered enough health workers, or even when this will start. Very few people believe that it will reach 67% of the population as previously indicated. Comments by Barry Schoub, the chair of health minister Zweli Mkhize’s advisory committee, that a “technical committee” is still grappling with the details, are not reassuring.

Then there’s the issue of supply. The government has indicated that it has secured enough doses to achieve its aims. The big question, of course, is when? Many numbers have been thrown about — 11-million committed by Johnson & Johnson and 20-million in the offing from Pfizer — but it will make a big difference whether SA gets them well before the next surge in infections or in the second half of the year.

With the global scramble for vaccines and leaders in rich countries under pressure to scale up their programmes, securing enough and applying them to the population soon enough to minimise a winter wave will be no easy task. The government needs to show it has a plan.

IT WILL MAKE A BIG DIFFERENCE WHETHER SA GETS VACCINES WELL BEFORE THE NEXT INFECTIONS SURGE