Covid-19 cases climb — but jab numbers fall

● Despite a Covid-19 resurgence and evidence that those hospitalised and dying are unvaccinated, the pace of jabs has slowed to a trickle.

Only 40,000 people a day were vaccinated in the week ending on Friday — a fraction of the original target of 250,000 and President Cyril Ramaphosa’s dream of 300,000.

Just 45% of the adult population is fully vaccinated, a figure that brought stinging criticism this week from health department deputy director-general Nicholas Crisp.

“It has been in South Africans’ hands for months now but the public want a scapegoat for their abysmal behaviour. It’s very sad,” he said.

“We may be government but we are health professionals first and it saddens me deeply that people still don’t see the obvious value of immunisation.”

He said the unvaccinated will “bear the brunt” of the latest resurgence, but “we are all at risk because pools of unvaccinated and non-immune people raise the risk of new variants, so while the unvaccinated will bear the brunt, they won’t be alone”.

A large study in the US, published this week in the British Medical Journal, showed counties with high vaccine coverage had a more than 80% reduction in death rates compared with largely unvaccinated counties.

This augments the findings of many other global studies.

Many South Africans still refuse to be vaccinated, however, and Mosa Moshabela, a medical professor at the University of KwaZulu-Natal, told the Sunday Times: “Ever since we ended the state of disaster we’ve spoken about personal responsibility.

“The responsibility lies with the individual, while the state will be responsible for the health system. Those two things should happen at the same time.”

He said it is deeply concerning that “some people have still not been vaccinated and I am concerned that there are people with vulnerability factors, ranging from socioeconomic factors to health issues such as comorbidities.”

Calling for a “tailored approach”, he said the government “has done a good job going by age groups, but we now need interventions that are closer to communities and people, and we need to make sure the health department works closely with the education department and social development so that targeted policies and actions” can ensue.

The homeless would be an example of a non-age-specific cohort, he said.

Speaking on behalf of the Network for Genomic Surveillance, UKZN expert Richard Lessells said South Africans have a “complex mix of immunity” but waning of natural immunity against infection “happens quickly” while this is less true for vaccine-induced immunity.

“The key public health measure against all these variants and lineages will always be vaccination to prevent severe disease and death. That is regardless of whether you’ve been infected before or not.”

Based on the scientific evidence that vaccine-induced immunity is the strongest, some countries have opted for mandatory vaccine policies.

But deputy health minister Sibongiseni Dhlomo said the department would still rather “persuade people that this [vaccination] is how you prevent severe disease and death”.

He said the real target is the 18-35 cohort. Less than 35% of the 5-million people in this group have been vaccinated.

“We will persuade, not force,” said Dhlomo, “and we hope that South Africans will rather be incentivised to get vaccinated because their certificate will allow them to watch sport in a stadium, for example.”