South Africa says vaccines and natural immunity are limiting latest Covid wave

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Vaccines and high levels of prior exposure to coronavirus in South Africa appear to be protecting against the more severe symptoms seen in the previous three waves of the pandemic, according to the country’s health minister.

The suggestion that previous exposure to another variant of coronavirus – or vaccination – might provide protection from the Omicron variant echoes analysis by South African experts earlier this week that suggested prior exposure or vaccination gave a degree of protection from serious disease.

That has been backed by several reports, including by public and private health providers, that suggest a lower level of hospital admissions during the current wave.

Echoing the findings of Shabir Mahdi, a vaccine expert at the University of the Witwatersrand, Johannesburg, the health minister, Joe Phaahla, told a news conference: “We believe that it might not necessarily just be that Omicron is less virulent, but … coverage of vaccination [and] … natural immunity of people who have already had contact with the virus is also adding to the protection. That’s why we are seeing mild illness.”

While there has been an increase in hospitalisations and deaths in South Africa in recent days, driven by the surge in cases of the Omicron variant, along with continuing infections by the Delta variant, health officials say it remains at lower levels than in previous waves.

Michelle Groome, from the National Institute for Communicable Diseases, said: “[We are] starting to see a slight increase in deaths nationally, but once again this level is very much lower even than the baseline period we were seeing between the second and third waves.” She added that these were “relatively small increases in deaths”.

Wassila Jassat, also from the NICD, said the number of people requiring oxygen was lower than in any previous period. “Patients do seem to stay for a shorter duration,” she said.

Phaahla said early indications were that infections may have peaked in Gauteng province, where cases initially surged. However, the latest figures from the NICD showed Gauteng continued to account for most new Covid infections as of 16 December, at 27%, followed by KwaZulu-Natal (23%) and Western Cape (19%).

His comments came as the G7 group of countries called the Omicron variant the “biggest current threat to global public health”, saying it was “more important than ever” for countries to “closely cooperate”.

While South Africa’s experience with Omicron has been carefully watched around the world for evidence of how infections may progress, experts say populations with larger numbers of older and more vulnerable people may experience it differently.

Given how infectious the Omicron variant is, one of the most pressing concerns is that the very rapid and concentrated burst of infections that it provokes could overwhelm health systems because of the sheer numbers.

The South African press conference on Friday, however, goes to the heart of a number of the unknowns about the Omicron variant.

While it has been established that Omicron is more infectious and more able to evade neutralising antibodies provided by vaccines and prior exposure, questions remain over whether other aspects of the body’s acquired immunity to Covid-19 may be mitigating against more serious disease.

According to some experts, while Omicron may be more easily able to evade key neutralising antibodies that stick to the virus’s spike protein, other tools in the immune system’s repertoire of defences, including so-called killer T cells, may still be doing their job.

A presentation given by Wendy Burgers, of the University of Cape Town, at a World Health Organization symposium into evidence of Omicron evading immunity earlier this week indicated preliminary research appeared to suggest that the body’s T cell response remained strong against Omicron.

That, however, remains in question, with England’s chief medical officer telling the House of Commons this week that there was a lack of “very good T cell studies” to establish whether this was happening.

South Africa has given 44% of its adult population at least one dose of Covid-19 vaccine, more than many African countries but well short of the government’s year-end target. Among the over-50s vaccination coverage levels are more than 60%.

The latest information out of South Africa came as Omicron continued to spread rapidly around the globe with India – which suffered a devastating Delta outbreak earlier this year – reporting 101 cases in 11 provinces.

Denmark’s prime minister, Mette Frederiksen, said theatres, cinemas, concert halls, amusement parks, museums and art galleries must shut down to contain the spread of coronavirus in some of Europe’s toughest new measures.

The German health minister, Karl Lauterbach, also warned that he expected the Omicron variant to lead to a “massive fifth wave” of the pandemic.

Lauterbach, a former epidemiology professor, said during a visit to the Lower Saxony region that Germany must prepare for a challenge “that we have never seen in this form before”.

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