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14 August 2020 | Story Andre Damons | Photo Supplied
Max du Preez, Editor: Vrye Weekblad (top left), was the facilitator was the facilitator for Thursday’s UFS Though-Leader webinar that included Prof Salim Abdool Karim, Director: Centre for the AIDS Programme of Research in South Africa (CAPRISA) and Chair: South African Ministerial Advisory Committee on COVID-19 (top right); Prof Glenda Gray, President and CEO: South African Medical Research Council (SAMRC) (bottom left); and Prof Felicity Burt from the UFS and NRF-DST South African Research Chair in Vector-borne and Zoonotic Pathogens Research (bottom right), participated in Thursday’s Though-Leader webinar.

Although the decline in COVID-19 cases is a promising sign for South Africa, there are concerns about a second surge, and the country should not become complacent.

This was the opinion of the three experts who took part in the first Thought-Leader webinar presented by the University of the Free State (UFS) on Thursday, 13 August. The 2020 UFS Thought-Leader Webinar Series, themed 'Post-COVID-19, Post-Crisis', is taking place in collaboration with Vrye Weekblad as part of the Vrystaat Literature Festival’s online initiative, VrySpraak-digitaal.

The panellists included top experts such as Prof Salim Abdool Karim, Director: Centre for the AIDS Programme of Research in South Africa (CAPRISA) and Chair: South African Ministerial Advisory Committee on COVID-19; Prof Glenda Gray, President and CEO: South African Medical Research Council (SAMRC); and the UFS’ Prof Felicity Burt, NRF-DST South African Research Chair in Vector-borne and Zoonotic Pathogens Research.
Prof Karim said the downward decline is consistent and the number of patients presenting at hospitals is also declining.
 
Promising trend of decline
“What we are seeing is a promising trend, and it looks like we are on the decline. A question that I am often asked is: Is the worst over? The answer is not clear-cut. We are concerned about the risk of a second surge. If anything – what really concerns me at this stage is a second surge, as I think about how the pandemic may play out over the next few weeks,” said Prof Karim. 

He also referred to countries such as the US, Spain, New Zealand, Vietnam, and South Korea, which are now facing a second surge. 

“We need to be very careful; this is not the time for complacency. We need to maintain all our efforts. If we look at one of the key drivers, it is the need for our economy to restart. We need to get people back to work,” said Prof Karim. 
According to him, we have to look at COVID-19 not as a sprint, but as a marathon. “As we learn to co-exist with this virus, aim for containment; we need to plan for the long term. Even if we get a vaccine, it is unlikely that we will be able to vaccinate a substantial part of our population before the end of next year.” 

“We need to transition from being scared to a situation where we can control our risk. When we know that we can control the risk and then influence the risk, we influence the risk of everyone around us. Part of the new normal is the strategy of mitigation with prevention, plus preventing outbreaks.”

Schools and vaccine development
Prof Gray spoke about whether schools should be open and the role that children play in transmission, how to avoid the second wave, how to adjust our testing, and the exciting news around vaccine development. 

As a paediatrician and a parent, Prof Gray said she believes schools should open. “Children have a different immune response to COVID-19. They have different immune responses to Coronavirus and they probably have less viral-load copies which makes them have milder diseases. They are lucky to have been spared from symptomatic or severe disease,” said Prof Gray. 

According to her, schools need to be de-risked as much as possible, with children and teachers wearing masks, washing hands, making sure that there is good ventilation in the school and that windows are wide open. 

“We also need to know about the comorbidity and ages of teachers, so that we can keep the sick and older teachers out of direct contact. The younger teachers with no comorbidities should be teaching. 

“We also know from our experiences with health workers that transmissions happen in the tearoom where teachers take off their masks and talk. We need to minimise the transmissions in tearooms and protect teachers and parents who are older and have comorbidities.”  

Prof Gray said from data she has seen, schools play a very small role in the transmission of COVID-19; a lot more (transmissions) happen in the community, by commuting, and overcrowded taxis.

Prof Gray agreed with Prof Karim that we should be concerned about a second wave, and that we need to make sure community transmissions are minimised. 

Regarding a vaccine, Prof Gray said a global race is on to find a vaccine. “The more vaccines the better, we want more vaccines to work. The more vaccines, the more affordable they are, and the more doses are available.”

One health approach

During her presentation, Prof Burt said the current response to outbreaks is largely reactive rather than proactive, and “if we have more of a one-health approach, with forecasting, early detection, and a more rapid response, we could have an impact on public health in the future”. 


News Archive

Nuclear Medicine on the forefront of cancer research
2017-07-10

Description: Nuclear Medicine on the forefront of cancer research Tags: Nuclear Medicine, cancer research, Dr Je’nine Horn-Lodewyk’s, tumour detection method, cancer, Department of Nuclear Medicine 

Dr Je’nine Horn-Lodewyk’s tumour detection method
could be the cost-effective breakthrough needed to decrease
the mortality rate in breast cancer patients.
Photo: Anja Aucamp

The field of Nuclear Medicine in South Africa and the rest of the world are expanding rapidly due to the development of hybrid cameras and new radiopharmaceuticals. These developments have a huge impact on the diagnosis and therapy of cancer.

The most advanced of these cameras, Positron emission tomography combined with normal CTs (PETCT), are not yet widely available in South Africa due to the cost of the cameras and the radiopharmaceuticals. A more cost-effective alternative can be of great benefit. To achieve this, the focus should be on developing new radiopharmaceuticals that can be used with the current cost-effective gamma cameras, according to University of the Free State researcher, Dr Je’nine Horn-Lodewyk from the Department of Nuclear Medicine.

Fluorodeoxyglucose (18F-FDG), a radiolabelled glucose analogue, is currently the radiopharmaceutical most commonly used in PET/CT imaging for mainly oncology indications. Although it is considered the gold standard for imaging in several malignancies, it does have certain disadvantages. An 18F-FDG PET/CT diagnostic imaging study can cost between R25 000 and R35 000 for a single patient in the private sector. The 18F-FDG is also more radioactive, which requires much stricter handling and shielding to avoid high radiation dosages to staff and patients.

Successful research potential innovative solution
In the search for the ideal radiopharmaceutical for tumour detection, the South African National Nuclear Energy Corporation (Necsa) developed a local synthesis process for ethylenedicysteine-deoxyglucose (EC-DG). EC-DG is also a glucose analogue similar to FDG. They succeeded in labelling the compound with Technetium-99-metastable-pertechnetate (99mTcO4-), the most common nuclear medicine isotope used for approximately 95% of nuclear medicine procedures, creating 99mTc-EC-DG.

In partnership with Dr Horn-Lodewyk, this compound was successfully used in various animal models and clinical scenarios, resulting in approval by the Medicine Control Council to use it in a human study. Research is also planned in order to investigate diagnostic accuracy in other cancers like lymphoma.  The end result of this research can produce a radiopharmaceutical that is cost effective, does not require the use of costly specialised equipment, has no significant side-effects, no special patient preparation, renders late imaging possible, and has decreased radiation risks.

Dr Horn-Lodewyk is grateful for the support of her mentor, Prof Anton Otto, as well as Dr Gert Engelbrecht, Head of the Department of Nuclear Medicine, Prof Jan Rijn Zeevaart from North-West University’s Preclinical Drug Development Platform and Necsa, and Judith Wagener from Necsa. This innovative research would also not have been possible without the financial assistance of Dr Glen Taylor and Eleanor van der Westhuizen in the Directorate of Research Development.

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