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01 April 2021 | Story Andre Damons | Photo istock
The Easter weekend runs the risk of being a major catalyst for the third wave and people’s behaviour will be the primary driver of transmission for the third wave.

Similar trends as during the festive season of 2020 – when the behaviour of people was driving COVID-19 transmissions and played a role in the second wave – have emerged due to the Easter holidays, and may contribute to a third wave. 
“This means that we can already anticipate gatherings and a higher rate of travel during the next three weeks. As a result of this as well as non-adherence to the non-pharmaceutical interventions, we can anticipate this event to serve as a catalyst for transmission.” 

“If nothing is done to prevent this, it is anticipated that the Free State will see a steady increase and a potential third wave between 17 April and 26 June,” says Herkulaas Combrink, the interim Director of the UFS Initiatives for Digital Futures and PhD candidate in Computer Science at the University of Pretoria (UP).

The Easter weekend runs the risk of being a major catalyst for the third wave

According to him, the vulnerability and population density dynamics in each province, the behaviour of people, and the social norms between communities must be taken into consideration to contextualise the impact of Easter on disease transmission – especially when looking at SARS-CoV-2.

For the Free State, the Easter weekend runs the risk of being a major catalyst that will lead up to the third wave, says Combrink. “If no interventions are put in place and people do not adhere to non-pharmaceutical interventions to mitigate the spread of the disease, then we will see a steady climb and increase in cases up until that time. This means that the behaviour of people will be the primary driver of transmission for the third wave.”

Reducing the severity of the third wave

According to Combrink, who is involved in risk communication and vaccine analytics with other members of the UFS, we may be able to reduce the severity of the third wave if the variant remains the same and the vaccination roll-out plan is in full effect. It will also help if the correct number of people are vaccinated, the general population adheres to PPE and mitigation strategies, and people practise the appropriate behaviour as indicated in all official COVID-19 communication, including the UFS COVID-19 information page.  

According to Prof Felicity Burt and Dr Sabeehah Vawda, both virology experts in the UFS Division of Virology, the current vaccination programme is aimed at reducing the severity of the disease among health-care workers. Prevention of further waves of infection through vaccination will require sufficient coverage to induce at least 70% herd immunity in the country. Currently, no country has achieved that level of herd immunity through vaccine programmes – this is the long-term goal of vaccination. 

“Irrespective of the government’s vaccination programmes and schedules and a virus that may mutate and perhaps become more virulent, the fundamental ways to protect yourself remain unchanged, namely social distancing, wearing of masks, and regular hand washing. People need to realise that this ‘new normal’ is going to be with us for a while and remains the best defence against all SARS-CoV-2 viruses and even provides protection against other respiratory pathogens.”

Vaccines and mutations

The exact frequency of mutations differs between different types of viruses, but generally, SARS-CoV-2 is known to have a slower ‘mutation rate’ than other RNA viruses because of its built-in ‘proofreading’ enzyme. The true mutation rate of a virus is difficult to measure, as the majority of mutations will be lethal to the virus. Irrespective, very few have actually resulted in clinical impact. 

“This highlights the rather gradual process of mutation, so vaccines should remain effective or at least partially effective in the near future, as they elicit antibodies that target different parts of the virus. Continuous surveillance of SARS-CoV-2 is necessary and ongoing to monitor for changes that may impact vaccines and diagnostic tests,” the experts say.

According to Prof Burt and Dr Vawda, scientists are continuously monitoring the situation to detect if the current vaccines would remain effective and to try to adjust them accordingly. How or when the virus will mutate in a clinically significant way is unknown, so at this point, the current vaccines have been shown to be effective against severe disease and hence have application in reducing significant disease. 

“There remains a lot unknown about the extent of protection and the duration of protection, and it is obviously hoped that the vaccine’s immune response in the human body would be able to provide at least some protection or decrease the possibility of severe disease even against potentially newer variants.”

News Archive

UFS researcher selected as emerging voice
2016-11-03

Description: Andre Janse van Rensburg  Tags: Andre Janse van Rensburg

André Janse van Rensburg, researcher at the
Centre for Health Systems Research and Development
at the University of the Free State, will be spending
almost three weeks in Vancouver, Canada. He will be
attending the Emerging Voices for Global Health programme
and Global Symposium on Health Systems Research.
Photo: Jóhann Thormählen

His research on the implementation of the Integrated School Health Programme (ISHP) in rural South Africa led to André Janse van Rensburg being selected to become part of the Emerging Voices for Global Health (EV4GH) group.

It is a collection of young, promising health policy and systems researchers, decision-makers and other health system professionals. A total of 222 applications from 50 countries were received for this programme, from 3-19 November 2016 in Vancouver, Canada.

The EV4GH is linked to the fourth Global Symposium on Health Systems Research (HSR2016), from 14-18 November 2016. It also taking place in Vancouver and Janse van Rensburg will be taking part, thanks to his research on the ISHP in the Maluti-a-Phofung area. He is a researcher at the Centre for Health Systems Research & Development (CHSR&D) at the University of the Free State (UFS).

The theme of the HSR2016 is Resilient and Responsive Health Systems for a Changing World. It is organised every two years by Health Systems Global to bring together roleplayers involved in health systems and policy research and practice.

Janse van Rensburg also part of Health Systems Global network
The EV4GH goals relate to the strengthening of global health systems and policies, particularly from the Global South (low-to-middle income countries with chronic health system challenges). The initiative involves workshops, presentations, and interactive discussions related to global health problems and solutions.

As an EV4GH alumni, Janse van Rensburg will become part of the Health Systems Global network. Partnering institutions include public health institutes from China, India, South Africa, Belgium, and the UK.

“The EV4GH is for young, promising health
policy and systems researchers, decision-makers
and other health system professionals.”

Research aims to explore implementation of schools health programme
In 2012, the ISHP was introduced in South Africa. This policy forms part of the government's Primary Health Care Re-engineering Programme and is designed to offer a comprehensive and integrated package of health services to all pupils across all educational phases.

Janse van Rensburg, along with Dr Asta Rau, Director of the CHSR&D, aimed to explore and describe implementation of the ISHP. The goals were to assess the capacity and resources available for implementation, identify barriers that hamper implementation, detect enabling factors and successful aspects of implementation and disseminate best practices in, and barriers to, ISPH implementation with recommendations to policymakers, managers and practitioners.

“A lot of people were saying they don’t
have enough resources to adequately
implement the policy as it is supposed to
be implemented.”

Findings of project in Maluti-a-Phofung area
Janse van Rensburg said the ISHP had various strengths. “People were impressed with the integrated nature of the policy and the way people collaborated across disciplines and departments. The school team were found to work very well with the schools and gel well with the educators and principles.”

He said the main weakness of the implementation was resources. “A lot of people were saying they don’t have enough resources to adequately implement the policy as it is supposed to be implemented.

“Another drawback is the referral, because once you identify a problem with a child, the child needs to be referred to a hospital or clinic.” He means once a child gets referred, there is no way of knowing whether the child has been helped and in many cases there is no specialist at the hospital.

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