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07 October 2021 | Story André Damons
Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director of the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate?

Panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate, felt it was critical for everyone in South Africa to get vaccinated in order to return to a sense of normality and to a university environment where lectures and learning not only happen in the lecture room, but in the ‘informal’ academic environment. 
Large numbers of the community need to be vaccinated to halt the progression of the pandemic and to maintain non-pharmaceutical interventions. 

Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director for the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists. This was the fifth webinar (28 September 2021) in the series, which is part of the Free State Literature Festival’s online initiative, VrySpraak-digitaal. 

Critical that everyone get vaccinated to return to a sense of normality

Dr Pearce indicated that patients seemed hesitant to present to both private and state health-care facilities during the COVID-19 pandemic. This resulted in patients presenting in the final stages of cancer (stages 3 and 4 as opposed to stages 1 and 2). “The quicker we are able to exit the COVID-19 pandemic – and we will probably never totally eradicate it as it might become endemic – we can go back to treating other medical conditions that are currently not being optimally managed,” said Dr Pearce.

He is also concerned that the impact of the pandemic on other medical diseases (such as mental issues) will only become visible over a number of years. We must be careful that we do not forget about the non-COVID diseases, according to Dr Pearce. 

Dr Pearce said it was critical that everyone be vaccinated in order to return to a sense of normality. The COVID-19 protocols of social distancing and the wearing of masks have left a mental toll on us as a society. He said depression and suicide are on the rise, and if we want to go back to a sense of normality, a large number of people need to get vaccinated.

The economic problems caused by COVID-19 are huge, as a large number of people have stopped their medical aids in the Free State. Some of the other economic problems due to COVID-19 is that a larger number of the younger population got infected during the third wave, which means that many breadwinners lost their lives. In the medium and long term, this is going to have huge economic repercussions. 

Vaccine acceptance increased among South African adults

Armed with figures from a recent study by the Centre for Social Change at the University of Johannesburg (UJ) in collaboration with the Developmental, Capable and Ethical State research division of the Human Sciences Research Council (HSRC), Dr Coetzee illustrated the importance of getting vaccinated. 

The study found that even though hesitancy dropped by 5%, vaccine acceptance increased to 72% among South African adults.

She said according to the study, South Africa faces two significant challenges. “First, if all 72% were actually vaccinated, we would still be 8% short of the government’s target of 80%. So, we know that government has secured significant vaccines to vaccinate the entire adult population and that the supply of vaccines should no longer be a concern as we had seen earlier this year. What we need to do is to convince some of the people who are currently hesitating about the value of getting vaccinated.”

Acceptance among the older age group has risen substantially by 11% when comparing the results from round three (December 2020 to 6 January 2021) with round four (June 2021 to July 2021). Said Dr Coetzee: “But what is still concerning is that the acceptance among those aged 18 to 24 years has actually declined from 63% to 55%.”
The second challenge that came to the fore, continued Dr Coetzee, is one of access. “We have said many times before, vaccines should be brought to the people, and not the other way around. Finally, we are now seeing that this is starting to happen, but I think it is too slow – especially in the rural areas – and maybe a bit too late. Let’s see what is going to happen going forward.”

According to Dr Coetzee, the message must be clear: We need to vaccinate to save the health-care workers and to save lives and maintain the non-pharmaceutical interventions. She said it does not matter how many times people are told to get vaccinated, they still want to take their chances with the virus. 

Aim higher to achieve herd immunity

According to Prof Puren, the threshold for herd immunity of about 67% vaccinated adults in South Africa now seems to be more mythical. “We should be aiming higher than that, meaning 90% or higher in terms of the proportion of the population being vaccinated in order for us to have a more endemic control,” says Prof Puren. 

“A large number of people in South Africa have been infected with COVID-19, but there is still a significant proportion of people that have not experienced this virus. Herd immunity is about the indirect effect of protecting those individuals who are susceptible. So, it’s a particular threshold of the number of people who had an immune response.” 

Prof Puren said there will have to be a breakthrough in infections. Vaccines do work, they are effective. It is possible for us to achieve endemic control, and vaccines are the critical component to do that. 

Important benefits of vaccination are to gain control of the academic year

“The questions about the benefits of mandatory vaccination at university – to prevent hospitalisation and deaths.  With vaccination, you also impact isolation and quarantine challenges. If you have good coverage of vaccinations, institutions will not have to keep closing classrooms, or hostels. It will help keep the workforce open. 

“One of the important benefits of vaccinations is to gain control of the academic year. All the universities have suffered, having to move to online learning where a lot of students don’t have the luxury and privilege of having data available to them all the time.”

“The issue of hybrid learning is important, and you will still see a lot of hybrid learning going on as we go into different surges. But students still need interaction, they still need face-to-face teaching, and they still need the interaction, the socialisation. We have to maximise the university experience,” said Prof Gray.  

In answering the question – would it be beneficial for employees and institutions to formulate and implement a vaccination policy – Prof Gray said it was a critical move to open up academic institutions.  

She agreed with Prof Puren that the 70% is almost mythical, and that a higher level of vaccination will be needed to start controlling the pandemic. 

“Why should we vaccinate? Why should we try and control the transmissions in our country? We have to do that, because we need our economy to start, we see how we have been affected by being on the red lists of certain countries. This affects our economy, our tourism, and jobs. A lot of people have lost jobs. If we want to interface with the rest of the world, we are going to have a discussion around making sure citizens are vaccinated.”


• The recording of the webinar can be found here  

 Passcode: nJv%p7Rp

News Archive

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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