PART 7b: SA UNKNOWINGLY WELCOMED THE CORONAVIRUS MUCH EARLIER THAT WE THINK
BY PROF DOUGLAS BOATENG
Peer–reviewed research publications from among others UCL’s Genetics Institute, are increasingly supporting the hypothesis that SAR-COV-2 (i.e. Coronavirus) may have been with us since the last quarter of 2019. According Professor Francios Balloux, director of the Institute, genetic evidence supports suspicions that the virus was most likely infecting people in Europe, the USA and elsewhere weeks or even months before the first official cases were reported in January–February 2020. Dr Yves Cohen, head of resuscitation at the Avicenne and Jean Verdier hospitals has similarly revealed that a man in France was infected with COVID-19 as early as 27 December 2019, nearly a month before authorities there confirmed the first cases. Professor Balloux further opined that at most, 10% of the world’s population (i.e. 790 million people) has been exposed to the virus. As Professor Marc Lipsitch from Harvard University rightly pointed out, the SAR-COV-2 spreads rapidly with “infectants” transmitting it before they even know they are infected. For this reason he projects that between 40 and 70% of the world’s population could become infected.
The rapid global spread may have been started by travellers who got infected when they went to China, then travelled back home and/or directly to various destinations in Europe, USA, Africa and the rest of the world. Some of these “globe trotters” included South African–based business people, C-suite executives, academics, policy makers, students, tourists, politicians, traders, diasporians and so forth.
There is always an influx of visitors and business people into South Africa – particularly the Western Cape and Gauteng – for holidays, business meetings and conferences. It is highly possible that this cunning and elusive Coronavirus could have made its way into the country through these provinces in the last quarter of 2019 via several asymptomatic carriers. The two provinces currently account for over seventy percent (70%) of recorded infections directly linked to the inflows during that period.
The swift, bold and decisive move by the President and Government to lock down the country as well as immediately commence tracing and testing certainly helped South Africa to avert the unfortunate cataclysmic incidents currently unfolding in the USA, Spain, Brazil, Italy and the UK.
As at May 17: (1) known infections as a percentage of South Africa’s total population remains below 0.03%. Of these documented infections, one hundred and nineteen (119) cases or roughly 0,0002% of the total population were deemed serious or critical cases; (2) the over two hundred and sixty (264) COVID-19 unfortunate fatalities as a percentage of the over fifteen thousand (15,515) known infections was circa 1.7%. This is well below global and African mortality benchmarks of around 6.7% and 3.6% respectively. (3) The over seven thousand (7006) recovered cases as a percentage of documented infections was 45% and above the global and African benchmarks of 38.4% and 38.5% respectively. These factual data certainly provide further proof that the interventions by Government coupled with citizenry vigilance is working and augurs well for the future.
With more testing and tracing, infection cases both locally and globally will definitely show an upward trajectory for the rest of 2020 and possibly beyond. However, there is increasing evidence that getting infected with SAR-COV-2 does not necessarily lead to the full-blown COVID-19 disease. Nor is the disease COVID-19 a death sentence.
It is for this reason that out of the more than four million infections that have been documented globally, over 38% (i.e. 1.8 million people) have already fully recovered. As of May 17 2020, serious critical cases as a percentage of the recorded global and African infections were approximately 1% and 0.4% respectively and improving. In South Africa the one hundred and nineteen (119) serious and critical cases as a percentage of locally known infections was roughly 0.77%.
South Africans must respectfully accept that since the Coronavirus spread supposedly started during the late 4th quarter of 2019, it is highly possible that there are a relatively high number of asymptomatic carriers already in our society. These nationals have unintentionally infected others. The new asymptomatic “infectants” who do not know that they are carriers also innocently continue to spread the virus. Hence the need for ongoing vigilance by all. Time will be the best judge as to whether these earlier carriers have developed innate or adaptive immune responses to the virus.
To date around 0.60% of the world’s population have recorded infections. Leading academics and scientists, including Dr Fauci of NIAID, continue to warn that the true extent of the pandemic is not known due to insufficient testing infrastructure globally. The situation in South Africa is no different. Hence, there is an urgent need to improve public health care supply chains and tracing and testing capabilities in anticipation of an extended show down with this highly contagious, cunning and elusive beast.
The World Health Organisation (WHO) estimates the reproductive number (R0) for the SAR-COV-2 – which indicates the transmissibility of the virus – to be between 2 and 2.5. Behaviour patterns are inextricably linked to the R0. If the number is above one (1) the infectivity rate increases exponentially. If below one (1) the virus dwindles as virtually no infections are occurring. South Africa is yet to determine the country-specific R0 for this dreadful virus. However, it is looking increasingly likely that it is currently nowhere near the WHO estimate and most likely currently BELOW 0.
For the reproductive number to remain below zero (0) there can be NO relaxation on: (1) onoing tracing, testing, isolation, treatment, continuous tracking and monitoring; and (2) strict adherernace to containment measures such as the wearing of the right face protection masks (FPM), improved personal hygiene, washing of hands, restrictions on public gatherings, distancing in communal and public areas, in offices, schools and work areas, and border controls, etc.
Finally, South Africa is part of an interconnected world. The country is increasingly becoming the aero logistics, supply chain hub and gateway into the SADC sub–region and has already been drawn into this complex global ‘war’. On May 12th Dr Ryan, executive director at WHO, warned the world that like HIV and AIDS the SAR-COV-2 virus and COVID-19 disease may become part of the global community for a long time to come. All South Africans must therefore prepare their minds for a possible prolonged battle with this lethal micro-organism by individually and collectively continuing to: (1) act as true citizens by adhering to the strict protocols to protect each other as well as (2) help to especially shield the aged and vulnerable in our society from this incredibly dangerous micro-organism.
Without a doubt, science and engineering will eventually solve this complex COVID-19 conundrum. However, nobody currently knows how long it will take. South Africa has done well so far and will emerge stronger to implement the nation’s transformational agenda.