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15 March 2021

From plague to polio: how do pandemics end?

Business Day 15 March 2021 - History provides a window into how the coronavirus outbreak might come to a close

In the mid 17th century as Britain battled outbreaks of smallpox, plague and typhus, John Graunt, widely viewed as the founder of epidemiology, sat poring over four decades of mortality records collected by parish clerks. These “Bills of Mortality”, he had realised by 1666, could be used to prove a simple idea: that epidemics ended not when the disease disappeared but when deaths returned to rates seen in normal times. This measure of mortality would later become known as “excess deaths” and nearly 400 years later, Andrew Pollard, chief investigator for the Oxford vaccine, put forward a similar thesis for Covid-19. “The end of the pandemic is not the end of this virus — it’s the end of an unsustainable impact on health systems,” he said. “If we can convert it into something more innocuous, then we’ll have the end of the pandemic in sight.” History, however, teaches otherwise. Pandemics do finish but their endings are rarely neat. Diseases are seldom eradicated and outbreaks never end everywhere at the same time. 

EU angry as AstraZeneca cuts supply of Covid-19 vaccine

Business Day 12 March 2021 - An AstraZeneca document dated March 10 shows that the drug-maker expects to have delivered 30-million doses to the EU by the end of March, 10-million fewer than pledged in February

AstraZeneca has again angered the EU by scaling back deliveries of Covid-19 vaccines, but got a boost on Friday when the World Health Organisation (WHO) dismissed fears that have prompted countries in Europe and Asia to suspend use of the shot. The EU has been much slower to start mass vaccination than neighbouring Britain because of a slower approval and purchasing process and repeated supply holdups. EU regulators have dismissed scattered reports of blood clots in people who had received the AstraZeneca vaccine, but on Friday Thailand joined a handful of European countries in suspending use of the shot — the first and cheapest to be developed and launched at volume around the world. 

More South Africans want to get vaccinated, survey shows

Business Day 12 March 2021 - An Ipsos-WEF survey shows citizens intending to get vaccinated have increased from 53% to 65% — still not enough for herd immunity

South Africans are increasingly showing an interest in getting vaccinated against Covid-19, according to the latest Ipsos-World Economic Forum (WEF) survey.

As recently as December, SA ranked among the countries in which citizens exhibited the lowest intention to get vaccinated, with only 53% of people saying they would get a shot. The latest survey, conducted in late February, shows that has increased to 65%. Vaccination in SA has already begun with the first phase aimed at health workers. It is anticipated that the second phase, for essential workers, the aged and those with co-morbidities, will start sometime in April. As of Friday, total recorded coronavirus cases stood at more than 119-million worldwide, with about 2.65-million people having succumbed to the disease. 

Governments target production as vaccine nationalism grows

Business Day 12 March 2021 - Germany plans to become new centre for vaccine production as countries enter manufacturing partnerships amid the pandemic

In the German town of Dessau, one of the sites of the Bauhaus art school, an institute was set up in 1921 to mass-produce vaccines that later helped strengthen the German Democratic Republic. Exactly 100 years later, the site is gearing up to be a one-stop shop to produce Covid-19 vaccines for Germany’s pandemic response. It is just one example of a rash of efforts by governments across the globe to access fragmented vaccine production, after manufacturing setbacks deprived EU members of drugs made on their own soil this year. From Australia to Thailand, states planning home-based vaccine plants are starting to reshape the industry. The vaccine crunch in Europe has shown that states that depend on deliveries from multinationals can be vulnerable. 

African charities slam rich nations for blocking access to generic Covid vaccine

Business Day 11 March 2021 - More than 40 organisations, including Amnesty International and Christian Aid, say move stop generic or other manufacturers making more vaccines in poorer nations is an affront to people’s right to health care

Charities in Africa criticised rich nations on Thursday for blocking efforts to waive patents for Covid-19 vaccines, saying this would prolong the pandemic for years in poorer nations and push millions across the continent deeper into poverty.     More than 40 charities, including Amnesty International and Christian Aid, said Wednesday’s move by Western nations to prevent generic or other manufacturers making more vaccines in poorer nations was an “affront” to  people’s right to health care. Peter Kamalingin, Oxfam International’s Africa director, said Sub-Saharan Africa with 14% of the global population received only 0.2% of 300-million vaccine doses administered worldwide. The World Bank estimates that the new coronavirus crisis has already pushed 40-million people in sub-Saharan economies into extreme poverty, that is, living on less than $1.90 a day. 

Higher hospital death rates in second wave might be due to new variant

Business Day 11 March 2021 - The new coronavirus variant detected in SA late in 2020 may be one reason for the higher death rates among patients hospitalised with Covid-19 during the country’s second wave of infections, according to a study released on Thursday.

Analysis of records from 627 public and private hospitals found the in-hospital case fatality rate peaked at 29.1% during the second wave, compared to 20.8% at the peak of the first wave, an increase of almost 40%. The second wave saw a steeper rise in new cases and hospital admissions than the first wave, peaking in January at levels almost double that of the first peak in July. The higher hospital mortality rate recorded in the second wave was surprising, as many countries have reported lower death rates during their second wave due to improvements in treatment and better hospital preparedness, said the National Institute of Communicable Disease’s (NICD’s) Waasila Jassat, lead author of a study describing the work, which was published on the preprint server MedRxiv on Wednesday. The research has not yet been peer-reviewed. Part of the increase in the in-hospital case fatality rate was due to the strain placed on facilities by the sudden surge in admissions in the second wave, but it was also likely to be due to the new variant, 501Y.V2, she said. 

J&J’s single-shot Covid-19 vaccine cleared by EU regulator

Business Day 11 March 2021 - Supply issues are expected to arise with this vaccine

The EU's drugs regulator on Thursday approved Johnson & Johnson's (J&J’s) single dose Covid-19 vaccine, as the bloc seeks to speed up a stuttering inoculation campaign and boost its supplies. The shot is the fourth to be endorsed for use in the EU after vaccines from Pfizer-BioNTech, AstraZeneca-Oxford University and Moderna, and is recommended for those over 18 years of age, the European Medicines agency (EMA) said. It's the first single-dose shot. The US, Canada and Bahrain have also approved the shot. SA is carrying out an expedited review. 

SA decision on AstraZeneca vaccine a ‘potentially historical mistake’

Medical Brief 10 March 2021 - South Africa‘s decision not deploy the AstraZeneca vaccine is financially expensive, poor in science, and goes against the government’s own assurances that it would take its lead from WHO recommendations, writes Professor Shabir A Madhi, dean of the faculty of health sciences at the University of the Witwatersrand and director of the SA Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit.

Madhi, writes: 

The past month has been a roller-coaster ride when it comes to the rollout of COVID-19 vaccines in South Africa. The government has halted the distribution inside South Africa of 1m doses of the AstraZeneca vaccine and is poised to make a potentially historic mistake. After much criticism early in January 2021 of the virtual absence of any strategy beyond procuring a limited quantity of COVID-19 vaccines through the COVAX facility, the government successfully negotiated procurement of 1.5m doses of the AstraZeneca COVID-19 vaccine through a bilateral agreement with Serum Institute of India.

Government still deliberating on phase 2of vaccine plan

Business Day 09 March 2021 - B4SA has urged the government to sequence phase 2 by age due to the limited number of vaccines available between March and June

Work is still under way to determine how to sequence people in the second phase of the government’s coronavirus vaccination strategy, according to a senior health department official. Last week, Business for SA (B4SA) called for the elderly to get their jabs first to ensure the most vulnerable people are protected ahead of the next surge in infections. The government’s vaccination strategy has three phases, starting with health workers, before broadening out in phase 2 to essential workers, people over the age of 60, adults with co-morbidities, and people living in congregate settings such as care homes.  The health department’s Anban Pillay said age is “certainly the highest risk factor” for death from Covid-19, and certain underlying conditions, such as diabetes, obesity, hypertension and cardiovascular disease, are also significant risk factors for more severe illness, but there are “a number of alternative views” on the sequencing of the four groups. 

AfroCentric first-half results helped by diverse product range

Business Day 09 March 2021 - The health-care investment company said increased efficiencies also helped its headline earnings per share rise 11%

Health-care investment company AfroCentric, which owns Medscheme, one of SA’s largest medical aid administrators, said on Tuesday that its diversification strategy and increased efficiencies held it in great stead to navigate the economic environment induced by Covid-19. Headline earnings per share, which is the main profit measure used in SA and which strips out exceptional items, rose 11% to 26.03c in the six months to end-December 2020, from the comparable period a year ago. The medicine management contracts won by Scriptpharm, a national pharmacy network, have positively bolstered the profits of the retail segment, while the services segment, which is largely made up of medical scheme administration business, managed to keep the lid on costs. 

Fewer than half a million have received jabs in Sub-Saharan Africa so far

Business Day 09 March 2021 - Andrea Mendelsohn is dreading the arrival of April and May — that is when the weather will get cooler in the southern hemisphere and bring a surge in coronavirus cases.

Few people in SA — aside from medical staff like Mendelsohn — will be vaccinated by then. Elsewhere on the continent even health workers will not be inoculated, making Africa a large reservoir of the virus that has infected almost 117-million people across the globe and killed more than 2.5-million. “The arrival of vaccines is going to have zero impact on the third wave, but at least I can be confident that when I go to work I won’t die,” Mendelsohn, a senior medical officer in the Western Cape department of health, said. “I am sure health workers in Malawi and Tanzania want to have the same relief.”