South Africa needs to look towards Spain and South Korea on the handling of the second wave of the pandemic as the world awaits a vaccine, writes Amil Umraw. 

While researchers and scientists race to formulate a viable vaccine to halt the spread of Covid-19, infection rates across the globe have waxed and waned as societies unfurl.

The resurgence of the virus in countries that – at a time – appeared to have quashed their first wave, such as a South Korea and Spain, gainsays the notion that the pathogen can be eradicated without a cure.

In South Africa, infection rates have dipped in the wake of the of Covid-19’s first wave, but looking to states like South Korea and Spain, the risk of a resurgence that threatens hospitals and newly opened societies looms large.

When the outbreak spread from ground zero, the city of Wuhan in China’s Hubei province, the expanse that is the East China sea did little to shield the island of South Korea. The state provided a stencil to manage the outbreak, and was able to arrest the spread without locking down cities and towns.

The South Korean government and health officials created a management strategy of three specific principles: detection, containment and treatment.

According to research conducted at Northwestern University, which examined South Korea’s grapple with the virus, the spread was mitigated by quick and decisive action.

Detection, containment and treatment

The first pillar, detection, saw the country create hundreds of innovative screening facilities and clinics, and the inclusion of the private sector ensured that there was never a shortage of testing kits, researchers found.

The second principle, containment, ensured all individuals who tested positive were properly isolated and quarantine facilities were adequately equipped to prevent the further spread of the virus. Expedience was key, the study found, propelled by the deployment of hundreds of intelligence officers to aid in contact tracking and tracing.

The last principle, treatment, saw the health system in the country effectively manage and, to an extent, rebuff the spread. Treatment facilities were built, and additional health workers were deployed in high-infection areas to curb the spread and effectively manage the outbreak.

But South Korea’s early triumph was transient, with the rise of cluster outbreaks, seemingly fuelled by unwitting carriers of the pathogen seeding communities.

The resurgence has largely been attributed to cluster outbreaks within a given area of major metropolitan areas and could spread nationwide if not contained successfully. Outbreaks occurred within several heavily crowded areas and venues, with one such venue being a church.

This is according to research advanced by Dr Lisa Lockerd Maragakis, of Johns Hopkins University, which suggested that close-quarter gatherings may be the spreading events behind the resurgence in South Korea.

Fears of a nationwide outbreak prompted the South Korean government to impose stricter social distancing measures, while relying on their proven three-tier response to stamp out the cluster outbreaks.

Spain’s experience 

In Spain, the limits of the healthcare system were pushed to the brink in January. Cases surged and the administration responded by imposing a strict national lockdown.

Despite the restrictions, Spain was one of the hardest-hit countries within Europe and saw a significant number of deaths. The elderly and healthcare workers were most vulnerable and represented a large portion of the infected populous.

By May, restrictions in Spain had begun to ease and life returned to relative normalcy as the number of cases and deaths had decreased substantially. The healthcare system was able to manage the caseload. But by August, cases surged once again.

For Spain, elucidating patterns have emerged from their second wave. Most of those returning positive tests were of the younger demographic. A higher number of asymptomatic cases have also been reported.

Hospital admissions and the severity of the symptoms have been significantly lower, allowing the Spanish government to effectively manage and control the rate of spread and avail medical resources where they are needed.

In South Africa, nosing into the trough of infections after cresting the first wave, there are lessons to be learnt.

As economic activity resumes, and restrictions on gatherings have been eased, the Presidency has stressed the need for vigilance. Social distancing measures and the use of personal protective equipment (PPE) remains critical.

With mounting fears of a second wave, the preparedness of government entities is key in stopping this before it starts.

Critical to this is the advent of a smartphone application that allows for the geolocation of Covid-19 clusters. The app is also an early warning system, alerting the user if they have encountered someone who has tested positive.

Another contingency, in effect, is the extension of the State of Disaster to allow sufficient time for all health facilities and infrastructure to be adequately prepared should a second wave arrive.

The continued curfew and closure of social gathering spots, such as nightclubs and public events, also minimises the spread of infection as far as possible.

Need for a vaccine

But this is not a status quo that can be sustained, and South Africa – and indeed the world – is looking to science for a vaccine.

The testing and approval of a vaccine is a long and technical process aimed at maximising the benefits it poses to the general public; in the protection it offers against a particular virus or disease and minimises the possibility of any risk or side effects.

One such trial is the ChAdOx1 nCoV-19 (Oxford-AstroZeneca), currently in its third phase of testing.

The vaccine component comprises ChAdOx1, a weakened and non-replicating version of a common cold virus.

“This vaccine expresses a spike protein component of the Covid-19 virus which allows for the body to develop an immune response to this protein component. This then prevents the same spike protein found in the Covid-19 virus from entering human cells, thereby preventing the virus from incubating in the individual and making them ill,” according to those running the trial.

But the development of the ChAdOx1 vaccine was hampered by a medical anomaly with a participant within the trial.

While other vaccines are in development the world over, progress in their advances are a herald of hope. The only absolute answer to the prevention of resurgence is vaccination, and hope springs eternal.

– Amil Umraw is a freelance writer based in Johannesburg.