Experts take a stab at vaccine queries
With the rollout of vaccines imminent in South Africa, a panel of local experts weighed in on the subject in a webinar hosted by the SA Jewish Report on Thursday, 21 January.
Aspen Pharmacare Group’s senior executive, Dr Stavros Nicolaou; the chairperson of the Ministerial Advisory Committee on the COVID-19 vaccine, Professor Barry Schoub; and the chief commercial officer of Discovery Health, Dr Ronald Whelan, answered questions posed by hundreds of viewers from around the world.
Q. What does vaccine efficacy mean?
A. Efficacy refers to the results in controlled trials. Volunteers are separated into groups of those who get the vaccine, and those who are given a placebo, and both groups are monitored to see whether the people given the vaccine are infected at a lower rate than those who get the placebo. If a vaccine is 90% effective, it means that if 100 people who were not previously infected by the coronavirus are given the vaccine, on average 90 of them won’t contract the virus.
Q. Will the vaccines be effective against the South African variant of the virus?
A. In spite of some concerns, at the moment it seems that the vaccine will most likely be effective. Some trial samples of post-vaccine blood haven’t neutralised the variant, while the Pfizer vaccine has been shown to effectively neutralise artificially constructed virus variants in studies conducted in the United States. According to the panel, this is a work in progress that may need to be studied closer at a later point but it won’t affect the rollout of vaccines in South Africa at the moment.
Q. What’s Aspen’s potential role in making vaccines in South Africa?
A. On the whole, there’s little vaccine manufacturing capability and capacity on the continent. Capacity for vaccine production is a rare and limited commodity in Africa, with rudimentary capability in Senegal and two facilities in South Africa, namely Aspen and BioVac. As part of its agreement with Johnson & Johnson (J&J), Aspen has repurposed some of its capacity for vaccine production (with capacity for 300 million doses a year). However, while it can formulate, fill, package, and label vials of the vaccine, it can’t create the active ingredient essential for the vaccine.
Q. Can the vaccine be purchased from Aspen?
A. After the trial process, only J&J can supply the vaccine. The decision about where the vaccine will be allocated remains that of J&J, which has estimated that the vaccine should become available to the global market in the second quarter of 2021.
Q. Will the J&J vaccine be a single or double-dose vaccine (the latter being the case with the Pfizer, Moderna, and AstraZeneca vaccines)? Does it matter?
A. J&J hasn’t released its data yet although we expect it to do so by the end of January. There are indications from J&J that it will be a single-dose vaccine. This is important because it reduces challenges on the African continent given the dispersion of the population in more remote areas. The single dose has other benefits such as compliance, reducing the cost of transportation and storage. If 40 million South Africans – 70% of the population – are to be vaccinated over 12 months, 170 000 vaccines would need to be administered per day (in a five-day working week), making a single dosage optimal.
Q. President Cyril Ramaphosa recently announced that South Africa has secured 30 million doses of the vaccine. What are they, and where are they coming from?
A. As reported, 1.5 million vaccine doses are expected over the next few weeks from the Serum Institute of India. There is a tranche coming from Covax (the international pool-procurement mechanism) which will provide about 12 million doses, along with a further 12 million doses secured from the African Union via Covax. J&J, too, has reportedly committed to supplying South Africa with nine million doses, bringing the total to about 34 million doses (a bouquet of AstraZeneca, Pfizer, and J&J vaccines). According to the panel, this is roughly half of the amount necessary in order to achieve herd immunity and bring the virus under control, though it won’t eliminate it.
Q. In what order will the population be vaccinated?
A. The first phase will vaccinate 1.3 million healthcare and allied workers (receptionists at medical practises, cleaners, and so on.) In quarter one 2021 (January to March), those who are in regular contact with patients precede those who aren’t. In phase two, the elderly, key personnel (including police and possibly teachers) and patients with comorbidities (roughly 21 million people in total) will be vaccinated through quarters two and three (April 2021 to September 2021). The final phase (which will probably extend into 2022) targets the broader public, and will last until roughly half the population (40 million) has been vaccinated. We will probably vaccinate only people over the age of 18.
Q. What system is in place for the vaccine rollout? How will people register for their shot?
A. Planning is in place to identify healthcare workers in the private and public sectors. The process is being headed up by the department of health, and Discovery has offered to assist with gathering the details of frontline healthcare workers for the first phase of vaccination. Communication is expected to go out in the next few days asking doctors, nurses, pharmacists, and other frontline healthcare workers to submit their names and those of all workers in their practises to a database. This information will be fed into the vaccination planning system. A vaccine management and registration system for the broader public is also being developed along the same lines, prioritising patients based on their risk category and informing them when they can make a booking.
Q. Does it make a difference if I mix my vaccines and get shots from different suppliers?
A. Mixing them isn’t recommended. If your first dose is Pfizer, for example, the second shot should be as well. Mixing hasn’t been validated in any trial, and isn’t registered as a treatment.
Q. Are there any people who shouldn’t have the vaccine?
A. There are very few, rare contraindications that mean a person should avoid the vaccine. This includes people who are allergic to the constituent parts which make up the vaccine. Pregnant and nursing women are being advised to wait (depending on how pressing the need may be), but data hasn’t shown any impact of the vaccine on fertility. The vaccine is currently approved only for adults over 18, meaning children aren’t yet included in the vaccination programme.
Q. Vaccines have been tested, approved, and produced extremely rapidly. Does this mean that shortcuts have been taken where safety is concerned?
A. Coronaviruses aren’t new, and the technology that is being used in combatting them today has been developed over decades. The years of research mean that new products can be brought to the market faster than in the past. Moreover, all clinical data is reviewed by independent drug regulatory agencies for safety, and the panels of experts have no vested interest in the product directly. In fact, major pharmaceutical companies GlaxoSmithKline and Sanofi have delayed their vaccine to the end of the year because their results weren’t good enough and warranted some improvement.
When asked whether the panellists themselves would take the vaccine, each said they wanted to be first in line. A poll taken during the webinar indicated that 95% of viewers wanted the vaccine, 4% were unsure, and only 1% said they would decline it.
It’s believed that the first vaccines have already arrived in South Africa, and are undergoing quality testing before distribution.
Dizengoff attack still haunts families 25 years on
South African-born Tali Gordon and her friend, Inbar Atiya, had gone to Dizengoff Center to find an outfit on the night of Purim 25 years ago, but instead of celebrating the chag, they were killed in a terrorist attack outside the shopping centre.
So many years later, her father, Barry Gordon, is still haunted by the loss of his beautiful daughter who was killed at the age of 24. Tali was killed on 4 March 1996, when a suicide bomber detonated a 20kg nail bomb at a busy intersection next to the centre in the middle of Tel Aviv.
He murdered 13 people, including Tali. Her father, who lives in Johannesburg, says, “Every time there’s another terror attack, it adds fuel to the fire. You don’t get over it, the pain gets worse.”
Tali was living in central Tel Aviv, and she and her friend went to Dizengoff Center, which had a number of shops where one could buy dress-up clothes for Purim, he recalls.
They walked out of the centre and had crossed the road to the ATM. While they were waiting at the traffic light, the Hamas terrorist blew himself up in the middle of the road. Both Tali and Inbar, who was 22, were killed instantly.
“They died together. I first heard about it when my son phoned me in the middle of the night from the mortuary in Jaffa. Tali had a small tattoo of a seagull on her right shoulder, and that’s how they identified her. They also found her car in the vicinity.”
Tali was born in South Africa, but grew up in Israel. Her father spent his whole life in Johannesburg, and attended King David schools. Fiercely Zionist, he headed to Israel straight after school as a volunteer after the Six-Day War. He was there for three years, and met his first wife there. They went to South Africa, where they had two children, Tali and Alon. After 1976, they returned to Israel, but eventually he and his first wife divorced and he returned to South Africa. The children remained with their mother, and visited him once a year. Tali spent a year in Johannesburg, and attended King David.
After school, she went to the army. Talented in languages, she could speak Arabic, French, Hebrew, and Spanish, and she worked in intelligence. She was also recruited to the paratroopers. After the army, she travelled widely.
“She was quite worldly, and went to America and the Far East. She started studying political science at Bar Ilan University, and was very politically motivated. Without a doubt, she would have gone into politics. She was a remarkable young lady and we had a special bond,” Barry says.
Strangely, a number of disconnected South African families were also affected by the tragedy, including one Durban family in which a mother and sister were killed.
“What was so harsh about this pigua [terror attack] was the range of age of victims. There was Yovav Levy, who was 13 years old. I’m in daily contact with his mother since we met at the cemetery two years ago. The oldest victim was 84. Most of the victims were young – two were 13, one was 14, and one was 15,” Barry says.
He wasn’t able to get to Israel in time for the funeral. But there was another memorial on the seventh day after the tragedy, and about 2 500 to 3 000 students attended. His daughter is buried in a cemetery just outside Tel Aviv.
Barry says the families of the victims are like a support group. “We share our sorrow. There is such a void. They relate to your tragedy, and you get a bit of closure in that moment.”
His son was deeply affected by the loss of his sister, and has never managed to live a normal life. The family has also been affected by another tragedy. Barry’s mother (Tali’s grandmother) was killed two years before the terror attack in a hijacking in Johannesburg. “Her grandmother took her travelling around the world, and her death really affected Tali.”
Barry remarried, and he and his second wife, Theresa, had a girl named Tashima. “She is named after Tali and is the spitting image of her. She is in her late 20s, and lives in Panama City with her boyfriend, working as an interior designer.”
The Gordons travel to Israel every year to commemorate the tragedy. Last year, they were there in late February and the memorial ceremony was cancelled as COVID-19 began to grip the country. Still, they went to the cemetery, and to the spot where the attack happened.
“It’s on the corner of King George and Dizengoff. There’s a memorial stone there, and a place to light candles. I don’t like the place very much, it gives me cold shivers. But when we were standing there, we saw a photographer and an Israeli actor doing an interview. They asked what I was doing there and I said I lost my daughter in the attack. They said they were doing a piece on the history of Dizengoff, and asked if they could interview me there and then. It was very emotional.”
Another strange coincidence was when they went into the centre to get something to eat, and spoke to the security guard who checks everyone at the entrance. “I told him I lost my daughter in the attack, and he said he was there that day. He got shrapnel in his arm, and it took almost nine months for him to recover. He saw the carnage.”
Barry says that in a strange way, the people who die in terror attacks are “the lucky ones”.
“They go to heaven, they’re with the angels, they’re done. But the families left behind – their lives are changed forever, never to be the same.”
Even though the Israeli government pays a monthly stipend to families of victims of terror, “the injured and their families suffer the most. The ramifications are endless”.
For him, the pain never goes away. “Terrorism has an impact on a person mentally, physically, spiritually, and religiously. Your loved one is there one minute, gone the next. I wonder about so many things, like if I would have had grandchildren by now. Terror means you don’t just lose that person, but an entire generation.”
Doctors pull back the curtain on COVID trauma
Watching a quarter of their patients die from COVID-19. Being yelled at by a family unable to come to terms with their father’s demise. Spending hours talking to families and rabbis when a patient refused ventilation. Seeing the first critically ill young patient typing a goodbye message to his wife, afraid to close his eyes in case he stopped breathing. Witnessing a 17-year-old flinging herself on her father’s body, begging him to keep fighting (when family were allowed into wards).
These are just some of the traumatic experiences that Drs Carron Zinman and Anton Meyberg describe as they try to capture why being on the frontlines of the COVID-19 war has been so devastating to the mental health of doctors and other frontline workers.
They are both pulmonologists at the Linksfield Clinic in Johannesburg, working together during the pandemic. “The most poignant time was when I watched Anton say the vidui prayer for our patients who we knew weren’t going to survive,” says Zinman.
Going back to the beginning, she recalls how they “understood coronaviruses, but SARS-CoV-2 changed the rules. While we were grappling with the complexities of this new disease, we had to contend with a deluge of patients”, many of whom were seriously ill.
“I remember the terror when the first AIDS patient was admitted. I looked after the nursing sister who picked up Ebola, dressing in a spacesuit to assess her. In those times, I felt calm and in control. But COVID-19 was overwhelming and exhausting, and caused a high level of anxiety and stress,” she says.
She remembers getting used to PPE (personal protective equipment), which is uncomfortable, restrictive, and depersonalising.
“We felt like we were fighting a war whose rules of engagement we didn’t understand. I remember the shock at the sheer number of death certificates we had to sign. I recall when Anton admitted a friend – it’s impossible to stay dispassionate in that situation.”
She was deeply affected by the rollercoaster of emotions when patients were well enough to be discharged, yet died suddenly, or the guilt of children who had inadvertently given their parent/s COVID-19.
“More often than not, only one of a couple would go home. The ward rounds felt interminable, often being interrupted by calls for resuscitation and admission. It’s an unpredictable disease and as such, we couldn’t always prepare the families for what was to come. We felt like we were being pulled in multiple directions while being physically tired, sleep deprived, and emotionally drained,” says Zinman.
“Then the second wave hit. We had become complacent, believing we understood this disease, but COVID-19 decided otherwise. The new variant affected younger patients, led to a fuller intensive-care unit and a higher percentage of patients on ventilators. This time, patients tried to get us to promise that they would survive to see their children grow up, and we witnessed last phone calls to wives in which they professed their love and asked them to look after their babies. A lot of time is spent agonising over our decisions, trying to find something more we could do. The emotional trauma inflicted by COVID-19 is unique.”
A local general practitioner (GP), who spoke on condition of anonymity, says, “Since the beginning of the pandemic, I have experienced anxiety, although over time, what specifically triggers it has changed.
“In the beginning, I felt overwhelmed by not knowing enough. We saw the hospitals in Italy, and it was frightening. The thought of possibly having to work in a hospital setting after a number of years as an office-based practitioner was overwhelming. The ‘silver lining’ was the realisation that I wasn’t alone in feeling majorly under-prepared.
“The fear of becoming ill, of bringing the illness home to my family, coupled with the enormous pressure of trying to be available to see patients while having kids at home remote-learning was exhausting,” she continues. “By the time the second wave came, I felt more knowledgeable, but when it came, it was much harder.
“The number of patients who contracted the virus was high. The practice couldn’t keep up with the appointments, tests, and patients who needed to be managed at home. The constant feeling of not being on top of things and also of ‘neglecting’ non-COVID-19 patients took a toll.
“There was the stress of trying to find hospital beds for patients. Everyone was under immense pressure, which was palpable. Trying to support families, keep them updated on their relatives, as well as dispel myths and give reliable advice all felt like a lot to manage.
“And then there were the deaths. So many deaths. It really took a toll on me. I had physical symptoms of anxiety such as a tight chest, abdominal cramps, insomnia, and headaches. I absorb a lot. Usually I try to make time to decompress, but during the peak, it was really impossible. The thought of a third wave gives me massive anxiety. I’m choosing not to think about it.”
Clinical psychologist Dr Hanan Bushkin says that among the medical professionals he has treated, “the rate of burnout, post-traumatic-stress disorder (PTSD), depression, and anxiety is through the roof. With the pandemic showing no end in sight, it has become way more difficult. The brain likes to predict the end point and if it can’t, despondency and depression set in.
“Doctors used to have time to be with family, rest, see friends, exercise, and so on but now they don’t,” he says. “This pandemic has piled on their stressors and eradicated their resources. It’s like being a soldier who has only trained for war but is now experiencing real war, and it’s a whole different ball game. They are seeing traumas that the public don’t see, and this can lead to huge frustration at the ignorance, arrogance, and lack of prevention they see on the street.”
Bushkin says GPs often treat generations of families and get to know them well. Now, he says, “they have a front-row seat to families being broken and the incredible losses of many people that they had a personal relationship with”. In addition, before the pandemic, people who died were usually elderly, or slowly declined after a cancer diagnosis. Now, patients of all ages are getting sick and dying within weeks. “It’s incredibly traumatic,” he says.
“PTSD doesn’t get you when you’re in it,” says Bushkin. “It’s afterwards when the trauma hits, when someone tells themself, ‘I cannot believe that’s the world I’ve just come from’.” He hopes that when the pandemic is over there will be some kind of platform or forum that allows healthcare workers to “de-brief” what they’ve witnessed.
Clinical psychologist Dr Dorianne Weil, who has consulted healthcare workers since the beginning of the pandemic, says, “Doctors are looked to for answers. But if they don’t have all the answers, it creates a dissonance that’s incredibly stressful. They may feel like an ‘imposter’, like they are ‘living a lie’. Everyone sees them as heroes, but they don’t feel that way.”
“There is also the pervasive fear of contracting the virus and passing it onto their families. They become ‘torn’ as they know it’s their calling. Sometimes they don’t want to rely on their families as a support system as there is a feeling that ‘unless you’re in my shoes, you don’t know what it’s like’,” she says.
Doctors have also had to take on the role of being their patients’ families, when family members haven’t been allowed to comfort dying loved ones. “They are stepping into a role that they aren’t usually called to do. It’s unprecedented, and it’s really getting to them.”
So what can we do to support our frontline workers? “There needs to be a group effort to do what these professionals are recommending,” says Bushkin. “I cannot think of a greater insult than for them to come out of a ward and witness people disobeying the rules. It’s incredibly disheartening, and doctors are devastated. It’s the least we can do.”
Toxic conspiracy theory paints Ramaphosa as a ‘Jew’
What do you get when you combine antisemitism, conspiracy theories, and COVID-19 denial? While white supremacists and QAnon supporters feel like they are far off, this toxic combination came much closer to home last week when a woman calling herself “Chabad de la Fontaine” started spouting such ideas to journalists at an anti-lockdown protest in Cape Town.
“[South African President Cyril Ramaphosa] became a Jew,” she told news photographer Esa Alexander in a video he took at Fish Hoek beach on 6 February 2020. Although the initial word “Ramaphosa” is cut out of the clip, Alexander confirmed to the SA Jewish Report that this was what she said. She isn’t wearing a mask in the video.
“And he is acting like the anti-Christ, so I don’t respect him, because people who take their knowledge of G-d and mis-interpret it and distort it the way he did need to be kicked out of the country,” she continued in a rant that became even more hysterical. “I don’t want him in South Africa anymore. He’s not a South African. He can go to America and live with all those people that are the Zionists and the cabal that are trying to manage our planet. No, Mr Ramaphosa, immigrate [sic], go and live in America, we don’t want you.” The video was posted on Twitter, and went viral, with almost 90 000 views.
She’s not the first person to spout such a theory. Local antisemite and white supremacist Jan Lamprecht also calls Ramaphosa “the Black Jew”.
Jevon Greenblatt, the director of operations at the Community Security Organisation in Gauteng said, “The first time we heard this theory about Ramaphosa was from Lamprecht. He would justify it by sharing photos of Ramaphosa talking to the chief rabbi, or of the president talking on the bimah of a shul. It proves that you can sell anything you want to if you have a willing audience.
“It’s not just about spreading propaganda, but having an audience that’s receptive to it. There are so many conspiracy theories out there that you can espouse anything that suits your own agenda.”
Greenblatt says the “Ramaphosa is a Jew” lie is attractive because it ties into age-old antisemitic tropes of Jews controlling the world. “When society is under pressure, this idea is often the first port of call. We see Jews being blamed for the virus or being implicated in benefiting from the virus. It’s a strong element of the extreme right-wing to blame others rather than look at themselves. And it suits them to say that the Jews are controlling the government or South Africa, and here is ‘proof’, ‘Ramaphosa is a Jew’.”
In November 2020, the Randburg Magistrate’s Court issued an interim protection order against Lamprecht following an application by Professor Karen Milner, the Gauteng chairperson of the SA Jewish Board of Deputies (SAJBD), after Lamprecht posted her personal details along with disparaging comments about her on his website, resulting in her receiving hate mail.
Over many years, Lamprecht has used his website to promote Nazi propaganda and disseminate extreme antisemitic and racist content. His published comments include, “Given what a race of two-faced, backstabbing fiends they are, I … have made the argument that there is no such thing as a good Jew”; “They need to meet a new kind of white man, the kind they’ve not met since the time of Hitler”; and “filthy little race of rats and pathological liars … They dominate EVERYTHING … and turn all the powerful against us … Hitler was too nice to them.”
He is prolific on social media, managing multiple websites. His homemade videos spread inflammatory, racist, and antisemitic material. He lauds lone-wolf white supremacists including Pittsburgh Tree of Life Synagogue mass shooter Robert Bowers, and Charleston Church mass killer Dylann Roof.
Lamprecht has continued to post inflammatory material and incite violence even after he was served with the protection notice. He is expected to appear in court on 16 March for his final order, and the interim order will be in place until then.
It’s clear that the woman calling herself Chabad de la Fontaine is elderly, and while some social media users laugh at her statements, others say that she is bigoted, a white supremacist, antisemitic, racist, and a danger to society. This became clearer in another clip posted by Alexander from a different lockdown protest at Muizenberg beach on 31 January.
“I’m a very highly skilled medical doctor as well as a virologist, immunologist, and quantum physicist, working with parasites that they call viruses,” she stated, also not wearing a mask.
“They’re not viruses, they’re parasites, and you don’t need to wear a mask because none of it can be transferred, even with kissing or in a sexual act. What we need to understand is that you’ve got to build up your immune system, like mine, I’m 77 years of age, and I’ve got a strong immune system.” A quick look at her LinkedIn profile and other investigations online make it clear that she isn’t a medical professional.
Asked if she’s on the radar of the SAJBD and if the organisation will take her on over her antisemitic conspiracy theories, Cape SAJBD Executive Director Stuart Diamond, said, “In 2019, we launched our ‘report hate’ tool to capture concerns about antisemitism, anti-Jewish rhetoric, conspiracy theories, hate speech, discrimination, and the like from the Cape community. To date, this tool has provided us with various cases that we consider in our antisemitism and legal subcommittee to determine appropriate action.
“The videos of Chabad de la Fontaine reached us via this tool over the weekend. It’s our first interaction with her content. We are following the same process to determine appropriate action, if any. Further findings on the reported content will be communicated in due course.
“Giving conspiracy theories any airtime is a dangerous activity,” Diamond said. “People are vulnerable to misinformation, especially as South Africa faces a pandemic and its associated complications, economic turmoil, and social challenges. We urge our community to refer to global and local health authorities on all matters related to COVID-19. We also urge our community to continue to use the report hate tool if they become aware of any possible hate incidents.”
Antisemitism expert and emeritus professor of history at the University of Cape Town, Professor Milton Shain, said, “She’s clearly living in a world in which ‘Zionists’ [the collective Jew] are ‘controlling’ and ‘manipulating’ global affairs. This is a classic trope. Her use of the ‘anti-Christ’ also suggests a penchant for conspiracies. This idea goes back to the medieval world. Such tropes are always available, but in times of crisis they seem to have greater traction.”
Darren Bergman, the shadow minister for international relations and cooperation, said he hadn’t heard fellow politicians say that Ramaphosa was Jewish. However, it is a theory circulated amongst some right-wing extremists.
“It’s sad to see such vile hatred. Unfortunately, as the government’s failures increase and citizens’ desperation increases, so will the risk of scapegoating, and that bottle could spin between race, religion, and parties. The sensitivity for Jewry is that we have seen this rodeo far too often, and for us, it has had fatal consequences historically.”
To report antisemitism in the Cape, visit at www.capesajbd.org/focus-areas/antisemitism/report-hate/
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