Looser lockdown, but danger still lurks

  • BarrySchoub
“Death threat: special report: inside the global race to avert a pandemic.” This was the cover of Time magazine of 17 October 2005. I was director of the National Institute for Communicable Diseases (NICD) at the time, preparing South Africa for the impending pandemic of H5N1 influenza.

The fear was of a devastating pandemic akin to the Spanish influenza pandemic of 1918/1919 (responsible for more than 50 million deaths). Fortunately, H5N1 petered out. However, the fear of a pandemic has come to pass in 2020, not with influenza this time, but a completely new virus to humanity, coronavirus.

The total novelty of the virus to humans, its infectiousness through respiratory transmission, and a virulence considerably greater than influenza, has made the SARS-CoV-2 virus a formidable enemy indeed.

The reality is that until a widely available, safe, and effective vaccine is delivered, hopefully sometime during next year, the only defence we have against this virus is social co-operation and personal hygiene.

Misunderstandings of reports in the lay media of a “breakthrough” in vaccine development, (Bacillus Calmette-Guérin) protection, and malaria drugs, simply lead to unfounded false optimism and disappointment.

We can thank the wisdom and foresight of the South African government, which gratifyingly, has listened to the counsel of the best scientific expertise in the country. It’s now a world leader in the management of the COVID-19 pandemic. Its strict control measures in the form of legislated lockdown regulations have largely slowed down the speed of the virus.

Economic and social pressure has now necessitated the release of some of these restrictions. Potentially this could come at the price of leaking hitherto confined virus into the susceptible population. At present, the disease in this country is largely inapparent, unlike countries to the north of us, and the enemy itself, unlike air pollution, is invisible.

As a consultant on the pandemic in our community, I have seen people respond in two opposing ways. Some have been overtaken by uncontrolled apprehension and anxiety to the point of despondency and depression. In others, especially a small section of our younger folk, there has been a lackadaisical dismissal of the threat as something of concern only to the elderly and sickly.

Make no mistake, as the director-general of the World Health Organization recently stated, the young aren’t invincible. Data coming from the epidemic elsewhere in the world have clearly revealed many cases of severe disease and fatality in young, otherwise fit and healthy individuals.

This country, like others which are starting to loosen severe lockdown regulations, is now entering a particularly vulnerable and sensitive phase of the epidemic. The release of some restrictions is far from a signal that the epidemic is heading towards decline. Nothing could be further from the truth.

The virus, penned up by the lockdown, could potentially invade and fully establish itself in the community, and even develop exponential growth if social distancing and personal hygiene aren’t meticulously maintained. Lockdown has simply restrained the spread of the virus. The great majority of the population remains vulnerable, and the virus will still run its course. The worst may still be to come.

Hopefully, if everyone in the community pulls together in this fight, the epidemic will grow at a rate that the healthcare system will be able to manage to treat patients satisfactorily and minimise mortality.

Regulation and legislation can, of course, be bucked. Ultimately, effective control of the epidemic depends on the goodwill, sensitivity, and the co-operation of everyone in society. No one has the right to arrogate to themselves the liberty to endanger other people’s lives and health.

What we do now will determine how successfully we can prevent a New York-style tragedy in this country.

  • Professor Barry Schoub is emeritus professor in virology at the University of the Witwatersrand, and the former director of the National Institute for Communicable Diseases (NICD).


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