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The third COVID-19 wave is due to hit the two big Eastern Cape metros of Nelson Mandela Bay and Buffalo City by the end of March/beginning of April. This is sooner than expected and we are confident of the prediction as it is based on a range of local and regional data and on a year of national modelling, from the time that COVID-19 hit South Africa in March 2020.

This scientific evidence informs us about the waves and how we can anticipate them. If we act in time and ensure all the prevention protocols are being followed and the health services facilities and processes are in place, we can control the spread of the virus. If we do not act in time, the virus will run rampant, our facilities will be overwhelmed and in all probability it will lead to a peak in the number of deaths.

From the modelling we used last year (based on the number of deaths) we predicted the first wave would peak around mid-to-end-July, while national models predicted much later in the year - from September. We now know that it peaked around 19 July 2020.

The data for the Eastern Cape further shows the province led the second wave but by the time additional restrictions were introduced in October 2020, it was too late to effect optimal systems as we were already heading towards the festive season, with a lot of movement and inter-provincial and cross-border travel. This led to the second wave rapidly spreading throughout the country. The rural areas were hard hit as people headed there from the cities to visit their families. We knew this would happen. And we know a similar situation will happen now if nothing is done as we head towards Easter and winter.

The runaway data at the moment signals more trouble is coming in the form of the third wave, and this time around even though it will hit our metros as we predict, it will not necessarily be the Eastern Cape driving South Africa’s third wave. It might be driven by the Western Cape and spread countrywide. The second wave’s peak in the number of deaths indicates the new variant was deadly. We should be concerned about the third wave.

From a year of data and modelling we can also look back at the number of people in our two metros who were infected and the number of people who have died of COVID-19. The data is showing us that the numbers might be five times higher than those reported. Therefore, 104 active cases is actually 520 active cases. A lot of people with COVID-19 are also not admitting they have it and at the same time there is less testing being done at a time when testing should be intensified.

This is highly concerning as it means that we have high numbers of people in our communities who are walking time bombs of infection. Just one person, as we know, can infect large groups, whether it is in our suburbs, townships, schools, shopping areas or places of worship. None of us know if we are going to be mildly affected by the virus or killed by it; or if additional, more infectious mutations are already in the mix. The younger generation still thinks they are not vulnerable and won’t be impacted by COVID-19, but everyone is at risk.

The reproduction number, aka R-zero, modelling we have been pursuing over time gives us a clear picture of the reproduction status of the virus. The disease is still spreading fast and is highly prevalent in our metro communities. The R-zero is currently more than one, and only when it gets to one or below does it mean we have flattened the curve and can control it.

What deeply concerns us is that people have become far too relaxed about the pandemic. During the recent heatwave people flooded to the beaches over the weekend and there was no social distancing. Give this the necessary incubation period and we will see the numbers from this gathering rising.

If we look back to the period between the first COVID-19 case in the country and the first wave, there was far more intensity in people’s precautionary response. As people were educated about the virus, they became afraid of it.

This time around, we once again need a concerted COVID-19 awareness drive. We are appealing to the local, provincial and national government to make sure we have the necessary education campaigns, healthcare facilities, personal protective equipment, oxygen and field hospitals at the ready.

We are appealing to all citizens to be highly vigilant about wearing masks, to frequently wash your hands with soap and water, and to use sanitisers. If you don’t have sanitisers, washing your hands with soap is very effective. And if you are experiencing symptoms, don’t ignore them or think you have flu, go to your nearest COVID-19 testing centre or clinic and get tested or at least have an antigen test.

We also clearly need to speed up the vaccination process. If we look at Rwanda, for example, they managed to vaccinate 140 000 people in two days whereas it is taking us weeks to achieve this number. South Africa needs to consistently vaccinate 140 000 people a day to hit 67% coverage by the end of the year.

From the national level to the local level, we further need to speed up all decision-making about the pandemic. At present it is taking two weeks to a month or more for critical COVID-19 management decisions to be taken and in a pandemic this is a very long time. The Easter weekend is coming up and the movement between provinces and religious gatherings is of great concern, as is the winter ahead. There is no way we can avoid a third wave but if strict preventive and management measures can be put in place, it can be less deadly. None of us are safe and until we control the spread, vaccinate the population and achieve population immunity, there will be more waves to come.

This opinion piece was written by Professor Azwinndini Muronga, the Executive Dean of the Faculty of Science and Professor Darelle van Greunen, the Director of the Centre for Community Technologies (CCT) at Nelson Mandela University. The article appeared in The Herald on 24 March 2021 and Times Live on 23 March 2021.



Contact information
Prof Azwinndini Muronga
Executive Dean: Faculty of Science