It’s ‘foolhardy’ to think omicron is a signal Covid is on the way out – epidemiologist

The ministerial advisory committee’s (MAC) latest problematic statement pointed to the department of health’s management struggling to fight Covid due to poor decisions made by the previous team, according to one of South Africa’s leading epidemiologists Dr Jo Barnes.

These, said Barnes, included the country’s initial harsh lockdown and the “continuing obsession with retaining control of so many processes: the control council system, electronic registration and the prioritising of certain groups who can be vaccinated”.

She said bureaucratic decisions needed changing and adapted “to suit the circumstances”.

In its problematic statement on quarantining and contact tracing, addressed to Health Minister Dr Joe Phaahla, MAC’s co-chairs professors Koleka Mlisana and Marian Jacobs proposed that:

• Quarantining be discontinued with immediate effect for contacts of cases of Covid – this applying to vaccinated and nonvaccinated contacts.
  
• No testing for Covid be required – irrespective of the exposure risk, unless the contact became symptomatic.
  
• Contact tracing be stopped.
  

In its rationale for the recommendations, MAC said: “As current testing only identifies a small minority of all Covid cases, quarantining contacts of these cases, serves no demonstrable general public health purpose.

“Quarantining is not feasible in many social settings and is associated with significant strain on staffing levels, costs to the individual and to the broader society.

ALSO READ: Covid-19 update: Omicron spreads faster and weakens jabs – WHO

“Since quarantining contacts of cases no longer serves a public health role, identifying contacts of Covid cases, serves little role.

“Contact tracing is impractical once the Covid caseload rises, due to the large number of contacts that have to be identified for each case.”

Prof Heather Zar of the University of Cape Town described MAC’s decision as “pragmatic”.

“A key thing that is missing is urgent implementation of a booster vaccination – not to wait until January or six months after last dose.

“We’re in middle of fourth wave and a booster to rapidly increase antibody levels is urgent to contain spread.

“Healthcare workers have been badly affected with omicron infections – we need to urgently provide them with better protection,” said Zar.

Barnes said she agreed with the MAC’s position, because contact tracing was “so inefficient and costly”.

“The vaccination prioritisation was needed while the country had an undersupply of doses of vaccine,” said Barnes.

“By now, South Africa had to sell or get rid of a substantial number of doses that were due to expire, while clinging to the previous system of dispensing vaccine doses.”

The mildness of many reported cases of the omicron variant was “heartening, but also carries the risk that omicron’s pervasiveness will be underestimated because many people with mild symptoms may not seek help from the health services”.

This, she warned, would lead to “an increase in the now well-known under-count in Covid data, as reported by the SA Medical Research Council scientists tracking this”.

“We have no guarantee that the next variant will be as mild in its clinical effects as omicron. So, deciding that omicron is now the signal that the pandemic is on the way out, is actually foolhardy,” cautioned Barnes.

ALSO READ: WHO sees unprecedented Omicron spread, ‘probably’ in most countries

South Africans could not afford to be complacent.

There is a deafening silence by government on measures to improve the ventilation in public buildings – shops, malls and government buildings,” said Barnes.

“It has been shown that improved ventilation can reduce the airborne transmission of the virus particles through the air and so reduce the spread.

“But there is no sign that this important aspect is receiving any attention.”

– brians@citizen.co.za