/ 20 June 2021

As South Africa’s Covid infections surge, the number of jabs can’t increase, yet

Safrica Health Virus Vaccine
Phase two of the vaccination rollout plan, to vaccinate people 60 years and above began on 17 May. (Mlungisi Mbele/AFP)

The Covid-19 third wave has forced South Africa into level-three lockdown, with an estimated 1.75-million people infected by midday on Wednesday 16 June — 80 000 of them currently active cases. 

Hospital admissions have increased 59% in the past two weeks, with the average number of people who have died from Covid-19 each day increasing by 48% — from 535 two weeks ago to 791 over the past seven days.

Except for the Northern Cape, all provinces are experiencing rising infections.

The average number of daily new infections has doubled in the past two weeks. From about 3 700 daily infections, South Africa has escalated to an average of 7 500 daily infections in the past seven days.

By Tuesday, more than 7 700 people had been admitted to hospital, with more than half of those (4 400) in Gauteng. Of the people hospitalised, 1 400 are in intensive care units. 

In his address on Tuesday, President Cyril Ramaphosa said that within days it was likely that the number of new cases in Gauteng would surpass the peak of the second wave, with private hospitals in the province reporting that they are near capacity. 

Although Ramaphosa said he would like the state to ramp up vaccinations to hundreds of thousands, it is unlikely the country will vaccinate more than 80 000 people a day at the more than 570 sites in the public and private sector for the foreseeable future. About two million people are already vaccinated.

Professor Nicholas Crisp, the deputy director general in the health department managing the Covid-19 vaccine distribution, said that we couldn’t roll out more than 85 000 jabs a day, given the supply constraints.

“That’s what we can handle, even with up to 700 sites operating. We have to wait for more vaccines to open more sites,” Crisp told the Mail & Guardian.

Asked why people were not being vaccinated over weekends, given how far behind the rest of the world and the continent South Africa is, Crisp said there were still not enough vaccine doses.

“And we don’t have the overtime budget. Healthcare workers also need to rest sometime,” Crisp said. 

Dr Stavros Nicolaou, head of business for South Africa’s Covid-19 initiative and Aspen Pharmacare Group’s senior executive responsible for strategic trade development, agreed with Crisp, adding that healthcare workers have been through “16 months of hell”.

“If we don’t give them a break, we’ll have people cracking. With this short-dated [Johnson & Johnson] stock, they’ll have to work overtime anyway.”

Low capacity

South Africa’s over-60s Covid-19 Pfizer vaccination programme is running at just 52% of its target, as overall vaccine supply shortages dramatically slow the national roll-out. 

According to Nicolaou, the 40-plus age group vaccination roll-out will now probably kick off in late August. Of the 60-plus group, 1.4-million people have been vaccinated so far, rather than the targeted figure of 3.5-million, meaning a late-July or early-August finish is  likely instead of the end June.

Crisp said, were it not for the global freeze on suspect J&J batches from the US’s Baltimore Emergent Bio Solutions factory, “we’d be vaccinating more than double of what we’re doing now.” 

The global precaution required the destruction of South Africa’s two-million J&J vials at Aspen’s Gqeberha factory earlier this month. The vaccines were initially due to be used from 17 May, the beginning of phase two of the roll-out.

Use the map above (provided by Africa Data Hub) to find a vaccination site near you.

Roll out for teachers 

However, teachers at all primary and secondary schools will benefit from an earlier single-shot J&J vaccine as organisers hurriedly adjust the programme to compensate for contamination-avoidance requirements.  

The “clean sourced” batch of 360 000 alternative J&J vials is due to land at OR Tambo Airport this week, and could mean that teacher vaccinations begin as early as next week, depending on how quickly the quality checks are conducted by the National Control Lab at the University of the Free State.

Nicolaou said the teacher cohort “neatly matches the new stock — it’ll probably cover about 75% of teachers and all basic education staff, but more is on the way.”

Crisp said that the health department had already identified education as a vulnerable sector, and had met with officials from the department of basic education to see if it’s feasible to vaccinate teachers.

“We will continue monitoring their readiness to make sure it’s a go,” he said.

Moving targets

However, Crisp  expressed deep frustration over the changing vaccine-expiry dates.

“They [J&J] seem to change every five minutes. Our systems are only so agile, and then they collapse. It’s not like tinned goods — vaccines are even more vulnerable than fresh goods. Introducing two vaccines in the same space was not in the original design,” Crisp said. 

“There are lots of challenges in the provinces, and it’s too complicated to push this J&J batch to both the public and private sector, so we’re sticking to what we can control within the public health arena.” 

Crisp revealed that South Africa had originally ordered 480 000 J&J vaccines to somewhat compensate for the destruction loss — but was then told the consignment was due to expire as early as 28 June. 

“That was not enough time for us to roll out without a major part of it expiring, so we signed up for just 360 000. Then they told us that they were satisfied the vaccine potency could last for another six weeks, taking us to 8 August,” he said.

Although this was a relief, South Africa was still scrambling to nail down extra supplies, with “several million” more J&J  vials due to arrive next week, according to Nicolaou.