As the tumultuous third wave, which has brought great anxiety and loss to many South Africans, wanes, the question remains: what can we do to prevent the dreaded fourth wave?
As a healthcare worker, I have witnessed the desperation in the eyes of clinicians, patients and loved ones as we race against time to save people from this oxygen-sapping, multi-organ-ravishing virus.
The reality is no country can ever have enough beds or ventilators, both in state and private facilities, to manage all in need of care during Covid peaks.
In the quest to do the best for the most in time of resource scarcity, critical care societies have developed difficult protocols to make challenging choices on allocation of ventilators based on likelihood of survival.
The mental health ramifications of such difficult situations will manifest on healthcare workers in years to come.
Surely, as society, we can contribute to relieving human beings from having to make such internally conflicting decisions and fight the spread of this deadly virus?
The most scientific solution at present is to have at least 70% of the community vaccinated. By doing so, more people will be protected from an acute infection, which decreases the ability of the virus to spread.
This is otherwise referred to as herd immunity. The problem with Covid is the delay in diagnosis and treatment. This leads to extensive damage to lungs and other organs, such as the kidneys. While early diagnosis may prevent hospitalisation into critical care facilities, preventing such occurrences is preferred.
As a country that has over 6 million (13%) citizens living with HIV and 12.8% with diabetes, many are immunocompromised. Furthermore, with male obesity at 31% and 68% at risk for poor clinical outcomes in Covid, it is critical for them all to be protected.
Reluctance to vaccinate does not only have an impact on the individual concerned but on everyone that person interacts with in shopping malls, gyms and workplaces.
Vaccinating will save the lives of individuals and those around them. The conspiracy theories and general fear of the unknown when it comes to Covid have made many people hesitant to vaccinate.
Historically, vaccines have been used to combat infections such smallpox and measles. These were either eradicated or brought below public health concern through expanded immunisation programmes.
The same principle applies to Covid, with vaccines designed based on historical knowledge.
This contradicts the notion that these vaccines are completely foreign and may be deadly. Through the use of modern technologies, scientists have access to historical models to work on to tailor-make vaccines.
Just as there was societal scepticism towards lifesaving antiretroviral drugs at some point, similarly we cannot afford to have non-evidence-based fallacies hinder us from doing the right thing.
Vaccine hesitancy hinders the ability to obtain herd immunity, which is important to protect a nation from a basket
of communicable infections, in this case the focus being Covid.
This challenge is not unique to South Africa and countries across the globe have looked at ways to increase vaccine uptake through:
- Providing freedoms;
- Financial incentives; and
- Increasing access to vaccination within communities.
The first point of providing freedoms is a strategy that looks at giving incentives to those who have been vaccinated, such as access to bars, movies and stadiums.
With the current economic situation due to Covid, financial incentives are enticing to the many who are unemployed. In the case of South Africa, given the spend on social services and Covid relief, this strategy would be bound to put further financial strain on an already heavily indebted government.
South Africa is in the advantaged position of having vaccine availability. Further strategies are required to boost vaccine uptake in the country.
The presidential health compact explored ways of bolstering the South African health system through the use of all stakeholders that impact on health.
Without health there cannot be a business, science or creative arts sector. Without a healthy nation the economy will fail. It is vital that all sectors start making health in all sectors an imperative performance indicator.
The key to a stable public health system is to ensure that there is access for all.
That not only entails looking at the most disadvantaged rural areas but also policy reform in high-end corporate spaces to encourage responsiveness to the pandemic.
Companies could look at giving a long weekend as a reward to employees who have been vaccinated.
Every community has the right to health and the responsibility to ensure a healthy environment. It is our responsibility as good social citizens to do our part. Get your household and those who work or reside in it vaccinated.
While we stagger along with a country coverage of 14%, vaccine hesitancy is a problem for all.
-Dr Majake-Mogoba is a public health medicine specialist