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Update on COVID-19 and insights into the vaccine trials

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Leader in first in two vaccine studies undertaken in Africa briefs alumni.

A familiar name to many South Africans over the past few months Wits alumnus Professor Shabir Madhi (MBBCh 1990, MMed 1999, PhD 2004) provided an update on the COVID-19 pandemic in South Africa on 29 September 2020. Prof Madhi has been appointed as Dean of the Health Sciences Faculty in 2021 and leads the charge in two COVID-19 clinical vaccine trials in South Africa. He serves both as Director of the Vaccines and Infectious Diseases Analytical Research Unit at the South African Medical Research Council and Research Chair in Vaccine Preventable Diseases of the Department of Science and Innovation/National Research Foundation. He holds the Chair of the National Advisory Group on Immunization in South Africa and is a member of the WHO Strategic Advisory Group of Experts.

Prof Madhi outlined infection rate statistics, the deaths and excessive mortality, the implications of a “second wave” as well as insights into the access to COVID-19 vaccines for low-middle-income countries.

He said when reflecting on the numbers around the pandemic and how it unfolds, that one of the important metrics (to see if you’re getting a true reflection of the cases) is the positivity rate. “A high positivity rate, reflects the bias that a select group is being tested more.” The threshold which WHO recommends, as an indicator that an adequate amount of testing is being done, is where the positivity rate is less than 10%. Once this is under 5%, it suggests a limited spread of transmission in a population and an adequate testing rate.

“In South Africa when we were recording between 10 000 to12 000 new cases per day (around middle of July), the positivity rate was 27%. This indicates at the peak of the outbreak, although we were reporting about 14 000 case per day, that was probably a complete underestimate of the number of individuals being infected.

“More recently our positivity rate is in the region of 5-10%, suggesting that there is dampening of transmission of the virus, but we’re not out of the woods.”

One of COVID-19’s striking features, is that less than 5% have been documented in Africa. There’s a disconnect between the size of the population relative to the number of COVID-19 cases documented. The data indicates the limitations we have on the continent to quantify the pandemic. “This is more than an academic exercise. When it comes to vaccines, countries may be prioritised based on what is shown as being the burden of COVID-19. This is an important narrative, so that African countries aren’t at the short end of the stick for making a case for access to COVID-19 vaccines.”

Prof Madhi said: “We don’t have ability to contain the spread of the virus. Infections will continue to occur. What we do have control over, is our ability to protect individuals who are vulnerable from severe disease. There should be a much greater focus on how to protect them.”

The full talk is available here: https://www.youtube.com/watch?v=vmseJjN2Vqk

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