what to expect in the short and long term

In light of the approaching winter months, coupled with the recent repeal of the national disaster law, South Africans are anxious watching the increase with Covid infections. The Conversation Africa spoke with infectious disease specialist Veronica Ückermann about the current trajectory of the pandemic in the country.

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How is the last peak different from the previous ones?

By mid-May, the number of Covid cases in South Africa was once again on the rise.

The latest data also shows that hospital admissions have increased in both the public and private sectors, although much less than in previous peaks. proportion of patients requiring hospitalization in the intensive care unit, as well as fewer deaths.

This shows that most of the identified cases were mild or incidental (in other words, they tested positive when admitted to hospital for another reason). A similar pattern was observed with the fourth wave, which was short-lived in December 2021/January 2022.

The fourth wave of Covid-19 infections in South Africa was dominated by a variant of Omicron that was named the virus. “Worry Option” World Health Organization following a report by South African scientists.

The concern with the Omicron variant was its increased transmissibility, leading to a rapid increase in cases and high test positivity rates. It became clear that the clinical picture of this variant is very different from its predecessors.

He had reducing the severity of the disease. And more random diagnosis among patients admitted to the hospital for other reasons.

The current increase in infestation is associated with BA .4 and BA.5, sublineages of the Omicron variant. It may be the first days, but it seems that they have similar clinical manifestations.

It is hoped that the discrepancy between the number of cases and hospitalizations and deaths observed in fourth wave will continue to be observed with these sub-variants.

Where from here?

The evolution of the pandemic reflects changes in both the SARS-CoV-2 virus and human carriers.

evolution of SARS-CoV-2 of the virus is an adaptation process to increase transmissibility and evade the host’s immune response (particularly antibody-mediated neutralization).

As far as the human host is concerned, the majority of the population has some degree of immunity against the virus – whether through vaccination or as a result of a previous infection.

In the future, we will likely see SARS-CoV-2 become endemic with seasonal outbreaks and the need for updated vaccines and boosters. Covid-19 will not disappear, but we will be able to control its impact on our lives and health systems.

Compared to the previous part of our pandemic, our understanding of immunity to SARS-CoV-2 has improved. And the role of neutralizing antibodies, T-cell responses, and B-cell responses was well described.

Emerging variants may have mutations to evade neutralizing antibodies, but this does not result in a complete loss of immunity from vaccines or natural infection, as other components of the immune response are retained. Booster vaccines are also produced strong immune responses to the Omicron variant.

As much as we would like to return to pre-pandemic reality, complacency and a complete abandonment of all caution at this stage will likely lead to an increase in cases, hospitalizations, morbidity and mortality. Caution is not yet worth throwing to the wind in order to protect yourself, as well as the most vulnerable.

What about long term effects?

The changing landscape of the COVID-19 pandemic has led to the emergence of a new syndrome known as “Long COVID”. This may be less dramatic than an acute severe infection but has a significant impact on the quality of life of people affected by it.

The syndrome is defined as persistent symptoms (eg, fatigue, palpitations, shortness of breath, muscle fatigue, chronic cough, insomnia, and brain fog) that are detected 12 weeks after the initial infection. The incidence of long-term COVID is higher among patients who have been hospitalized. But it has been described in mild acute infections as well.

The functional impairment associated with the long course of COVID has a significant social, psychological and economic impact on faces and them communities.

On top of that, proper screening and management of long-term Covid patients is likely to continue to be an additional burden on heavily overburdened healthcare systems.

Has the health system suffered collateral damage?

There has been significant collateral damage to health care during the years of the pandemic.

The management of chronic diseases and other infectious diseases such as HIV and tuberculosis (TB) has been affected. For example, there is a slowdown in the rate of decline in the incidence of tuberculosis in the world. In addition, the number of people receiving TB treatment dropped significantly during the pandemic. An increase in mortality from tuberculosis by 5-15% is predicted. next five years.

The failures occurred because the effects of the pandemic created significant barriers to the care of chronically ill patients. These include:

  • Medical facilities are overwhelmed with acute patients during various waves
  • Lack of public transport at times
  • Closure of some outpatient facilities and
  • People’s fear of contracting COVID from medical facilities.

As healthcare professionals, we hope that the current variants of SARS-CoV-2 will cause milder illness, but we must not forget that hospitalizations and deaths due to COVID-19 continue to occur.

Veronica UeckermannAdjunct Professor: Department of Internal Medicine, University of Pretoria

This article has been reprinted from Talk under a Creative Commons license. Read original article.