Close to 10 000 people have died of Covid-19 in the past 150 days since the country detected the first case. With about 140 000 active cases, South Africa is in the top five worst-affected countries in the world. And the peak has not hit yet. But scientists agree that South Africa has learned a lot from countries that have experienced their peak, especially with regard to treatments.
Just more than a month ago, it was announced that Shabir Madhi, professor of vaccinology at the University of the Witwatersrand, would lead Africa’s first trial to find a Covid-19 vaccine.
Madhi said that the team expects to know by December whether the vaccine works. That doesn’t mean South Africa will get a vaccine by then. The manufacturing and distribution of the vaccine would still have to take place, but these matters are being addressed.
The vaccine team is still enrolling about 2 000 participants. The study excludes people who have HIV and have tested positive for the coronavirus.
Madhi said the study will involve two phases.
“We need to wait until 42 of the participants have developed Covid through natural infection. At that point, we will do an analysis of the results,” said Madhi.
Meanwhile, the Russian government is reportedly gearing up to roll out its homegrown vaccine within two months, with Minister of Health Mikhail Murashko quoted as saying the country plans to vaccinate teachers and doctors in October.
But Madhi believes this is scientifically unsound.
“The Russians are rolling out a vaccine to its population and so have the Chinese to its military. You need to understand what the effect is going to be in terms of its safety and its efficacy before you roll out a vaccine to the population.
“The reality is that the two countries have done this in the absence of scientific evidence that the vaccine would protect against Covid-19.”
As work on the vaccine proceeds, the National Ventilator Project is shipping out hundreds of noninvasive ventilators. By Monday more than 800 of these ventilators will have been sent to hospitals.
A few months ago there was no alternative but to put severely ill Covid-19 patients, who battle to breath, on traditional ventilators. There were not enough of those in the country, which caused considerable alarm.
Professor Justin Jonas, the chief technologist at the South African Radio Astronomy Observatory (Sarao), which is the project lead on the National Ventilator Project, said that, based on the experience in the United Kingdom, Italy and other places where Covid-19 has hit hard, “We have realised that, actually, what’s needed is an intermediate therapy; the so-called noninvasive ventilation.”
The two types of noninvasive ventilators being manufactured locally are the Continuous Positive Airway Pressure (CPAP) and High-Flow Nasal Oxygen devices.
The number of devices being manufactured looks promising. The Council for Scientific and Industrial Research is contracted to supply 10 000 units, according to the Sarao spokesperson, Khulu Phasiwe.
“The Solidarity Fund has approved to increase production to 18 000 units with 63 000 patient circuits. This also includes support, tracking and tracing and distribution.
“Save-P [the South African Emergency Ventilator Project] has been contracted for 2 000 blenders — the combination gives a total of 20 000 CPAP units,” he said.
Phasiwe added that all the units are to be delivered by the end of September, in time for the expected peak.
Dr Tedros Adhanom Ghebreyesus, the World Health Organisation director general, said dexamethasone “is the first treatment to be shown to reduce mortality in patients with Covid-19 requiring oxygen or ventilator support”.
This comes after the findings of a randomised clinical trial to test a number of potential treatments in the United Kingdom through the University of Oxford.
Dexamethasone is a corticosteroid that has been in use since the 1960s to reduce inflammation in a range of conditions, including certain cancers.
A very ill person’s body tries to fight off the virus, causing inflammation in the process. The drug works by suppressing the immune system. For this reason, dexamethasone is not being given to people with mild cases of Covid-19.
South Africa’s Health Products Regulatory Authority spokesperson, Yuven Gounden, said the treatment is widely used for patients in hospital.
“The medical fraternity has kept a keen eye on the medical literature in an attempt to ensure that they are up to date with ever-growing knowledge on the performance of old and newer treatment modalities targeting Covid-19 infection,” said Gounden.
He added that although there are no registered medicines for treating Covid-19 infections, other medicines have been used in the past few months for the management of Covid-19 infections.