'It's a national emergency': Alarm over SA's Covid-19 jabs drop

SA is facing a national emergency on top of the Covid-19 state of disaster as the pace of vaccinations slumps, says an expert in infectious diseases.

But the health department says it has no money for a mass communications campaign aimed at turning the tide.

Friday's total of 153,999 jabs administered was more than 43% lower than the daily record of 273,011 set on July 21. This week's total was the lowest since the end of June.

"The continued inability to hit daily vaccine targets should be seen as a national emergency now," said Francois Venter, professor of medicine at Wits University. "Simply dropping vaccination age thresholds is not going to prevent a fourth-wave disaster."

Venter said the fact that many vaccination sites around the country are deserted is due to "total communication failure [by the government]".

SA has sufficient supply of vaccine doses, but health department statistics paint a dismal picture, revealing that in the 50-59 age group, only 14% of women and 10% of men have been vaccinated. About 25% of women over the age of 60 have been vaccinated, but only 16% of men.

Health department deputy director-general Nicholas Crisp told the Sunday Times yesterday: "Well, we do not have a budget at the moment, that's the problem."

He declined to elaborate, saying he did not want to be drawn into a discussion on the R150m paid to Digital Vibes for Covid-19 communications.

"All I can say is that at the moment we are using the good services of GCIS [the Government Communication and Information System] and the internal resources of the department, as well as being supported by the private sector and the Solidarity Fund."

Crisp said a "special working group is looking at a lot of communication strategies, because obviously there are different targets for different audiences and communities".

Men who are working in the cities and go back to the rural areas and their ancestral family grounds for Christmas ... if they are not protected, they are going to spread this

—  Nicholas Crisp, health department deputy director-general

Stavros Nicolaou of Business for South Africa, which is working with the government on the vaccination rollout, said it is time to take vaccines to the people rather than expecting them to come forward.

"We are only going to win now by ramping up with this second phase of getting vaccinations to people," he said. "We need to go hard on broader mass mobilisation now. I am talking about community interventions, community radio stations, mobile clinics and more."

Crisp said the department is also looking at this approach. "There are lots and lots of things happening behind the scenes to try and get to people," he said.

Nicolaou said vaccinators need to go "ward by ward" and communication has to target segments of the population who are not registering, chiefly men. "Males relate to sports celebrities and heroes, so we have to tweak our communication with that in mind."

Crisp said men's low vaccination rate is at the heart of fears of a fourth wave of Covid-19 infections around Christmas. "What's going to happen is that men who are working in the cities who go back to the rural areas and their ancestral family grounds for Christmas will cross the borders," he said.

"If they are not protected and they get sick, they are going to spread this in areas which up until now have not been a problem and then the numbers are going to go up again and they will affect vulnerable people in the communities and then we are going to see people die."

Crisp also expressed concern about vaccine hesitancy and condemned doctors such as Cape Town cardiologist Susan Vosloo for spreading "absolute rubbish and outright lies" in statements discouraging people from getting vaccinated.

Vosloo's remarks were made in a video on the right-wing BitChute platform, and Crisp said the department is ready to report such infractions to the Health Professions Council of SA.

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Professor Jeremy Seekings, director of the centre for social science research at the University of Cape Town, said the department needs to "change gear in terms of both making vaccinations accessible and its public education efforts".

The department has set a target of inoculating 70% of the adult population, about 28-million people, by the end of the year. "Only 4-million people have been fully vaccinated and only 7-million people partly vaccinated," Seekings said, noting that the health department would need to quadruple the pace of vaccinations to hit the target.

"Unfortunately, vaccinations have slowed down over the past month and the department doesn't seem to have any clear idea of how to turn this around. Instead, they are beginning to blame vaccine hesitancy."

Friday's media briefing, led by health minister Joe Phaahla, offered some answers in a presentation from Limpopo about how it achieved SA's highest per capita vaccination rate.

The province's deputy director-general for health, Dr Muthei Dombo, said: "We do not have unlimited resources but we ask how one person can assist, we keep things simple, and we make sure we understand our context."

Traditional healers and leaders, church leaders and other community influencers have been co-opted, and Dombo said "the rule of one" is being applied to achieve greater impact. "We have said, for example, that if one community health-care worker can register one person per day, that is another 9,000 registrations per day - and from there you can multiply and the numbers grow."

Zion Christian Church leaders are "assisting the province in ensuring that there is minimum attendance at church to prevent spread, while also telling congregants that vaccination is safe". Traditional health practitioners have also been co-opted, and the health department is "very clear in communicating our schedules and our sites".

Without high numbers of people vaccinated, we are going to see a deluge of variants that we cannot cope with

—  Stavros Nicolaou, Business for South Africa

Farms and mines are being targeted by vaccination teams, sport and recreation groups are hosting weekend vaccination drives and nurses are visiting elderly people to vaccinate them.

"We have reached out to tribal offices and community halls. We have a drive-through site and have also set up mobile facilities in high-transit zones like shopping malls," said Dombo.

"We track the gap between the actual eligible population and those getting registered and vaccinated, and then we go district by district to close those gaps because not all districts are the same."

Alarm about the vaccination rollout coincides with warnings that the third wave of the Covid-19 outbreak in SA is not yet over.

"[The curve] is hovering and could turn back up again," said professor Gesine Meyer-Rath, Wits University health economist and Boston University associate professor. "It is not coming down symmetrically, as it did in the first and second waves."

All provinces remain in the third wave, with four experiencing rising infections. "KwaZulu-Natal is going up. The Eastern Cape is going up. Cases are still increasing in the Free State and Northern Cape, and stagnant in the Western Cape," said Meyer-Rath.

Nicolaou said without high numbers of people vaccinated, "we are going to see a deluge of variants that we cannot cope with" as the virus mutates in the unvaccinated.

Crisp said making vaccines mandatory would be a last resort. "For now what is happening is that workplaces are independently starting to get their own legal opinions and starting to make it mandatory," he said.

Health spokesperson Popo Maja yesterday denied the department had dropped the ball in communicating the importance of the vaccine to the public, saying it was using different channels, including social media, to debunk misinformation and fake news.

"One of the gaps we are trying to close is low vaccination rates among men," he said.

"There is a lot of work we do in collaboration with provinces and the private sector, which includes community engagements, community radio programmes."

Asked if the government is considering incentivising people to get the vaccine, Maja said the department is looking at "different sustainable strategies to get people to vaccinate".