As Covid-19 changes course, so too must our tactics in dealing with it

SA’s discovery of the Omicron variant late last month set off alarm bells around a world that appears to have learnt little over the 20 months in which the disease has held us in its terrible grip.

Omicron set off a slew of  travel bans intended — though this was not stated — to confine the latest variant of the virus to SA and its neighbours, while the West gorged itself on further doses of life-saving vaccine.

By the latest count, however, Omicron is alive and all too well in 106 countries, according to the World Health Organisation.

What better proof is needed that the epidemic is a global phenomenon and that we will only be safe once most of the world’s population has been vaccinated?

But as many countries tighten restrictions and hospitalisations soar, the shiver of fear we felt with Omicron’s arrival is being replaced by a feeling of relief.

In the most important indicator areas — severe illness, ventilation of patients and death — Omicron’s relatively muted effect in SA, and in some other countries, raises intriguing questions about how the pandemic will evolve.

If these preliminary and apparently promising  observations are correct, they would have policy implications in the health sector and beyond.

The words of Winston Churchill after the Allies’ victory in North Africa in 1942 come to mind: “Now, this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” 

This is not the time to claim easy victories or to let down our guard in respect of important measures such as mask-wearing and sanitising.

It is the time, though, to reinforce the message that vaccination provides the best possible protection for the individual, while contributing in a small way to stopping the circulation of the virus and subsequent mutations. 

The fact that new lockdown restrictions  have not been imposed in SA in response to  the fourth wave reflects the recognition that the country is tired of regulations, perhaps, but also shows a growing maturity in the handling of the pandemic.

The accent now has to be on the recovery of the economy, and the creation of jobs to revitalise SA after the decimation wrought by Covid and the July riots.

It’s also important that policy be tweaked or entirely overhauled to take proper recognition of the new realities.

As an editorial in the South African Medical Journal put it: “At the start of the pandemic, testing, quarantining, and isolation policies were our only tools to contain and mitigate Covid-19 in a completely susceptible population… Changing strategies will inevitably provoke anxiety in those who still take comfort in the idea that Covid-19 can be isolated and eliminated.’’

It continues: “After multiple waves of Covid-19 infection and vaccines, our bodies are better protected against severe disease, independent of any putative pathogenicity benefits of this variant. We must shift our monitoring away from cases towards hospitalisations.

“We cannot continue to cripple the health-care system and the economy with what does not work — overwhelming primary health-care services with high-volume testing of mild Covid-19, quarantining contacts, and isolating cases for a prolonged period.

"People must stay at home if they are mildly ill, and only go to hospital if they are unwell and in need of treatment. Indoor masking, avoiding large indoor crowds, socialising outdoors, ventilation, and most importantly vaccination are the best defence against future seasons of endemic Covid-19, and the best way of ensuring that our health services are able to provide optimal management of all health conditions.’’

 It is essential that our health services do not become Covid box-ticking factories, and that diseases that plague so many South Africans, and which have been put on the medical back burner for so many months, once again get the attention they deserve.

If changes are needed in the testing and self-isolation regulations, these too must be introduced. And if a vaccine mandate is needed, we must get moving on it to reap the greatest possible benefit.