Prof Salim Abdool Karim Weekly COVID-19 UPDATES

17 April 2023

Unfortunately, I have some not so good news to start with – these weekly emails will end in mid-May this year as our grant funding from GIZ comes to an end. It is now 3 years since these emails started. Initially, my weekly emails only provided a set of slides and then over time, I included text with the slides until it got to be a short narrative with some slides to provide supporting information.

I am sending today’s missive from New York, as I am at Columbia University this week. At a global level, viral transmission is at a low level is most countries (Figure 1), even in the midst of yet more newer omicron XBB* variants emerging. Deaths have continued to decline.

In South Africa (Figure 2), the situation remains quiescent. Both reported cases and deaths are low. Finally, home test kits for SARS-CoV-2 have become available in South Africa – more than a year after they were available in many other countries. Sadly, I do not anticipate much update of these kits as few people are testing themselves in South Africa these days, even when they may have symptoms suggestive of Covid-19. 

In order to check if there are any underlying trends that differ from the global trends in mortality, Figure 3 provides an analysis by continent. Case fatality across all continents is either stable or showing a downward trend.

As acute respiratory illness from Covid-19 recedes as a major concern due to high levels of pre-existing immunity, even against new sub-variants of omicron, other aspects of Covid-19 become more important. The manifestations and consequences of Long Covid are now becoming clearer, even though there is no clear definition or known pre-disposing factors for the condition. The most common feature of Long Covid is fatigue and malaise. This has major repercussions on social functioning, especially on the ability to fulfil daily tasks and perform work. In Figure 4 below, the extent to which Long Covid is leading to non-employment, unemployment and partial employment has been assessed in the USA. Unemployment was one third higher in those with Long Covid, and those with cognitive impairment stemming from the condition are most likely to be unemployed.

I am concluding this week’s email with some new data that addresses the question – has Covid-19 become “just like flu”?  Covid-19 denialists used to argue at the beginning of the pandemic that Covid-19 is “just like flu” and so public health measures and lockdowns were unnecessary. This “just like flu” brigade subsequently directed their energy to the anti-vaxx movement.  But every now and then, they emerge from the woodwork – the evidence to refute them has just been published in JAMA. The study in Figure 6 below showed that Covid-19 is associated with a higher risk of hospitalisation and once hospitalised, a higher risk of death. So, even with background immnunity, hospitalisation rates and case fatality rates remain higher for Covid-19 than for Flu. The answer in short is no, Covid-19 is definitely not “just like flu”. 

Have a great week.


Salim S. Abdool Karim, FRS
Director: CAPRISA
CAPRISA Professor of Global Health: Columbia University