Prof Salim Abdool Karim Weekly COVID-19 UPDATES

3 February 2022

There have been some interesting developments:

  1. The world has past its omicron peak (slide 4) – the peak in this 4th wave was more than 4 times higher than the previous peaks. Due to omicron’s high transmissibility, it rises rapidly but also drops rapidly – would be interesting to see if this holds even at global level.
  2. South Africa is experiencing an intriguing new trend in its case numbers – the overall number of cases is no longer declining in South Africa.  There has been a slight increase (slide 1) but the case numbers but it still remains below the threshold for low transmission.  The problem is that cases have been increasing in several of the smaller provinces. Ordinarily, we would expect some variability in the declining cases – but we are seeing increases of 20% or more in at least 3 provinces (slide 9). This is unlikely to be background variability. Its timing links it to the opening of schools and the cases are increases mainly in the young and adolescents. I do not yet have the sequencing data but I think it is most likely that this rise in cases is being driven by BA.2, given the higher transmissibility of this virus.
  3. I am not concerned about this increase in cases across several provinces because the excess deaths have reached a point where they are within the expected range and more importantly, has reached a point where excess deaths are equal to the reported Covid-19 deaths (slide 11) – that most Covid-19 deaths are occurring in the health services, where death reporting is generally good. Normally excess deaths are about 3 times higher than reported Covid-19 deaths. So, even though we are seeing increases in cases in some parts of the country, the reported Covid-19 deaths and excess deaths remain low – lower than we have seen in more than a year. While there are no concerns regarding Covid-19 illness, this increase in cases does point to how our policy decisions such as reopening of schools can impact viral transmission.
  4. The CDC released a simple but impactful analysis of deaths (slide 12) – this uncomplicated analysis shows that the death rate is about 13-fold higher in unvaccinated people compared to those with 2 vaccine doses and that 3rd dose boosters reduce the mortality rate a further 6-fold compared to vaccinated without boosters.  When asked about the benefits of vaccination, this simple 3 bar picture speaks a thousand words.
  5. Finally, I would like to share one of the most over-looked and under-estimated effects of Covid-19 infection. The tendency is to focus on cases, admissions and deaths when measuring the effects of Covid-19. But there is a more insidious and devastating effect of Covid-19 infection, even when it is clinically mild – that it takes long to recover, even when a person feels clinically well. On slide 13, the graphs from The Economist show how top-end sportsmen like American football players are still struggling with the after-effects of Covid-19 – they have less game time and when they do get game time on the field, they have a lower pass rate. Since passing the ball is critical to reaching the goal-line, it is a marker of how Covid-19 affects performance many months after initial infection. When you translate this impact for example to top-notch bankers, high productivity scientists and our most productive farmers, you get an impression of just how much Covid-19 is impacting society, including long after clinical recovery. This finding in the elite football players with past.
Salim S. Abdool Karim, FRS
Director: CAPRISA
CAPRISA Professor of Global Health: Columbia University