Covid: The worst is yet to come

SOUTH AFRICA could have as many as 30 coronavirus mutations and now health experts fear patients with advanced HIV could become “a factory of variants for the whole world”.

This week, the country reported 9 149 new cases and the government is being urged to step up efforts with experts saying the speed of the roll-out could determine how severe the third wave proves to be.

To add to the Covid-19 woes, scientists recently detected potentially dangerous coronavirus mutations in a woman with advanced HIV.

The 36-year-old carried the coronavirus for 216 days, and during that period the virus collected more than 30 mutations. The case was published as a preprint in the medical journal medrxiv this month.

After the woman tested positive for Covid-19 in September last year, the virus gathered 13 mutations to spike protein and 19 other genetic shifts that might change the behaviour of the virus. But scientists are unclear if the woman passed on these mutations to others.

However, they added that it is possibly not a coincidence that most of the new variants have surfaced from areas such as Kwazulu Natal, where one in four adults is HIV positive. Although there is limited evidence to indicate that Hiv-infected people are more susceptible to contracting Covid-19 and developing grave medical consequences, researchers are of the opinion that if more such cases come to light, it will not bode well.

Covid-19 expert Professor Salim Abdool Karim warned that the “real current rate of infections” is probably twice what is being reported and that the latest data is actually a reflection of what happened well over a week ago.

“It is going to increase, and we know this from our first and second waves that the virus will grow in one or two provinces initially. From then, it cedes to other provinces. So we should be expecting that in the next two weeks cases would rapidly rise,” said Karim.

Professor Shabir Madhi, a vaccinologist at Wits University, is already predicting that Gauteng, in particular, will experience its highest number of Covid-19 cases during the third wave.

“Despite a high percentage of the population likely having been infected during the course of the first two waves in Gauteng, the trajectory of the current resurgence is on track to exceed the number of cases that occurred in either of the first two waves,” Madhi told the Saturday Star.

The country’s National Institute for Communicable Diseases said the increase in cases has brought the national seven-day moving average incidence to 5 959 cases, which exceeds the new wave threshold as defined by the government’s Ministerial Advisory Committee (MAC). MAC defines the new wave seven-day moving average threshold as 30% of the peak incidence of the previous wave.

By yesterday, the country reported a total of 1 722 08 cases, with the 9149 new cases representing a 15.7% positivity rate based on tests completed. A further 100 related deaths were also reported, bringing total fatalities to 57410 by Friday.

There was an increase of 844 admissions and 127 additional in-hospital deaths reported.

The majority of new cases were from Gauteng (61%), followed by the Western Cape (10%).

Madhi said that despite Gauteng’s high number of cases, the province has yet to hit its peak.

“It’s likely that we are yet to peak in Gauteng, which is likely to occur over the course of the next two or three weeks. Based on past experience, it is likely that the current surge will then start subsiding and taper off by late July.”

Madhi added that while some provinces have only entered into their third wave recently, Gauteng has been in its third wave for some time now.

“We have been in a third wave in Gauteng for the past three weeks – since the positivity rate of tested cases went above 10%. Using a threshold of onethird of the peak of the past waves as a measure of the start of a resurgence does not make epidemiological sense, as subsequent resurgences can be less severe, but still constitute a wave.”

Asked what factors will influence how South Africa’s third wave plays out, Madhi said: “The struggling roll-out of Covid-19 vaccines to high-risk groups poses the greatest challenge, since if we had protected the high-risk groups against severe disease and death, we would be better placed to weather this wave, which was predictable.

“The failure of the timeous roll-out of the Covid-19 vaccine programme now places the burden of weathering the third wave on the shoulders of the public, who need to be more responsible in adhering to masking and avoiding indoor gatherings in particular. The main driver of transmission is indoor gatherings in poorly ventilated spaces, more so when people are not wearing masks,” said Madhi.

He has even called for more restrictions on public gatherings, including places of worship, and indoor dining.

There are also growing calls for schools across the country to close to curb the spread of the virus.

Despite an increase in cases, Madhi doesn’t expect the country to move into a stricter level of lockdown.

South Africa is currently on an adjusted level 2 lockdown.

AN ARREST warrant, the issuing of an Interpol red notice and now an extradition treaty is making the world a smaller place for the Gupta brothers.

While South Africa and the United Arab Emirates (UAE) this week, welcomed the ratification of the treaties on extradition and mutual legal assistance, there is still concern that it could take some time before the alleged masterminds of state capture find themselves back in the country.

National Director of Public Prosecutions advocate Shamila Batohi, speaking at a press conference yesterday, said even with these new developments, this did not necessarily mean the Guptas would be on the next flight to South Africa.

Batohi said an exact timeline could not be put on the extradition processes and explained that “it will take some time”.

Batohi said that, in general, once the suspects were arrested abroad, legal processes would have to take place in that country first.

Then it would be a political process. The country’s executive would decide if they would surrender the suspects to South Africa for prosecution.

“And once they have been arrested, they have a right to defend themselves and do whatever they can to prevent that extradition from occurring in terms of UAE domestic extradition law,” said immigration lawyer Gary Eisenberg, who added that this process could include various appeals through the UAE courts.

Batohi yesterday also expressed wary scepticism over the new agreement.

She said the National Prosecuting Authority would only accept that there was co-operation from the UAE once they had received the evidence, such as bank statements and records of the Gupta family and their associates, which they had for over three years requested from the UAE authorities, thus far without any success.

“The ratification of the treaties is a positive development. But, we will only know if this is making a difference once our request for mutual legal assistance is fully executed by the UAE and we get the necessary evidence,” said Batohi.

Justice Minister Ronald Lamola and Batohi met with the UAE ambassador Mahash Saeed Alhameli, on Thursday, following the announcement on the ratification of the treaties made by Alhameli’s office, earlier in the week.

According to a source who asked to not be named, the South African government were eminently displeased that Alhameli’s office made the announcement before them, and therefore rushed to meet with the ambassador on Thursday.

Batohi responded sharply to whether the ratifications of the treaties would fast-track bringing the Gupta’s back to South Africa to formally answer in the country’s courts for their alleged wrongdoing.

“The treaty doesn’t really change anything. In the spirit of co-operation, we hope there is a change and positive response to our requests as soon as possible,” Batohi said.

Lamola said, the South African government did expect co-operation from the UAE going forward, “because it was a commitment we received from the