The Department of Health and its entities have been monitoring developments about Covid-19 globally since we uplifted all restrictions in June 2022. Genomic Surveillance has also continued under the Network for Genomic Surveillance of South Africa, based at Stellenbosch University.
In December, there was a global increase of 25% (14.5m) in new cases and 12% (46.6k) in deaths reported compared to November 2022. Japan, South Korea, USA, China and Brazil represented 70% of these new cases in December. There were more than 3 million new cases and at least 10 000 deaths. This was 22% down in new cases and 18% down in deaths compared to the previous week i.e. week 3 of December and week 51 of the year.
In the last week of Dec, new cases declined in all the mentioned countries except in China. In this week 52 of 2022, the China cases increased by 45% and deaths rose by 48%. These have been several media reports of over-burdened hospitals and crematoriums in China during December 2022 and the early days of January 2023.
This situation has caused much panic in various parts of the world, including among some South Africans. As a result of these developments, several countries imposed special requirements for travelers coming from the People’s Republic of China. The are 12 countries known to be requiring a negative PCR test less than 48 hours old for travelers from China. These are the USA, UK, Canada, France, Taiwan, Philippines, Spain, Italy, India, Israel and Japan. Malaysia and South Korea require a PCR test plus testing again on arrival, while Morocco imposed an outright ban on travelers from China.
The rest of the world has kept their position the same, meaning no new measures, while Germany, New Zealand and South Africa have formally indicated that no new requirements will be imposed.
On the 7 January, the Genomic Surveillance Unit at Stellenbosch University, a member of the Network for Genomics Surveillance in South Africa (NGS-SA) reported the detection of XBB.1.5 sub-variant of Omicron variant from a specimen which was obtained from a patient on 27 December 2022. The specimen was submitted as part of a random sample for laboratory tests, so no patient details are known, probably not even from Western Cape.
What we know at this stage is that:
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The SARS-Covid-19 variant of concern which remains dominant in the world at between 97 – 98% remains Omicron. Omicron has had more than 100 sub-variants or sub-lineages since it started to dominate the Covid-19 environment in late 2021.
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The Omicron sub-variants dominant in China are BA.5.2 and BF.7 at 97%.
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The XBB.1.5 was detected in Stellenbosch and has been detected more in USA where its prevalence is at about 6.8% and rising.
While the various sub-variants or sub-lineages have shown different transmissibility levels, there has thus far been no marked change in the severity of illness. The primary reason for the reported overwhelming of health facilities in China and high deaths is the recent lifting of restrictions allowing people to travel as they wish after prolonged lockdowns with a high population, limited natural immunity and limited vaccination rates, especially in small towns and rural areas.
The dominant variant of concern in China and in the world remains Omicron and the immunity of South Africans from vaccination and natural immunity is still strong, putting us in a better position and at less risk. That is why we have not seen any changes in rates of infection, hospital admission and deaths
We have consulted the Ministerial Advisory Committees (MACs) and World Health Organisation (WHO), and in both cases the advice has been that there is no need to impose travel restrictions on any country, including China, and that we do not need to re-impose any internal restrictions. However, we have been advised as follows:
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Increase the rate of testing i.e. we must encourage people who experience the known symptoms of Covid-19, such as flu-like symptoms including body aches, tiredness, loss of appetite and/or taste loss and even diarrhea, to approach health facilities and, encourage health practitioners to order antigen or PCR test. For every positive PCR test, a specimen must be sent to NHLS by all laboratories for sequencing.
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To increase Surveillance, the NICD will also increase wastewater testing for Covid-19 from flights arriving from high-burdened countries like China and possibly USA due to XBB.1.5 detection.
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Re-invigoration of the vaccination campaign for COVID-19 with improved communication and messaging. The Vaccines-Ministerial Advisory Committee will soon make adjustments for boosters’ qualifications per age and timelines between boosters.
Vaccination remains the bedrock to protect us against any variant and sub-variants, not travel restrictions. This approach and measures were approved by the National Coronavirus Command Council (NCCC) meeting today morning, 09 January 2023, chaired by President Cyril Ramaphosa.
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