Winter of discontent ebbs as COVID-19 cases fall

Mbongeni Mguni | Monday July 11, 2022 11:44

Experts in the Ministry of Health believe the country has seen the worst of the fifth wave of COVID-19, which manifested in late May causing cases to exponentially rise in recent weeks.

In the week from 19 to June 25, the country recorded 2,351 cases, down from 3,718 cases between June 12 and 18 and considerably lower than numbers of 4,000 and above for the preceding weeks dating back to the end of May when the latest wave began.

“It would appear that we have reached our peak of cases and the numbers are slowing down,” Health Ministry public health physician, Thebeyame Macheke told a televised update recently.

“Infection and transmission is going on, but the rate is lower than when the wave first began.”

The number of mortalities however remains high, with 21 deaths between June 12 and 18, compared to 11 between June 12 and 18. Macheke explained that deaths generally lag cases, as the affected patients are hospitalised, undergo treatment and deteriorate before eventually passing away.

The latest numbers and trends give hope that the winter spike in COVID-19, anticipated and dreaded by authorities and Batswana prior to the beginning of the cold season, is easing without the horrors witnessed by the country last year.

Last June and July were the worst months of the pandemic in Botswana, with cases peaking at a collective 69,711. That July was the single hardest hit month in terms of COVID-19 mortalities, with deaths rising to 573, from 219 in June and from an average of 184 in the five months before then.

During that period, funeral notices became a daily occurrence for many, as both public and private hospitals overflowed and the limited health human resources were stretched to breaking point. Reports emerged of stricken patients waiting for hours in the parking lots of health facilities, while the major hospitals issued notices essentially asking patients to stay away as they were filled up.

The uptick in cases last winter was driven by the delta variant of COVID-19, which is more aggressive in terms of transmission and tends to have worse outcomes in terms of the disease burden. Cases were also worsened by the then low levels of vaccination, as the country’s immunisation campaign had only kicked off months earlier in March, with few doses in hand and the risk-based approach targeting the most elderly, as well as healthcare workers.

Since the winter horrors last year, COVID-19 in the country has been driven by the initial Omicron variant and its subsequent subtypes, which, while far more easily transmitted than delta, have generally proved less deadly and also met with higher levels of immunity due to higher vaccinations.

The initial Omicron variant which drove the pandemic’s fourth wave lasting from late November to March, saw mortalities peak at 106 in January, while the fifth wave, being driven by subtypes, has seen mortalities peak at 41 in June.

Despite the more positive outlook for the pandemic in the short-term, authorities have said an analysis of mortalities indicates the continuing threat of COVID-19 for the country. Most mortalities recorded have been amongst the elderly, particularly those above 55 years, and have been in patients with co-morbidities such as cancer, HIV, diabetes and high blood pressure. In addition, most mortalities have been patients who were vaccinated but did not come forward for boosters, meaning their initial immunity had elapsed.

The trend, authorities say, indicates that while younger generations may not suffer severe illness from the virus, they still pose the threat of passing it onto the more vulnerable elderly.

The situation is compounded by stagnant vaccination rates, with 1.52 million people or 60% of the population inoculated at the last count, less than the 70% target set by the World Health Organisation for mid-2022.

The Health Ministry this week launched a vaccination drive for children aged between five and 11 years, while introducing booster shots for those aged between 12 and 17. People aged between 12 and 49 who are classified as immuno-compromised such as cancer patients, can now also receive a second booster.

“For children, when schools are open, outbreaks occur and the children infect their elderly, more vulnerable family members,” Macheke said.

While children are accessed through school immunisation campaigns for first doses and boosters, health authorities continue to face a challenge persuading other age groups to come forward for boosters, particularly those aged between 18 and 30.

The Health Ministry has launched a study into the reluctance, but in the meantime, officials have some guesses.

“When we had the delta variant, everyone wanted to get vaccinated although we had do the risk based approach,” Macheke said.

“When people were vaccinated and saw the usefulness of that, by the time Omicron came, it did not affect us as much as delta and some started believing that COVID-19 was gone or not as deadly.

“Risk perceptions changed.

“In addition, recently when we did not have many cases or going from week to week with zero cases, some people began asking why we were busy taking about this virus, thinking it was gone.

“But here it is again.”