Mia Malan Profile picture
17 Nov, 16 tweets, 10 min read
[Thread]. 1. What will influence the severity of a 4th #COVID19 wave?

New variants.

We don't know if there will be a new variant, but we do know that each previous SA wave was driven by a different variant:

Wave 1: Original form of SARS-CoV-2
Wave 2: Beta
Wave 3: Delta
2. What can we not for certain say about a 4th #COVID wave?

* We cannot predict if + when a new variant will emerge + what it will look like
* SA's modellers = decided to use a variant that can escape immunity (make jabs work less well) 4 their modelling 2 look @ a 4th wave
3. What else can influence what a 4th #COVID19 wave looks like?

Vaccination coverage.

Where are we at?
* About 16 million adults, or 40% of adults, have received at least one dose of vaccine
* 34% of adults = fully vaccinated

.
4. Where is SA at with #COVID19 infections?
1. 60-70% of SAs have likely had #COVID (this is what modellers estimate using different data sources)
2. This estimated infection rate is much higher than in the Northern Hemisphere
5. Modellers made the following assumptions for their estimations:
1. 70% of adults (and 75% of 60+) would have received one jab by the end of March
2. Vaccines = not 100% effective
3. Vaccine effectiveness @ #COVID infection wanes after 6 mnths, but no waning 4 hospitalisation
6. Modellers considered 4 scenarios:
1. Changes in behaviour in terms of mask wearing, social distancing, etc. (Think: Dec holidays; people = tired of measures)
2. A variant that reduces vaccine effectiveness by 25% emerges

They looked @ different combinations of these things.
7. Scenario 1 a and b:

a. If people slow down with mask wearing, etc in Nov (no new variant):
- Peaks of hospital admission = smaller than in previous waves

b. If they slow down in Jan (no new variant):
- Hospitalisations = later, but in nrs = about the same as in "a"
8. If we vaccinate a higher % of people of 60+ than in younger groups, there will be far fewer hospital admissions (60+ = most likely to fall seriously ill).
9. Scenario 2: People return to the way they behaved before #COVID19 (no masks, etc) despite increased infections (unlikely scenario) amidst a new variant that can escape immunity emerging.

- Admissions = higher than in scenario 1, but lower than in Wave 2 and 3, except for EC
10. Scenario 3: A new variant emerges that makes jabs 25% less effective, but people don't slow down with protective measures at all (unlikely scenario)

- Slow increase in admissions, but with higher peaks than in scenario 1
11. Scenario 4 (most realistic): New variant, people slow down with protective measures
1. Admission peaks lower than in Wave 2 + 3 (NC/FS = hard to model)
2. That doesn't mean hospitals won't run out of capacity as most of their resources = no longer allocated to just #Covid19
12. If we have a high (75%) vaccination rate among 60+ then hospital admissions for Wave 4's scenario 4 (new variant, slow down in protective measures) will be reduced significantly.
13. How many admissions did we have in previous waves?

Wave 1: 103,400
Wave 2: 149,300
Wave 3: 177,500

How many admissions will we have with scenario 4 for Wave 4?
About half of those in Wave 2 and 3
14. What will #COVID19 infections look like? In all scenarios they're still high, but the difference is that hospital admissions = lower because vaccines protect you against falling seriously ill with #COVID.
15: The crux?

Modelling predicts, with all 4 scenarios, that Wave 4 will generally have fewer people falling seriously ill with #COVID19 (so fewer hospital admissions) because of vaccination. So still many infections, but fewer hospital admissions and deaths.
16. Data source = @nicd_sa webinar this afternoon: we.tl/t-H7JvoK1Jyk

Full report here: bit.ly/3FlEHB0

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More from @miamalan

12 Nov
#Phaahla:
Which countries accept SA's digital vaccination certificate?

[Thread]

SA = not yet negotiated with countries, @healthza 1st needed 2 upgrade the security features of the cards

Why? Whether a country accepts a card depends on the features = in place 2 prevent fraud
2. Have any of the #VaccineRollOutSA digital vaccine certificate security features been upgraded so far?

Yes. The QR code on the cards will go live next week. That means 3rd parties will be able to scan the code to verify if the data on the card is valid.
3. What security features on #VaccineRollOutSA digital vaccine certificates still need to be upgraded?

A digital/cryptographic signature needs to be added. #JoePhaahla says that will go live by the end of Nov (you'll then have to download a new card).
Read 5 tweets
10 Nov
[Thread] 1. Five provinces in SA have fully vaccinated more than a third of adults against #COVID19.

Fully vaccinated = 1 shot of #JnJ or 2 shots of #Pfizer.

1. Limpopo: 41.6%
2. WC: 38.7%
3. FS: 38.3%
4. EC: 37%
5. NC: 33.5%

SA (national) fully vaccinated % = 32.5%
2. What is our goal?

We want to vaccinate 70% of people of 50+ with one shot of #COVID19 vaccine by the end of December (so before a 4th wave).

Where are we?
60+: 63.31%
50-59: 57.11%
3. Has any province covered 70% of people of 60+ with 1 #COVID19 vaccine shot?

Yes, Limpopo has vaccinated 76.17% of people of 60+ with one dose of vaccine (1 #JnJ or 1 #Pfizer shot).

WC isn't far off: 69.12% of 60+ = covered with 1 shot. (EC, KZN and FS = all above 65%)
Read 7 tweets
8 Nov
[Thread] 1. How many #COVID19 #vaccine doses has SA received and used since the start of #VaccineRollOutSA?

@HealthZA :
The total number of #JnJ and #Pfizer doses received by Nov 8 = 37,764,320
2. What's the breakdown — how many #JnJ and #Pfizer doses has #VaccineRolloutSA received?

@HealthZA :
JnJ: 10,695,200

Pfizer: 27,069,120
- Pfizer (bilateral agreement): 17,799,210
- Pfizer (COVAX): 1,392,300
- Pfizer (US donated doses via COVAX): 7,877,610
3. How many #COVID19 vaccine doses did #VaccineRolloutSA buy via bilateral agreements with #JnJ and #Pfizer?

@HealthZA :
#JnJ: 30,738,250 in Feb (we’ve received 10,695,200, so 34,8%)

#Pfizer: 30,002,310 in March (we’ve received 17,799,210 so 59,3%)
Read 17 tweets
6 Nov
LATEST #VaccineRollOutSA: Fri, 5 Nov

[Thread]

1. Jabs, past 24 hrs: 126,598 (Thu: 152,049 )
Adults: 109,827
12-17: 16,771

2. Total doses: 23,101,617

3. Adults fully vaccinated: 12,823,833 (32%)
(18+ pop = 40.1mil)

4. 12-17, 1 #Pfizer: 201,646 (3.1%)
(12-17 pop = 6.5 mil)
2. What % of adults have received at least 1 dose of #COVISD19 vaccine, so 1 shot of #JnJ (fully vaccinated) or 1 shot of #Pfizer (partially vaccinated)?

39% of adults, or 15.5 million people

Why is this important? @healthza
's goal = 70% of adults must have had 1 jab by Dec
3. Will we make @heatlhza's goal to have 70% of adults vaccinated with 1 dose of #JnJ/#Pfizer by Dec?

No. @healthza
is now aiming for:
70% of adults of 50+

Where are we with this?
60+: 63.13%
50-59: 56.8%

Everyone of 50+ = 60.2% (so we're 9.8% or 1 mil jabs from the goal)
Read 7 tweets
4 Nov
[Thread] BREAKING 1. Real-world @Discovery_SA data on how well #Pfizer's two-dose #COVID19 jab works in SA:

14 days to 3 months after taking the 2nd shot: :
- 94% effectiveness @ COVID-related death
- 92% effectiveness @ COVID-related hospitalisation
2. What is real-world effectiveness?

It’s data from an actual vaccine roll-out. During studies jabs = used under tightly controlled conditions. In the real world those conditions = more fluid. Real-world data = how well jabs work outside of a trial.
3. Is there a difference between the protection offered by 1 dose of the #Pfizer jab and 2 doses?

Yes.

- 1 dose = 78% effective @ hospitalisation (28 days after you’ve had a jab)
- 2 doses = 94% effective @ hospitalisation (14 days after the 2nd jab)
Read 11 tweets
29 Oct
[Thread] 1. What's happening with #COVID vaccine boosters in SA?

Nicholas Crisp, @heatlhza:
1. SA = not yet vaccinated enough people to focus on boosters for large groups of people
2. HCWs = special group as they get exposed to #COVIVD19 more so their infection risk = higher
2. Crisp:
1. Some #HealthWorkers vaccinated in the #Sisonke trial were vaccinated 8 months ago, so they may need booster shots
2. They will receive 2nd #JnJ doses in a study starting in Nov
3. What about people with weak immune systems who may need boosters?
Crisp:
The MAC has advised that people with a specific set of immunocompromised conditions get a 3rd #Pfizer/2nd #JnJ dose 28 days after they were fully vaccinated. This is not a booster, but an extra dose.
Read 8 tweets

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