Thread by @miamalan

🧵1. It used to be straightforward to determine when we were in a #COVIDinSA wave. Everyone used the ministerial advisory committee’s formula. In 2022, things are a bit more complicated. Some researchers argue this method is no longer all that useful. bit.ly/3wkRRwv

2. If we use the MAC formula, the fifth wave started on May 7. But since these numbers alone no longer translate into curfews, lockdowns or liquor bans, @nicd_sa researchers believe a new benchmark may be necessary. bit.ly/3wkRRwv

3. The @nicd_sa's @Dr_Groome says #COVID19 case numbers have become less meaningful — using them to calculate a wave, even more so: “Severe outcomes like hospitalisations and deaths are better metrics to use now that we have seen the decoupling of cases and severe outcomes.”

4. Decoupling means that a smaller % of new cases now fall very ill with #COVID or die of it than in pre-#Omicron waves. A Nature study found people infected with Omicron have a 2-5-fold lower risk of dying than people infected with the #Delta variant.
nature.com/articles/s4157…

5. So what we now want to keep track of most is whether — and when — new infections will put strain on our health system because of hospital admissions, rather than how many new #COVID cases we have, says @Dr_Groome.

6. @Dr_Groome: "The purpose of calculating the beginning + end of previous waves with case numbers = 2 adjust public health measures accordingly. But increases in cases alone = no longer lead 2 public health interventions. We now need 2 redefine what we consider 2 be a wave."

7. So why should we still care about #COVID19? People still die, even of #Omicron. 9 557 people in South Africa died of #COVID between 1 Jan 2022 and 15 May (almost all cases were Omicron infections) bit.ly/3wkRRwv

8. 9 557 #COVID19 deaths = only the reported cases. @MRCza estimates that at least 85% of excess deaths in the country can also be attributed to COVID.
Excess deaths tell researchers how many more people died in a certain period of time than those expected.

9. Since the start of 2022, SAMRC and University of Cape Town researchers tallied an extra 22 823 deaths. 85% of excess deaths could be #COVID-related, so the true death count for 2022 (so far) = likely more than triple the official figures (32 380).
bit.ly/3wkRRwv

10. Compare this to other respiratory infections such as the flu. According to @nicd_sa, flu kills between 6 000 and 11 000 people per year in the country.

11. But dying or getting hospitalised are not the only COVID-related risks — research shows #COVID can cause long-term heart (cardiovascular), brain (neurological) or hormonal (endocrine) effects.

12. Scientists in the UK took scans of people’s brains before + after they were infected with #COVID19. People who caught the bug showed signs of brain damage in brain sections that play a role in memory/ smell — even people who had mild forms of #COVID. go.nature.com/3a1IQ2B

13. There's also #LongCOVID. International studies have shown that long COVID could affect between 25% and 35% of people who were infected with SARS-CoV-2. bit.ly/3wkRRwv

14. #LongCOVID has a list of over 50 debilitating symptoms such as persistent headaches, fatigue, hair loss, shortness of breath and attention disorder, that can show up months after someone has recovered from #COVID19 infection.

15. Recent studies have shown that even people who had no visible symptoms when they got infected with SARS-CoV-2, can develop #LongCovid. ncbi.nlm.nih.gov/pmc/articles/P…

16. Most people with #LongCOVID just don’t recover after they get sick initially, says Resia Pretorius, the head of Stellenbosch University’s department of physiology. “Instead, their symptoms ebb and flow, but never fully disappear.”

17. New #COVID19 treatments are becoming available to lower the chance of severe disease and death in infected people — but these treatments are expensive, for now, they're mostly only available in high-income countries.

18. In the absence of these #COVID19 treatments in SA's public health sector, the best ways to reduce your risk of falling very ill with #COVID = either not get infected or to develop immunity from getting vaccinated, naturally infected, or both. bit.ly/3wkRRwv