Published on 1 March 2021 in the SA Medical Journal, the article titled Viruses, variants and vaccines was co-authored by Rhodes University’s Professor Rosemary Dorrington from the Department of Biochemistry and Microbiology. The article addresses some of the major global clinical, sociological and economic issues brought about by the SARS-CoV-2 pandemic, focusing on short-term factors such as virus variants and vaccine efficacy, and also considers the longer-term implications of the current pandemic.

According to the article, SARS-CoV-2 will probably remain in circulation for decades or longer. However, “The core issue is not whether SARS-CoV-2 is here to stay, like its common cold-causing relatives, but how we as the human race will deal with it in the medium to long term. How will human behaviour and lifestyles ‘normalise’ in a ‘post-COVID pandemic’ world?”.

Th authors contend that although vaccines are becoming available at an unprecedented rate, vaccination programmes are subject to various limitations such as vaccine production capacity, affordability and access. Concerns over high-income countries’ governments ‘buying up’ large proportions of the available vaccines, (so-called vaccine Nationalism), leaves low- to middle-income countries (LMICs), which account for the majority of the global population, in the disadvantaged position of not being able to vaccinate their vulnerable (and often poverty-stricken) communities, even where financial provision has been made. As such, it is imperative that LMCIs continue to practise nonpharmaceutical interventions such as hygiene, social distancing and lockdowns.

“It is likely to be some years before the global community has developed sufficient immunity to overcome the COVID-19 pandemic, and national and international agendas will need to take this into account,” the article says.

Regarding SARS-CoV-2 variants, many now exist across the world, and there are probably many more that have not yet been detected because of absent or inefficient surveillance programmes. The authors warn that additional SARS-CoV-2 variants will continue to emerge in the future – we can be sure of this as long as the pandemic continues.

An uncomfortable revelation in the article speaks to South Africa and Africa’s vaccine manufacturing capacity overall. It states: “It is perhaps not widely known that SA currently manufactures just one component of one paediatric combination vaccine: the country effectively has no significant human vaccine manufacturing capacity and the same is true for the whole of Africa. There is therefore effectively no emergency-response vaccine manufacturing capacity on a continent that is home to over 1 billion people. This MUST change, or Africa will always be at the wrong end of the global queue for emerging disease vaccines – and the next pandemic could well be far worse than the present one.”

In addition, the article explores how the world will adjust, once the COVID-19 pandemic has subsided. It highlights that everyone needs to be equipped to manage ‘normal’ (working) life in an increasingly infectious environment.

COVID-19 is just the latest in a series of severe viral diseases circulating in the human population, the article explains. As such, an approach that surveys diseased animals and humans, such as the seroepidemiological and genomic surveys of stock animals in SA for viruses associated with encephalitic disease, is necessary.

According to the authors, one key to managing future virus epidemics is through broad, meaningful community-based education, driven by heightened awareness that compliance will come from everyone being provided with relevant information, which must be available, understandable and accurate. “People from all disciplines will need to work in integrated, collaborative ways to provide information and educate communities. Moreover, leadership in science communication will be as important as leadership in science itself,” the article says.

In conclusion, the authors offer five recommendations that relate to surveillance, increasing pharmaceutical production capacity, promoting equity in terms of access and increasing educational and awareness programmes.

A full list of the article’s authors are:

• D A Cowan, Centre for Microbial Ecology and Genomics, Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa
• S G Burton, Future Africa and Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa
• P Rybicki, Biopharming Research Unit, Department of Molecular and Cell Biology, Faculty of Health Sciences, University of Cape Town, South Africa
• A-L Williamson, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
• R A Dorrington, Department of Biochemistry and Microbiology, Faculty of Science, Rhodes University, Makhanda, South Africa
• M S Pepper, Institute for Cellular and Molecular Medicine, Department of Immunology, and South African Medical Research Council Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa