The emergence of the new C.1.2 variant of the coronavirus in South Africa has heightened fears that the spread of the disease is increasingly undermining the efficacy of vaccines. According to researchers from South Africa’s National Institute for Communicable Diseases (NICD), C.1.2 is more mutations away from the original virus detected in Wuhan than any other variant identified worldwide. The new variant has already been found in England, China, the Democratic Republic of Congo, Mauritius, New Zealand, Portugal and Switzerland.
While the study analyzing the C.1.2 mutation still needs to be peer-reviewed, the emergence of this and other variants show that the pandemic is far from over. Indeed, case numbers have only increased across the globe despite widespread vaccination campaigns, with at least 100 countries battling higher numbers of cases in the past two weeks compared to the previous fortnight.
Cases on the rise in South Africa
Africa is at the center of this newest outbreak, where case numbers and deaths due to Covid-19 have skyrocketed as a third wave takes hold. From June to July, the continent recorded an additional one million cases – the fastest jump to an additional million cases ever recorded – while the number of deaths increased by 40% within a fortnight.
While the whole continent is affected, South Africa has become the worst-hit on the continent, with over 2.3 million confirmed Covid-19 infections. The number of national excess deaths, viewed as a more exact measurement of total fatalities from the virus, has risen to more than 200,000 people, and has set new pandemic-era records in the country’s more populated provinces.
The situation is exacerbated by the chronic shortage of intensive care unit (ICU) beds around the country as a consequence of spiking case numbers. The fire-related closure of Charlotte Maxake Hospital in Johannesburg, which normally has more than 1,000 usable beds, has stretched already-scarce resources to their breaking point.
Treatments like Leukine as the golden bullet?
Battling a pandemic, however, requires more than just beds: as frontline workers scramble to maintain screening, testing, isolation and contact tracing programmes alongside an endless demand for personal protective equipment (PPE), it is clear that new approaches are required to turn this public health crisis on its head. While vaccines are an important part of the public health response, the emergence of new Covid variants means that treating acute infections is increasing in priority relative to preventing infections in the first place.
Several treatments for acute Covid infections and its effects are already in trials with the objective of increasing the rate of survival and lessen the long-term effects of those suffering from serious Covid. One such candidate is sargramostim, also known as Leukine, from the American biotechnology firm Partner Therapeutics. The drug showed promise in trials carried out by University Hospital Ghent at five hospitals in Belgium. The trials showed that Leukine was effective in restoring oxygen uptake in the lungs, while also activating T-cells that boost the body’s own immune response against the disease. According to the study’s authors, these T-cells are the same cells that tend to be observed after vaccination. A follow up study, conducted at 11 U.S. hospitals and supported by the U.S. Department of Defense, evaluated 122 patients with acute hypoxemia due to Covid-19 infection, finding that Leukine successfully improved oxygenation in 84% of those hospitalised.
Taking the terror out of Covid
These results are encouraging at a time when even AstraZeneca has managed to throw a new treatment into the ring following the failure of an earlier trial. This new treatment relies on monoclonal antibodies, or lab-made proteins, that boost immune responses by binding to proteins on the Covid-19 virus. A Phase 3 study is currently underway with more than 5000 participants to determine the immune response to AstraZeneca’s drug.
Ultimately, there can be no doubt that effective coronavirus treatments are essential for South Africa and across the globe. Researchers say the discovery of an immunity-boosting treatment could prove vital for tackling future variants that are more resistant to vaccines. As terrifying a prospect as this is, health authorities warn there is a very real chance of this kind of variant evolving in the near future. In fact, recent research has already indicated the Peruvian lambda variant may be more resistant to vaccines than other strains.
As South Africa is still in lockdown but with a view to ease restrictions if the case numbers decline, Pretoria needs to adapt its public health policy from one marked by reaction to ongoing events to one defined by forward-looking pre-emption in order to avoid worst possible outcomes. Considering the unremitting emergence of new Covid-19 variants, and the looming risk of vaccine-resistant strains, the race to provide an immune-boosting treatment – and using it consequentially – is on.