'The govt has blood on its hands': State blamed for 'ineptitude' on Covid-19

The government's "total ineptitude" has come under fire from one of SA's most eminent vaccine and infectious diseases experts as the Covid-19 vaccination rollout struggles to take off and infections hit new highs.

Professor Shabir Madhi, who was dumped from the ministerial advisory committee in a purge of those whose advice was unpalatable to the government, said the slow rollout was the latest example of its preference for dogma over science.

His comments, in an interview with the Sunday Times, were echoed by other leading health scientists and coincided with a record daily rise in Covid-19 infections on Friday.

About 58% of the 24,270 new cases were in Gauteng. Scientists say a similar infection rate is imminent in other provinces.

The number of deaths is also soaring. The 1,711 fatalities nationwide this week exceeded the previous week's tally by 45% and are twice the total of 849 a week earlier.

Gauteng funeral director Sonja Smith said: "It's horrific. It's young people - even babies ... people we know."

Covid-19 beds in Gauteng's hospitals are expected to run out within days. Hospital staff used phrases like "beyond a catastrophe" when they spoke this week about shortages of nursing staff and equipment.

South African Medical Association head Angelique Coetzee said: "Now, when the country is in the midst of the third wave, the government is suddenly running around trying to stop our health system from collapsing. It's too late."

The number of vaccinations administered rose only modestly this week, reaching a new high of 136,954 on Friday. The health department's daily target is 250,000.

Professor Jeremy Seekings, director of the University of Cape Town Centre for Social Science Research, and UCT economics professor Nicoli Nattrass, who are tracking the vaccinations programme, said the programme needed to triple its pace.

Madhi, the dean of health sciences at Wits University and a former president of the World Society of Infectious Diseases, is frustrated by the slow rollout.

"Government seems intent on creating obstacles rather than creating an enabling environment," he said.

This comes after slow procurement, which he strongly lambasted.

"The government has blood on its hands. Hundreds of lives could have been saved," he said of the sale earlier this year of 1-million AstraZeneca doses.

Madhi, who led a South African trial of AstraZeneca, said: "There was a complete blind spot to the critical evidence. There was no safety issue and a decision was made to leave those at high risk unprotected."

This flew in the face of what the World Health Organisation recommended and was "an arrogance that came at a huge cost".

Mistakes had been repeated in the rollout with a "fixation on implementing technology rather than getting vaccines into the arms of people as quickly as possible, and that technology does not speak to our local reality".

Madhi said electronic registration had "simply not worked" to get people to register before rather than on the spot, and short notice for appointments was problematic.

The second major problem was that the government was "insisting that people without health insurance can't be vaccinated in the private sector".

Another difficulty was vaccinating at the peak of a resurgence. The government was not sending a critical message that symptoms in many cases were not because of vaccine side effects but because some unknowingly had the virus when they went for a jab.

"During a resurgence, you would have 10% to 15% of people at the vaccine site already brewing the virus. Three days later they get Covid and end up in hospital and blame the vaccine," Madhi said.

"This causes tremendous damage to confidence in the vaccines, and yet government has been completely silent about it and is not sending out a clear message that the association is temporal but does not infer causality."

In other words, it was about timing and not cause and effect.

Possibly most disturbing for Madhi is the "government's total ineptitude in adapting to science" by still rolling out second doses of Pfizer in a resurgence when those doses should be given as first doses to others.

"After a single dose, protection is at 92%. After the second dose, it only goes up to 96%," he said.

"It is too late for Gauteng," he said, but the other provinces should change immediately.

Madhi was a critic of some early lockdown regulations.

He said some, such as a curfew, were "meaningless". The only vital regulations were "complete restriction on any indoor gathering ... including places of worship, and consistent wearing of masks". The rest, he said, was "Covid theatre".

He said lockdowns "damage livelihoods" if the government can't enforce them.

Madhi's predecessor as dean of health at Wits, professor Martin Veller, said he was alarmed by the "massive strain" on Gauteng's health system, which coincided with "nonexistent" leadership in the provincial health department.

"The situation is currently bloody awful," he said.

On top of the delayed vaccines the "government is completely inept when it comes to lockdown implementation and continues to use them as terrible blunt instruments".

He said the government failed to use the evidence "that is right before it" on the enforcement of regulations that are proven to reduce transmissions.

Professor Mosa Moshabela, the University of KwaZulu-Natal nursing & public health school dean, said the government was reactive and afraid to take risks.

"Government is constantly in crisis response mode and does not look ahead to strategise.

"The public does not know what government's strategy is. Not knowing means one cannot support government's interventions.

"Bold risks should have been taken, like keeping the AstraZeneca vaccine. And it's understandable that the vaccination process in Gauteng is so slow, since they are fighting the third wave."

* This story has been amended since its initial publication to correct a quote attributed to Moshabela who in fact said it was "understandable" – and not "incomprehensible" – that the vaccination process in Gauteng was slow because they are busy fighting the third wave of infections.