Our choices are key to delaying a possible third wave of COVID-19 infections

We must keep up our guard and continue to curb the spread of COVID-19 infection. We must also take the lessons from our devastating second wave of infection. Our individual choices will continue to fundamentally define the timing, scale and severity of our nation's third wave of COVID-19 infection.

South Africa experienced its first wave of COVID-19 in 2020 (peaking in mid-July) and a larger second wave peaking in January 2021, in which 501Y.V2 - a new variant of the virus that causes COVID-19 (the SARS-CoV-2 virus) became dominant.

This wave was in part fuelled by the increased transmissibility of the new variant and also by super-spreader events - gatherings of people where one or more people who have COVID-19 cause others to be infected and cause an outbreak among attendees. Super-spreader events include church services, weddings, funerals and large family parties (say, for birthdays or celebrations). Wherever we are, the more people attending an event, the higher our risk of contracting COVID-19. Super-spreader events aren't necessarily always linked to huge gatherings.

Despite the drop-off in cases since the peak of the second wave in January, experts believe we will face a third wave of the COVID-19 pandemic. When? It's likely to hit us just before the start of the colder, winter months of this year, and so coinciding with our yearly flu season. This means a double whammy in our risk of becoming ill, particularly for people considered to be at high-risk for severe COVID-19 illness or severe illness linked to contracting the flu.

The time to prepare for, and to delay, the third wave of infection is now. Here's how

To prevent the resurgence of infections, we need to ensure two things:

1. The success of the first (aimed at healthcare workers) and second phases (aimed at high-risk South Africans and essential workers) of South Africa's COVID-19 vaccine rollout
2. 2. That we are doing all we can as individuals and as a collective to prevent super-spreader events by ensuring we:
   • Wear appropriate facemasks when in public (and avoid touching them)
   • Frequently wash (use soap and water for at least 20 seconds) or sanitise our hands
   • Practice physical distancing
   • Stay at home when sick, practice coughing and sneezing etiquette
   • Quarantine for 10 days when exposed to someone who has COVID-19 and self-isolate for 10 days (or more, as needed) when we contract COVID-19
   • Avoid crowded and poorly ventilated places.

"We've lived through a long and challenging 12 months under lockdown, along with most of the rest of the world. This has been necessary to protect us," says Discovery's Chief Executive Officer, Adrian Gore. "Given the lockdown's suppressive effects on the financial wellbeing of South Africans, we unequivocally support opening up the economy. However, it is critical that we remain fully aware that there is still significant risk to us as individuals and as a country - now is not the time for false confidence or lowering of our guard against the ongoing risk of COVID-19 infections."

What we have learnt thus far from wave 1 and 2

South Africa's second wave of COVID-19 infection was severe. Based on the Medical Research Council's data on excess deaths, it is estimated that there were more than 130 000 deaths, likely from 30 million infections, for both wave 1 and 2 combined. Thankfully, infection rates have reduced dramatically and consistently for the last six weeks. In fact, the first week of March 2021 was the first week in which Discovery Health Medical Scheme recorded COVID-19 hospital admission rates at levels last seen in September 2020 (after the first wave started and before the second wave started).

"However, the data from the second wave demonstrated how the choices people made influenced the severity of the wave itself," adds Adrian. "It is clear from Google Mobility data that from the early weeks of December 2020, with the onset of holidays, rates of travel increased in our country. At the time, citizens were unaware that a second COVID-19 variant was spreading. Our data also indicates that just a few super-spreader events led to rapid transmission in the population."

Our monitoring of wave 1 and 2 has allowed us to understand the primary factors that influence the severity of waves of infection. They are:

1. The proportion of the population at risk of infection
2. The probability of coming into contact with the virus, coupled with the high transmissibility of the virus
3. Risk factors relating to age, chronic conditions and lifestyle.

Some insights relating to the above:

• Our analysis indicates that over the course of the first and second wave, over 50% of South Africans were infected with COVID-19. This means that a large proportion of the population will now have some degree of immunity, relative to many other countries.
• Critically, however, it is still possible to be reinfected with COVID-19. Our analysis further indicates that if you've had COVID-19 and recovered, approximately one in three will be reinfected if exposed to COVID-19 again.
• Importantly, your chances of reinfection increase or decrease in line with whether you take the right precautions - social distancing, frequently washing hands, working from home if you can, avoiding social gatherings (especially in enclosed places), amongst others.
• Encouragingly, our data also shows that among people who contract COVID-19, those who exercise regularly significantly reduce their risk of severe COVID-19 illness, hospital admission and death.

What this means for the months ahead

All of these factors must continue to be top of mind. Now is absolutely not the time to be complacent and relax our adherence to critical prevention measures.

While we are thrilled that phase two of the vaccine rollout programme is well underway, we are fully aware that it will take some time before a significant part of the population is vaccinated. We, therefore, urge you to be mindful; the data does not lie - everyone's actions matter. We have to act responsibly, together, at all lockdown levels. Thank you for every effort you've made thus far to make our country safer for all.