Johannesburg - The Kraken is here, but there is little to fear from this latest variant of the Covid-19 virus – and, whatever you do, don't spread panic on social media.
That’s the advice from some of the country’s foremost Covid-19 experts, who are all in agreement that, despite its fearsome mythological meaning (an enormous mythical sea monster said to appear off the coast of Norway), South Africans have nothing to fear from the Kraken Covid-19 variant.
Minister of Health Joe Phaahla said his department and its entities had been monitoring developments around Covid-19 globally since the lifting of restrictions in June 2022.
Genomic surveillance has also been continuing under the Network for Genomic Surveillance of South Africa, based at Stellenbosch University.
In December, there was a global increase of 25% (14.5 million) in new cases and 12% (46 600) in deaths reported as compared with November 2022. Japan, South Korea, the US, China and Brazil represented 70% of these new cases.
In the last week of December, new cases declined in all of the above-mentioned countries except China, where cases increased by 45% and deaths rose by 48%. The situation initially caused great panic in various parts of the world, including among some South Africans.
There are 12 countries/regions known to require a negative PCR test less than 48 hours old for travellers from China. These include the US, the UK, Canada, France, Taiwan, the Philippines, Spain, Italy, India, Israel, and Japan. Malaysia and South Korea require a PCR test and testing again on arrival, while Morocco has imposed an outright ban on travellers from China.
Other countries have not changed their position, meaning no new measures have been put in place, while Germany, New Zealand and South Africa have formally indicated that no new requirements will be imposed.
What scientists know at this stage is that the SARS-CoV-2 variant of concern which remains dominant in the world (at between 97% and 98%) remains Omicron.
Omicron has had more than 100 sub-variants since it started to dominate the Covid-19 environment in late 2021. And while the various sub-variants have shown different levels of transmissibility, there has been no marked change in the severity of illness.
The main reason for China’s reported overwhelmed health facilities and high number of deaths is the recent lifting of restrictions there, which has allowed people to travel as they wish after prolonged lockdowns. The situation has been exacerbated by China’s high population, limited natural immunity, and apparently limited vaccination rates, especially in small towns and rural areas.
“We believe that the fact that the dominant variant of concern in China and the world remains Omicron, as well as the fact that the immunity of South Africans from vaccination and natural immunity is still strong, puts us in a better position and means we are less risk.
“That is why we have not seen any changes in rates of infection, hospital admissions and deaths. We have consulted the ministerial advisory committees and the World Health Organisation, and in both cases the advice has been that there is no need to impose travel restrictions on any country, including China, and that we do not need to reimpose any internal restrictions,” Phaahla said.
South Africa and many countries around the world have, however, been urged to increase the rate of Covid-19 testing and encourage people who experience the known symptoms of the disease to get tested.
Professor of Vaccinology at Wits University Shabir Madhi said South Africans shouldn't panic.
"It is unclear what value exists in publicising something on social media which is not clinically relevant,” he said.
“We need to become more circumspect about sharing on Twitter with regard to what remains an ever-evolving variant for the past year – with repeated claims of greater transmissibility –which generally has remained clinically irrelevant in settings with high levels of immunity against severe disease. Alternatively, we risk creating unnecessary public panic and confusion. The data from the US, where XBB.1.5 dominates, does not show any major upswing in hospitalisation,“ Madhi said.
“In SA, Covid hospitalisation still occurs, although at low rates, which is expected. Even if XBB.1.5 is more transmissible and more able to evade antibody-neutralising activity, there is no indication that it is evading T-cell immunity, which mediates protection against severe disease. Furthermore, in SA, where almost two-thirds of the population was infected with BA.1 (the original Omicron variant), such infection confers protection against XBB.1.5, and even more so in people who have also been vaccinated,” he said.
Professor Jeffrey Mphahlele, the Deputy Vice-Chancellor for Research and Innovation at North-West University and a member of the ministerial advisory committee on vaccines, said he also believed there was no need for travel restrictions on citizens from any country visiting SA, and that reintroducing internal restrictions should not even be contemplated.
“The world is in a different phase of the pandemic, and we should learn how to live with the virus. XBB.1.5 will not be the last variant to emerge. More variants are likely to be seen in future, and it would not make sense to panic every time there is the emergence of a novel variant,” he said.
Professor Hannelie Meyer, head of the SA Vaccination and Immunisation Centre at Sefako Makgatho Health Sciences University, agreed that there was no reason to panic.
“Data on this new sub-variant is still limited, but there is currently no evidence of its ability to cause severe disease or lead to increased hospital admissions or deaths. Also, in South Africa we currently still have good population immunity from previous infection and vaccination,” she said.
On the question whether to wear a mask or not, Meyer said this should be a personal decision.
“Most importantly, we need to remain vigilant, because the virus is still circulating and people are still getting Covid-19. Get vaccinated if you have not received the vaccine yet, and get a booster if you are eligible for a booster. People must take responsibility for their own health,” she added.
Leading epidemiologist Professor Salim Abdool Karim said the newest Covid-19 variant XBB.1.5 was not necessarily one of concern, but was rather a mutation of Omicron.
“Because Omicron had so many mutations, this has now led to XBB.1.5.”
Abdool Karim, who is also the director of the Centre for the Aids Programme of Research in South Africa, explained that in South Africa the original Omicron variant began dominating in December 2021 and January 2022.
The nation then had BA4 and BA5 in May and June last year, which were also mutations of Omicron. XBB.1.5 is a relative of BA5 and stems from this variant, he said.
But Abdool Karim warned that new Covid-19 mutations are often able to spread faster than previous variants.
“If they don't, then they will be unable to be dominant, and as an example Delta has to spread faster than Beta in order for it to take over. Because it spreads faster, it means that it is more infectious, and because it transmits faster, it infects more people more quickly.”
He added that the elderly needed to be given booster shots so that they would have more antibodies to offer greater protection against the virus.
Abdool Karim also warned against labelling XBB.1.5 as the “Kraken” variant, as he considered this to be “scaremongering.”