It was a logical step for UKZN Pro Vice-Chancellor for Big Data and Informatics, Professor Francesco Petruccione, to turn to the online world so as to continue with his monthly data@breakfast seminar series in a time of national COVID-19 lockdown.
With the use of the online “zoom” webinar tool, some 130 participants – each sitting in the comfort of their own home on Day 1 of South Africa’s national #stayathome – tuned in at 07h30 sharp to listen to a highly topical and lucid talk presented by UKZN COVID-19 war room member, Dr Richard Lessells. Lessells’s talk tackled the issue of responding to the COVID-19 epidemic, and provided both a local and global perspective.
Lessells* – an infectious disease specialist based at UKZN’s Research Innovation and Sequencing Platform (KRISP) – is currently deployed to the UKZN COVID-19 war room and is supporting the local response to the epidemic.
‘COVID-19 is a remarkable epidemic that is going to change us fundamentally in many ways, including how we work as academics,’ said Lessells. ‘News first came out of a cluster of people with undiagnosed pneumonia in Wuhan, China, on ProMED on 30 December 2019. In just three months we have reached the half a million mark of diagnosed infections worldwide, and the epicentre has shifted from China to Europe to the USA. Such a pandemic was something we as epidemiologists were aware could happen at some stage. As countries we were prepared but at different levels. Countries expected to have coped have struggled.’
Lessells’s presentation provided a clear and cogent overview of the spread of COVID-19 around the world, the trajectory that the disease has followed in different countries, and the positive impact early testing and quarantine has had on the steepness of the infection curve.
‘Widespread testing, including of asymptomatic people, is what has made the difference and led to relatively low mortality in countries such as South Korea,’ he said.
International statistics presented by Lessells pointed to a higher mortality rate amongst older people. He noted, however, that whilst South Africa’s population pyramid indicated a younger population than a country such as Italy, which theoretically should work in its favour, what was not yet known was the effect that HIV and TB would have on the rate of COVID-19 infections. With South Africa being at the epicentre of the fight against AIDS, Lessells stressed the importance of people finding out their HIV status and taking the necessary medication if COVID-19 was to be tackled comprehensively.
In discussing the transmission dynamics of COVID-19, Lessells said that the R0 (Basic Reproduction Number, viz. how many people on average one person will infect) was estimated at 2-3, which made it significantly more transmissible than flu. Factors that affected the R0 included probability of transmission per contact between infected and susceptible (p), contacts per unit time (c) and duration of infectiousness (d). Global interventions were aimed at reducing this R0.
When questioned on the possibility of a vaccine being developed, Lessells cautioned that whilst ‘the startling fact of this epidemic is how quickly the science has happened,’ a widely available vaccine was at least 18 months away. ‘Where we are now, the essential thinking is to reduce contact between people, because this is the main variable that we can currently control. Transmission is primarily via droplets and contact. These transmission methods lead to the recommended measure of physical separation and respiratory and hand hygiene.’
Lessells explained that Stage 1 of South Africa’s response had focused on a public information campaign, international travel restrictions, school and university closures, and the limiting of mass gatherings.
‘The cornerstone of our public health response has been the identification and isolation of infectious cases, with monitoring and quarantine of close contacts.’
As South Africa entered the next phase of lockdown, Lessells explained the implications: ‘The purpose of the lockdown is to reduce the overall contact rate in the population,’ he said. ‘On its own, lockdown won’t extinguish the epidemic, but it buys us time. We need to use this time wisely.’
Lessells strongly supported advice provided by the World Health Organisation – who he praised for doing a remarkable job – on how to optimally use this window of opportunity provided by lockdown. In closing, he quoted Dr Tedros Adhanom Ghebreyesus, the Director General of the WHO: ‘Use this time to expand, train and deploy your public health workforce. Implement a system to find every suspected case at community level. Ramp up the production, capacity and availability of testing. Identify, adapt and equip facilities you will use to treat and isolate patients. Develop a clear plan and process to quarantine contacts. And refocus the whole of government on suppressing and controlling.’
UKZN’s COVID-19 war room efforts have been supported by a big data consortium led by Petruccione, which provides daily statistical updates to track the behaviour of the epidemic in South Africa.
‘We have amazing data visualisation tools,’ said Lessells. ‘What the graphs and statistics show us is that COVID-19 behaves in much the same way wherever it is and whatever the country. But the impact the virus has depends on us as humans and how we handle it.’
‘I am very happy that we have managed to continue with the tradition of data@breakfast in these challenging times,’ said Petruccione. ‘It is ironic that we just needed a tiny little virus to accelerate our use of the tools of the Fourth Industrial Revolution!’
‘The COVID-19 team at UKZN are doing exceptional work.’
*Dr Richard Lessells trained as an infectious diseases and internal medicine physician in the UK and has a PhD from the London School of Hygiene and Tropical Medicine. He has been conducting clinical and population-based research in HIV and TB in KwaZulu-Natal since 2007 and is based at KRISP, UKZN.
You can watch a video recording of Dr Lessells’s talk below.