At a virtual media briefing on COVID-19, officials of World Health Organisation and Nigeria Centre for Disease Control assured that African countries will get 900 million doses of vaccines and played down fears about severity of new Coronavirus variants, reports Moses Emorinken, Abuja
With spikes in COVID-19 cases, Nigeria and many African countries are already battling with how to manage a second wave of infections. Latest updates from the Nigeria Centre for Disease Control (NCDC) indicated that the country, as at the time of this report, had recorded 103,999 confirmed cases, with 1,382 deaths so far.
Africa has also recorded at least 25,000 deaths in the last two weeks, going by information from the World Health Organisation (WHO). To make matters worse, new variants of the virus have started to spring up across the globe with noted cases in South Africa, Botswana, Gambia, Zambia, United Kingdom, and other countries in Europe, Asia, North America and Australia.
However, WHO and other health experts have re-echoed that the manifestation of new variant should not be a cause for worry or panic, as available data shows that the new variants only have effects on the rate of transmission, but has no proven effects on diagnosis, severity, therapeutics and vaccines efficacy. Speaking during its first virtual media briefing on COVID-19 yesterday, WHO Regional Director for Africa, Dr. Matshidiso Moeti, explained that researches are underway to undress and understand the epidemiological implications of the new variants.
“While in 2020 Africa was spared much of the worst of COVID-19 with relatively fewer infections, cases and deaths compared to other regions of the world, we start a new year facing new threats from the virus, with an average daily new case count of more than 25,000 in the last 14 days. Africa is experiencing the second wave, which is higher than the peak experienced last July. We know that these numbers are likely to grow as the impact of holiday season and other get together becomes evident.
“The continent has now topped three million cases with over 72,000 lives sadly lost. This is a stark reminder that the virus is relentless, and that it still presents a manifest threat, and that our war is far from being won. In addition, we are now confronted with new variants of the virus. It is not surprising because the more the virus spreads, the higher the likelihood of mutations. However, some of these changes are concerning. Preliminary analysis finds the new variants circulating in South Africa to be more transmissible and it appears to be driving the surge in new infection in the country and in the sub-region.
“Genomic sequencing has found the 501y.v2 variant present in three other countries – Botswana, Gambia and Zambia, and it could be present in more countries. Deep investigations are underway to fully understand the epidemiological implications. But at present there are no indications that the new variant increases the severity of the disease. There is also no conclusive evidence that it will lessen the effectiveness of COVID-19 vaccines. However a virus that can spread more easily will of course put further strain the health system, and health workers who are in many cases already overwhelmed and overstretched. There is still much to learn.
“It is important for countries to improve routine sequencing of SARS-COV-2 viruses on the African continent to better monitor the emergence of variants and their consequent spread across countries.
“When we know how the virus has changed and fully understand the epidemiological and pathological significance of that change, then we can adjust our response accordingly. WHO, together with our colleagues at the Africa CDC, has supported countries to set up genome sequencing through a network of specialised laboratories. We are also helping in shipping samples, providing laboratory supplies, as well as technical guidance and mobilising funds. WHO is also working with a group of international scientists to coordinate research efforts. While we continue to increase our knowledge of COVID-19, we must persist with the proven public health measures that helped to slow down the spread of virus during the first wave including wearing masks and physical distancing,” Moeti said.
In his presentation, NCDC Director-General, Dr. Chikwe Ihekweazu, explained that there is still no evidence to show that the variant found in Nigeria, the p681h variant, or any other variants, is associated with increased transmission of the virus. “Following the reports in the United Kingdom on the 19th of December describing preliminary genomic characterisation of an emergence SARS-COV-2 lineage – the b1.1.7, our partners at the African Center of Excellence for Genomics of Infectious Diseases (ACEGID) did a rapid analysis of samples that we had collectively collected here at the centre and done genomic sequencing on. It identified two SARS-COV-2 sequences that formed an emerging variant called p681h variant in Nigeria that shares one mutation with the United Kingdom’s b1.1.7 lineage.
“However this variant does not share any of the 22 other lineage defining mutations of b1.1.7. These cases of p681h variant in Nigeria were found in two samples conducted on the 3rd of August and the 9th of October. The background to this is that the work done shows that there are 18 different lineages detected in Nigeria so far since the beginning of the outbreak, and we do not have any evidence to indicate that this p681h variant or any other variant currently circulating in Nigeria is associated with increased transmission.
“The emergence of new variants in and of themselves is not interesting and it is not news. What is news is if one of the variance has been shown to be associated or correlated with an increase in transmission, increase in variability, resistance to vaccination, and any other outcomes. While we do have genomic surveillance in the few centres in Nigeria, the relative difference is still in Nigeria versus the UK and even South Africa. It obviously implies a reduced likelihood to detect such changes when they do happen. We are currently in the process of sequencing more samples from the recent surge of cases in Nigeria in order to analyse firstly for changes in circulating viruses in Nigeria, but also specifically looking for those variants of interest circulating in South Africa and the UK that have already been shown to be associated with increased transmission.
“Our ongoing efforts in sequencing have two objectives – one is to identify if there is any variant that is associated with any change in outcomes, either in transmission, severity, mortality or any other. Secondly, to specifically look for the variants of interest already identified in the UK and South Africa to be associated with these changes in transmission.
“In as much as the full extent of these mutations and others are still being studied, the importance of a robust genomic surveillance system cannot be overemphasised. And that’s why I identify and report changes in the genome of pathogens such as SARS-COV-2 that are of public health interest. We really must learn from efforts in South Africa, specifically where they have done sequencing overtime periods. Because it is only when you do this overtime that you can demonstrate change in the prevalence of one variance over another, and that you can make conclusions on severity, transmission etc,” Ihekweazu said.
While speaking, Prof. Francisca Mutapi of Global Health Infection and Immunity, University of Edinburgh, UK, said analysis of the SARS-COV-2 genome of the WHO African countries has been published. By January 12th, she added that 24 countries from the WHO African region had deposited a total of just under 5,000 SARS-COV-2 sequencing in the publicly available database, representing about one percent of the publicly available sequences globally.
“58 percent of these genomes have come from South Africa. Variants of COVID-19 viruses are rising all the time and as such a new variant has been identified in South Africa. Globally the new variants have been reported in about 20 countries – Europe, Asia, North America, and Australia. This variant has several mutations and most of them are in what we call the spike protein. Research is currently underway in trying to determine the impact on infection diagnostic, therapeutics, and vaccine efficacy.
“So far, the following is what we know: In terms of transmission, the 501y.v2 mutation also on the spike is predicted to increase the binding of the virus to the human receptors, allowing easier access and therefore transmission. This is associated with more transmissibility. This mutation is not unique to the variant that has been observed in South Africa. It is also present in the rapidly spreading variants in the United Kingdom.
“In terms of PCR diagnosis, till date none of the mutations of the variants observed in South Africa variant has been reported to interfere with PCR diagnosis. So we have no cause for concern at the moment on the diagnosis of this variant. In terms of natural immunity and immune-derived therapeutics, one of the mutations – the h4k mutation, has been suggested to impair recognition of the virus by antibodies.
“But again, there has been no conclusive evidence that this may affect vaccine efficacy. So we do not have evidence for concern at the moment. As with all variants, this required continuous monitoring. It is very important that we continue to increase sequencing capacity in Africa so that we can know a lot more about the variants that are circulating in countries and in the continent as a whole. This is what we have been doing for the past four years working with colleagues to capacitate sequencing of work of viruses by local organisations within Africa.”
With regards to the number of labs conducting genome sequencing in Africa, Dr. Gumede Meletsi, said there 12 laboratories in the WHO African region, and these have been categorised based on the specialised laboratories. Two are based in Nigeria, two in South Africa, one in Senegal, one in Ghana, one in DRC, one in Gabon, one in Rwanda, one in Kenya, one in Morocco, Meletsi said.
WHO hails African Governments’ efforts in securing vaccines outside COVAX
The Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, has assured Nigerians that, in close collaboration with the Federal Ministry of Health and other relevant government agencies, is working out the plans and logistics to ensure that all states receive the much-awaited COVID-19 vaccines, starting with front line workers, especially frontline health workers, the elderly and those with underlying illnesses.
He also revealed that apart from the expected 20 percent free vaccines expected from the COVAX facility of the WHO, the Federal Government is also in talks with other countries known to produce effective COVID-19 vaccines. Some of the countries are UAE, India, China etc.
The WHO, in its virtual media briefing, also disclosed that Africa will be receiving about 600 million doses of vaccines through its COVAX facility, while hailing the Africa Union’s efforts to secure additional 270 million vaccines for the African region. “A top priority is ensuring that Africans access COVID-19 vaccines. It is unfortunate that so far, the vaccine distribution has been inequitable, but this is a massive undertaking and it takes time. The COVAX facility which is coordinated by GAVI, WHO and CEPI, aims to provide around 600 million doses for Africa we estimate in 2021.
“We expect the first doses to arrive by the end of March with a larger rollout by June. However, COVAX can only cover 20 percent of the African population. So it is really wonderful to see the African Union’s efforts to secure the provision of 270 million doses by the end of 2021 achieving success. Together we will deliver nearly 900 million doses for this year. We know that still more is needed. WHO has developed the guidelines for national deployment plans and trained all countries in key aspects of covid vaccines development. Our monitoring shows that there is still a lot to do in terms of preparedness, and I just like to emphasise that getting the vaccines is a very important step, but getting the vaccine into people’s arms is equally important and demands a lot of work but from countries, ourselves, and other partners.
“The groups that are considered the highest priority are the frontline workers, particularly the frontline healthcare workers, and we have seen in some countries, significant numbers of deaths among healthcare workers. Also other priority groups including people within a certain age, that is, people in the older age group and people with pre-existing conditions that make them susceptible and vulnerable to complications and severe forms of the disease.”
