Head of the Ministerial Advisory Committee on COVID-19, Professor Salim Abdool Karim says South Africa’s rollout of the coronavirus community screening and testing will lead to a drastic increase in the infection rate because the real picture will emerge.

Karim’s webinar hosted by the University of KwaZulu-Natal on Friday unpacked his thoughts around critical issues, such as the impact of increased community screening on infection numbers, how the virus will impact HIV positive people, and the sanctity of scientific data in tackling the scourge

He introduced himself as a spokesperson for the brilliant scientists, researchers and scholars making up the COVID-19 Ministerial Advisory Committee. However, this world-renowned epidemiologist is being called upon to use his years of leading HIV research and leadership to drive South Africa’s COVID-19 fight.

Karim cleared up concerns around why infection numbers are increasing despite the lockdown, something that’s been alarming South Africans. He explained that as the country’s screening and testing increase, so too will the number of new cases.

Karim says the third week of the lockdown is a more accurate indicator of the rate of infections in the country, compared to the first two.

He says, “We had such a strong effect of the state of disaster that there’s not much room for the lockdown to drop the cases even more. So when we look at the cases we’ve seen in this last week I bet all of you are wondering, why is it so much so often above the 90 mark? The problem is that we initiated a community health worker programme. So suddenly in this third week we now have a whole new reporting method. Active case finding.”

Prof Karim predicted that COVID-19 cases will spike significantly post-lockdown: 

HIV positive population

Questions came in on how South Africa’s large HIV positive population would handle the virus. The country bears the brunt of the world’s HIV burden. The United Nations Aids puts the latest figure of positive HIV cases in the country at over seven million in 2018.

Karim says HIV positive people on anti-retroviral therapy with good CD4 counts should experience the virus similarly to non-HIV positive people. However, he also says his concern is for HIV patients with a CD4 count below 300 and those who remain unaware of their HIV positive status.

He says, “They might have a clinical course that is more in keeping with what we saw in the elderly in other word case fatality rates that start climbing. If that pans out we’re going to have a problem on our hands because there’s a lot of those people. Of the 2-2.5 million people in our country who have HIV and are not on ART there’s probably somewhere around half a million who have low CD4 counts. So you can imagine what we may be heading into.”

‘Armchair critics’

Karim took a moment to decry what he called “armchair critics”, putting forward so-called solutions without scientific data to back it up.

He says, “Ideas are a dime a dozen. Everybody’s got them I’m amazed at the number of armchair experts after my Monday talk I got thousands of emails about people who have every kind of solution. They know how to cure this disease. I have no interest in them. I’m interested in your data.”

Karim reiterated sentiments he shared earlier this week. He says it’s unlikely that South Africa would be able to avert the shattering consequences of COVID-19, being felt by so many European countries.

He adds, “We have not escaped this bullet we have simply postponed it. It’s inevitable. We have a hole which has all the conditions for the spread of this virus. We have no protection in the form of a vaccine or natural antibodies. We’re gonna have to find a way to push it back as far as possible to give us time to prepare.”

In the video below, Prof Salim Abdool Karim speaks on SA’s response to COVID-19:

SA’s COVID-19 epidemic trajectory 

Earlier in the week, Professor Karim and Health Minister Zweli Mkhize, along with some of the country’s leading scientists and medical leaders on Monday hosted an online debate aimed at providing the latest information on COVID-19. Karim reported that South Africa seems to have beaten the curve in a way that no other country has.

He said the country’s epidemic trajectory, related to coronavirus COVID-19, is unique compared to other countries.

Karim said South Africa’s current plateau in the increase of the number of positive cases can be traced back to March the 26th, the first day of the lockdown.

“So when you look at this curve, what you can see is that we were on a simple trajectory like every other country, increasing rapidly day-by-day. And suddenly on the 26th of March, it turned and started going down again. And as it went down it reached a point, somewhere around 60, 70 cases a day, and it started hovering around there.”

INFOGRAPHIC: SA’s COVID-19 response in stages:

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INFOGRAPHIC: Lockdown in South Africa:

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