Adding up the numbers: COVID-19 in South Africa

The role of the social sciences and humanities in pandemic preparedness responses: insights gained from COVID-19, HIV and AIDS and related epidemics

The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations (e.g. adolescent girls and young women) who are the focus of these programmes and - as importantly but less well-documented - the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during "lockdowns"). The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic (e.g. wide-spread surveillance coupled with rapid updates on the epidemiology of infections, rapid development of vaccines and revisions of treatment). However, drawing upon the widespread criticisms of state responses to the socio-economic effects of the COVID-19 pandemic and of "lockdowns" themselves, this article elaborates a core argument within those criticisms, namely that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. Our critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses. At root, we re-assert a key value of 'integrated' interventions, namely the accommodation of context-sensitive considerations in the formulation of strategies, policies, plans and programme designs.

Defining the South African Acute Respiratory Infectious Disease Season

The acute respiratory infectious disease season, or colloquially the "flu season", is defined as the annually recurring period characterized by the prevalence of an outbreak of acute respiratory infectious diseases. It has been widely agreed that this season spans the winter period globally, but the precise timing or intensity of the season onset in South Africa is not well defined. This limits the efficacy of the public health sector to vaccinate for influenza timeously and for health facilities to synchronize efficiently for an increase in cases. This study explores the statistical intensity thresholds in defining this season to determine the start and finish date of the acute respiratory infectious disease season in South Africa. Two sets of data were utilized: public-sector hospitalization data that included laboratory-tested RSV and influenza cases and private-sector medical insurance claims under ICD 10 codes J111, J118, J110, and J00. Using the intensity threshold methodology proposed by the US CDC in 2017, various thresholds were tested for alignment with the nineteen-week flu season as proposed by the South African NICD. This resulted in varying thresholds for each province. The respiratory disease season commences in May and ends in September. These findings were seen in hospitalization cases and medical insurance claim cases, particularly with influenza-positive cases in Baragwanath hospital for the year 2019. These statistically determined intensity thresholds and timing of the acute respiratory infectious disease season allow for improved surveillance and preparedness among the public and private healthcare.