Enhancing health research and surveillance against COVID-19 in South Africa

Cape Town | The South African Medical Research Council (SAMRC) is working with stakeholders in South Africa, including the National Department of Health and Department of Science and Innovation, to support research and our rapid response to the novel coronavirus (COVID-19) disease outbreak. As of the 10th of March 2020, South Africa has identified seven confirmed cases of COVID-19, in persons who have a history of travel in Italy.

While we are rapidly learning more about the natural history of COVID-19, the impact of this virus in Africa is yet unknown. The risk factors for transmission and clinical outcome are likely to be different in this region when compared to the Northern Hemisphere. There is an urgent need to describe the epidemiology of COVID-19 in South Africa as well as to address diagnostic, therapeutic, host and viral factors that may facilitate transmission or protect against infection.

Currently, it seems that there is little mortality in children under 9 years of age. However, the incidence, morbidity and mortality, increases with age, and is higher among, persons who smoke and those with underlying conditions such as diabetes, respiratory and cardiovascular disease. People with immune disorders are also at greater risk of infection, although the impact of the virus on people living with HIV is at yet unknown. So far it does not appear that pregnant women are more vulnerable to infection, and men seem to be at greater risk than women, although this could be related to smoking habits.

South Africa with its high HIV and TB burden of disease, may face a protracted coronavirus outbreak, if these conditions prolong viral shedding. Local research must focus on surveillance, therapeutics and understanding the local epidemiology and natural history of the pandemic. 

A concerted effort and multi-stakeholder response are important to tackle what has become a Public Health Emergency of International Concern (PHEIC). “The SAMRC is making funding available to researchers to increase surveillance of COVID-19 in hospitals and health settings in South Africa,” says Professor Glenda Gray, the President and CEO of the SAMRC. Funding research for the evaluation of the impact that HIV and TB have on coronavirus infection is critical given South Africa’s burden of HIV/AIDS and TB. “We will also support research into surveillance of health care workers, patients in medical wards and intensive care unit,” adds Gray.

Under the stewardship of Professor Helen Rees, Chairperson of the South African Health Products Regulatory Authority (SAHPRA), and Dr Yogan Pillay, Deputy Director General of the National Department of Health, a consultation of South African researchers and public health officials was convened last week to discuss research priorities in collaboration with the World Health Organization. Priority was given to a   global study to evaluate therapeutic options in the management of COVID-19 infection in South Africa. “A coordinated response for the management, treatment and prevention of COVID-19 will be imperative, with clinical evidence derived from well-designed protocols critical for those infected or at high risk of contracting coronavirus,” says Professor Helen Rees.

Professor Jeffrey Mphahlele, the SAMRC’s Vice President agrees and he expressed that: “the SAMRC is in a position to rapidly facilitate interactions between researchers, regulators and ethics committees, and we will make resources available for this to happen as rapidly as possible.”

As a custodian of research for health, the SAMRC’s role in the fight against COVID-19 is part of supporting the Government’s commitment of a long and healthy life for people in South Africa.

NOTE TO THE EDITOR:
Coronaviruses were identified in the mid-1960s and are known to infect humans and a variety of animals (including birds and mammals). Since 2002, two coronaviruses infecting animals have evolved and caused outbreaks in humans: SARS-CoV and MERS-CoV. In December 2019, a novel coronavirus (2019-nCoV) was first isolated from three patients with pneumonia, connected to the cluster of acute respiratory illness cases from Wuhan, China. Information on the epidemiological and clinical characteristics of the infection caused by 2019-nCoV is accumulating.