Actuarial Society expects Covid-19 fourth wave in December; death rate will
depend on how quickly South Africans get the jab
South Africa’s vaccination programme faces a race against time with a fourth wave of
COVID-19 infections expected for December 2021 and into January 2022. Based on their
analysis of the COVID-19 experiences of South Africa and several other countries at
different stages of managing the pandemic, the COVID-19 Working Group of the
Actuarial Society of South Africa (ASSA) believes that, in spite of the low current case
numbers following the peak of the third wave, there is sufficient evidence to suggest
that a fourth wave is likely to emerge in December. The severity will most likely depend
on whether South Africa achieves its vaccination targets.
As of Sunday, 24 October 2021, only 29%** of South Africa’s adult population was fully
vaccinated against a target of 67% by the end of 2021. South Africa applies a 42-day
waiting period between the first and second dose of the Pfizer vaccine, which means
that unvaccinated South Africans will have to get their first jab before the end of
October in order to be considered fully vaccinated with Pfizer towards the end of
December. (People are considered fully vaccinated two weeks after their second Pfizer
dose or after their single Johnson & Johnson jab.)
Actuary Adam Lowe, a member of the ASSA Covid-19 Working Group, says while it is
unlikely that South Africa will avoid a fourth wave of infections, the severity will most
likely depend on whether the country is successful in building immunity in the majority
of the adult population through widespread vaccination to augment any natural
immunity present, especially in the elderly and other vulnerable groups.
According to Lowe and the ASSA COVID-19 Working Group, South Africa’s experience
could mirror that of many countries with large-scale vaccine rollouts, most notably the
United Kingdom, with a significant wave of cases but only a muted wave of severe
infections and deaths. However, says Lowe, achieving this would require a large number
of people to come forward very quickly to be vaccinated. “The logistics of the rollout
would have to be significantly enhanced to ensure vaccines reach especially the rural
and less technologically enabled population, as well as overcoming the vaccine
hesitancy and outright anti-vaccine sentiment which still exists.”
Experiences in other parts of the world
An analysis of experiences in other countries by the ASSA COVID-19 Working Group
shows that a high vaccination rate appears to have a material impact on the severity of
COVID-19 infection waves.
Lowe says Italy and Germany, for example, appear to be at the start of their fourth
waves, but without large peaks in either cases or deaths yet. In Italy, 73.5% of its
population is fully vaccinated, while Germany is at 66.7%.*
He adds that a study of the United Kingdom (UK) and the United States (US) indicates a
similar scenario where case numbers remain high but severe infection and death rates
are still comparatively low. According to Lowe, the UK and the US achieved relatively
high vaccine roll-outs and significantly eased lockdown restrictions before the onset of
their third waves. In the UK, 71.3%* of the population is vaccinated and in the US fully
vaccinated people account for 64.5%* of the population.
Lowe says the statistics from the UK and the US seem to indicate that vaccination rates
play a role in reducing severe infection leading to illness and death even in a population
where the virus continues to spread.
The two countries that appear to be out of sync with the wave patterns experienced by
the rest of the world are India and Brazil, which are amongst the hardest hit by the
pandemic. Lowe points out that both appear to be experiencing one very large infection
wave with no discernible wave patterns. In India only 37.4%* of the population is fully
vaccinated while Brazil has vaccinated 69.4%* of its population. Both are also amongst
the most populated countries in the world.
Lowe says since no country has as yet experienced a full fourth wave, it is impossible to
predict what the South African experience will be. However, adds Lowe, data is
emerging that shows that some countries, notably the UK, have been able to weaken the
link between cases and deaths most likely through a comprehensive vaccine rollout.
Lowe does not discount that increasing levels of natural immunity also play a role, but
suggests that vaccination provides a more certain method of ensuring widespread
immunity in a population and of managing population immunity over time as infection
levels vary.
Key drivers of infection rates
Lowe explains that in modelling the COVID-19 pandemic, it has become evident that the
key drivers determining the waves of COVID-19 infection are:
- The infectiousness and transmissibility of the particular virus variant prevalent in a
population; - Population behaviour that influences the spread of the virus, such as gatherings, mask
wearing, and social movement; and - The degree of immunity already present in the population, whether acquired through
vaccination or previous infection with the virus.
Lowe cautions vaccinated people against letting their guard down too quickly, because
one of the potential triggers of a severe fourth wave which cannot be disregarded is the
potential of a new variant emerging against which the existing vaccine could provide
insufficient protection.
Ends
Source of statistics:
• ** Percentage of South Africa’s adult population fully vaccinated (Slide 12:
https://sacoronavirus.co.za/latest-vaccine-statistics/)
• * Global vaccination statistics: https://www.bloomberg.com/graphics/covidvaccine-tracker-global-distribution/
Note to editors:
The COVID-19 vaccine programme is a critical risk mitigation tool to protect the
population from severe illness and death and accordingly creating the opportunity for
economic recovery. A number of actuaries have been supporting the planning and
implementation of the vaccine programme and ASSA recognizes their commitment to
supporting the public interest inherent in the professional promise. ASSA also notes the
importance of actuaries working collaboratively in multi-disciplinary teams with other
professions in understanding and addressing complex challenges such as what we have
faced in the pandemic.