South Africa's fifth wave potentially driven by new Omicron subvariants

A new wave of cases in South Africa is thought to be driven by new Omicron subvariants BA.4/BA.5 A small study from South Africa has found that antibodies from those infected with BA.1 have reduced ability to neutralise BA.4/5. In addition, antibodies from individuals that had been vaccinated with Pfizer/BioNTech or J&J and also had a BA.1 infection also see a decrease in neutralisation, albeit to a smaller degree than the unvaccinated. Therefore, those who have been vaccinated may have better protection from these new sublineages. With less than 31% fully vaccinated and <5% receiving boosters the majority of the immunity in South Africa is from natural infection; therefore, it is expected that cases will continue to rise in South Africa as BA.4/5 are now the predominant variants. The group state the escape they observe is substantially higher than what they detected for BA.2, where it was slight and non-significant. Therefore, countries that have experienced large BA.2 waves* and have higher vaccination coverage may be less impacted by BA.4/5. *South Africa did not see a wave of cases associated with BA.2; however reduced testing may mean more BA.2 infections occurred than recorded.

In January 2022, Airfinity modelled when the next wave in South Africa may occur based on the characteristics of previous COVID-19 waves.

A fifth wave was forecasted to start between 29.03.22 and 08.05.22. Now, following months of declining cases and deaths, South Africa has seen a ~160% increase in COVID-19 infections and a ~211% increase in deaths in the last two weeks.

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