It’s been 24 long months since phrases such as ‘pandemic’, ‘lockdown’ and ‘risk-adjusted strategy’ entered our daily lexicon. With more South Africans being vaccinated every day, hybrid-working on the rise and travel returning to something resembling ‘normal’, we decided to check in with the National Institute for Communicable Diseases (NICD) to find out what life could look like as we go forward into 2022.

What Are The New Rules For Socialising?

It’s good news on this front. ‘In the main, the rules may be the same with the possibility of further relaxation,’ says Professor Adrian Puren, the acting executive director of the NICD. However, he says that any decision regarding our social freedoms will depend on a few factors, including:

1 ‘The extent of the vaccination campaign in terms of coverage, in particular for those aged 50 and above and those with co-morbidities.’

2 ‘The types and nature of resurgences experienced and the effect these will have on the healthcare system.’

3 ‘Behaviour leading up to resurgences, for example application of personal non-pharmaceutical interventions (NPIs) and adherence to public NPIs.’ (NPIs include measures such as quarantine, social distancing, hand hygiene and the wearing of masks.)

4 ‘The presence and nature of any new variants and their effect on vaccine efficacy and pathogenicity and transmissibility.’

5 ‘The adaptation of the virus as an endemic pathogen.’

How Long Will We Need To Keep Wearing Masks?

They are equal parts reassuring and tiresome, but how long will masks be a part of our lives?

‘The answer to that is in two parts,’ says Prof Puren. ‘For now, we should encourage the wearing of masks until such time that we reach a point where decisions can be taken regarding how and where masks need to be worn.’ He explains that in the future we could be looking at scenarios in which, for example, we would need to wear masks indoors but not outdoors. ‘The point at which these types of decisions can be made, however, will be influenced by the factors described.’

No Vaccine, No Access?

Will we soon need to show a vaccine certificate before being allowed entry to a public place – or even to attend class? It’s a possibility, says Prof Puren. ‘We have already seen access to events based on vaccination status. There are also already discussions of and planned implementations of vaccine mandates at certain tertiary institutions. However, we should aim to reach high levels of vaccine coverage. Once we have achieved high levels of vaccine coverage, and the virus is endemic, we may not have the need for such interventions.’

Will Vaccinated People Need Booster Shots?

Get ready for more #VaxSelfies on your feed: ‘Boosters will become routine, as the evidence shows a decrease in vaccine efficacy or waning immunity,’ says Prof Puren. ‘Healthcare workers are currently being enrolled for boosters and we are likely to see this expanded.’ He says it’s also important to consider additional vaccinations for those who are immunocompromised.

Are There New Variants On The Horizon?

Just like us, the experts do not have a crystal ball. ‘There will be variants that arise, but will there be variants that have the properties of the current variant? That’s difficult to predict,’ says Prof Puren. ‘It is essential as we reach high degrees of vaccine coverage that we continue to monitor for the presence of variants and the properties of these variants in regard to natural infections and vaccine efficacy.’

How Close Is SA To Herd Immunity?

Unfortunately, ‘herd immunity’ may not be the promised land we all think it is. ‘The concept of herd immunity is difficult to apply in the context of the current variant in circulation, the route of transmission, the vaccine efficacies, and waning immunity,’ says Prof Puren. ‘What is thought essential is to achieve as high as possible population immunity. This level of immunity is likely greater than the 67% target set for adult herd immunity.’

Is Fomite Transmission Still A Thing?

Still obsessively wiping down all your grocery deliveries? You can probably take it down a notch. ‘Fomite transmission is possible, but not a major route of transmission,’ explains Prof Puren. ‘The main route for transmission is through respiratory droplets, therefore the wearing of masks – and wearing them correctly – is essential. In addition, practising hand hygiene will contribute to reduced fomite spread.’

Worried about your hybrid-office desk? ‘Cleaning surfaces using soap or detergent, not disinfectant, is enough to reduce risk,’ says Prof Puren. ‘However, disinfection is recommended in indoor community settings where there has been a suspected or confirmed case of COVID-19 within the last 24 hours.’