Covid cases surge in South Africa again just months after it became Omicron hotspot

Experts have urged people not to panic as South Africa once again becomes a focal point of the pandemic amid a fresh Covid surge of new subvariants.

The world watched in horror last November as the super-infectious Omicron strain (BA.1) spread through South Africa at unprecedented speed — which turned out to be mild.

But now the country finds itself at the cusp of a fresh explosion in infections, this time due to sub-strains that appear even more transmissible and resistant to antibodies.

Covid cases have nearly quadrupled in a month nationally and hospital admissions are ticking up in Gauteng province, the former epicentre of the original Omicron wave.

Researchers on the ground in South Africa say the BA.4 and BA.5 subvariants can evade immunity and cause symptoms in people who were infected with their parent strain just months ago.

What is still unclear is whether the new wave will create milder or more severe illness — but experts tell MailOnline the former is more likely, for the UK at least.

Professor Paul Hunter, an infectious disease expert at the University of East Anglia, said Britain’s second Omicron wave, triggered by the BA.2 subvariant, will have given Britons an extra layer of immunity against severe illness.

He pointed to a pre-print which showed the combination of vaccination and Omicron infection created ‘robust protection’ against Omicron’s sub-lineages.

However, it is less clear how the latest wave will play out in South Africa, where only three in 10 South Africans have had two jabs and just one per cent have had a booster dose.

History repeats: Gauteng province – the former epicentre of the original Omicron wave – is also seeing the biggest rises in cases again

Nationally there are about 1,400 weekly daily hospital admissions for the virus, only slightly higher than a month ago, but it takes several weeks for people to fall ill enough to be admitted

In Gauteng province, home to Johannesburg, admissions have doubled in a month

There has also been a lull in infections since the original Omicron wave collapsed in South Africa in January, whereas the UK’s case rates spiralled again over spring.

There are now nearly 4,800 new Covid infections per day in South Africa, on average, compared to around 1,300 this time last month. 

Nationally there are about 1,400 weekly daily hospital admissions for the virus, broadly unchanged from a month ago, but it takes several weeks for any trend to play out. 

In Gauteng province, home to Johannesburg, admissions have doubled in a month.

However, more than 90 per cent of South Africans are estimated to have natural immunity against Covid, which could limit the pressure on hospitals.

Professor Hunter told MailOnline he expects BA.4 and BA.5 to become dominant in the UK unless another completely new variant arises.

‘I suspect that unless something else comes along, one or both of these variants will become dominant in the UK but I can’t predict how big a surge of infections that would lead to,’ he said.

‘It is also likely that we will still have robust protection against severe disease for most of us.

‘Vaccines give good additional protection after a BA.1 infection so given the UK has a much higher vaccine uptake than South Africa, as well as having high prior infection rates, it is difficult to predict what that would mean for UK with certainty.’

Professor Christina Pagel, of University College London and part of a former Zero Covid campaign group, said a best case scenario would see a small BA.4/BA.5 wave in the UK.

At worst it could mean a wave as bad as the Omicron or BA.2 wave, which never overwhelmed the NHS, according to Professor Pagel, who is not normally known for optimistic Covid forecasts.

She told The Guardian that the UK was approaching summer, meaning more outdoor mixing and lower levels of transmission.

But there are naturally some intrigue about the latest rise in South Africa, given what happened last November when the country announced the Omicron variant to the world.

Last November it was recording fewer than 300 daily cases before the strain caused an astronomical surge, peaking at 27,000 daily cases within a month. 

The situation in South Africa caused international panic, with countries across the world shutting their borders to travellers from swathes of Africa in early December.

But Omicron quickly spread around the world and caused unprecedented rises in cases. 

Frightened that the surge could lead to a wave of hospitalisations, many leaders across Europe chose to lock down again — including the Netherlands and Austria and France.

In the UK, Britons were urged to cancel their Christmas parties and only see people if it was essential. That was despite doctors in South Africa strongly insisting that Omicron was milder than previous waves. 

Experts told MailOnline at the time that there was an element of ‘snobbery’ among UK experts in ignoring the pleas of South African doctors.

Dr Simon Clarke, a microbiologist at the University of Reading, told MailOnline that people need to get out of the habit of fixating on ebbs and flows of the virus in other countries.

‘Over the coming months and years we’re going to see numbers of infections rise and fall around the world. It’s natural and nothing to be afraid of or shocked by,’ he said.

‘The important thing is to maintain sufficient immunity in population so that we keep a lid on Covid-19’s worst effects and some reduction in spread.

‘Having a good level of immunity derived from vaccines and previous infections means that hospitalisations are reduced and when they do occur, tend to be at the less serious end of the spectrum with fewer admissions to intensive care.’ 

Since the more transmissible but milder Omicron strains took off in the UK in December, Covid cases have soared to record levels, with 4.1million infections logged at the latest peak last month. 

But, unlike in previous parts of the pandemic, surges in severe illness never followed. Deaths in England never breached 250 a day in April, similar to levels seen in bad flu seasons. 

Hospital admissions peaked at just over 2,000 — half of the peak in January 2021 — and more than half were likely admitted for a different illness and tested positive incidentally.