Johannesburg - Researchers from Wits University have been selected to be part of a multi-disciplinary study on the best way forward in order to beat Covid-19 as a public health threat.
Professor Bruce Mellado from the Wits School of Physics and iThemba LABS and Professor Helen Rees from the Wits Reproductive Health and HIV Institute (Wits RHI) were part of 350 global experts chosen to reach a consensus on the matter.
They were part of the Delphi study, which provided a platform for global scientists to discuss actionable recommendations to end the public health threat without exacerbating socio-economic burdens or putting the most vulnerable at greater risk.
The study is a well-established research methodology that challenges experts to garner consensus on answers to complex research questions in order to develop a global consensus on the best way forward in the challenge of combating Covid-19.
And while we might be entering a post-Covid period, a new study published in the journal Nature says that specific efforts and resources are still required to save lives.
This is just one of six main themes for action identified by a large panel of experts from different disciplines and over 100 countries, including SA’s Mellado and Rees.
During the national Covid lockdown periods, Professor Mellado was appointed to the Gauteng Premier’s Covid-19 advisory committee. His team used Artificial Intelligence (AI) in modelling in order to establish and forecast national outbreak hotspots in order to better manage resources to deal with the outbreaks.
“It is great to see a large team of scientists from different backgrounds get together to ponder the implications and vast experience accumulated through the Covid-19 pandemic,” Mellado said.
“Inter-disciplinarity and trans-disciplinary have played a significant role in dealing with this complex problem.”
Meanwhile, as part of the Wits RHI, Professor Rees and her Wits colleagues led Covid vaccine and therapeutics studies, as well as sero surveys in households, communities and among pregnant women.
Worldwide, over 180 organisations from 72 countries have already endorsed the findings of the consensus study, which was led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by the “la Caixa” Foundation.
As of October 2022, more than 630 million Covid-19 cases and over 6.5 million deaths were reported, with experts of the belief that the real death toll has been estimated to be upwards of 20 million. In addition, millions of patients with cancer and chronic disease have experienced dangerous healthcare delays, and Long Covid continues to elude definitive treatment, posing an ongoing threat to survivors.
The virus also continues to accumulate mutations that can make it better at evading previous immunity. This is why many public health leaders, including the authors of this study, continue to regard Covid-19 as a persistent and dangerous global health threat.
Despite notable scientific and medical advances, many health experts believe that the world’s response to Covid-19 has been hindered by broader political, social, and behavioural factors such as false information, vaccine hesitancy, inconsistent global coordination, and the inequitable distribution of equipment, vaccines and treatments.
“Each country has responded differently, and often, inadequately, which is partly due to a serious lack of coordination and clear goals,” Jeffrey V Lazarus, head of the Health Systems Research Group and co-director of the Viral and Bacterial Infections Programme at ISGlobal, Associate Professor at the University of Barcelona, said.
Lazarus was also a coordinator for the Delphi study.
To develop a global consensus on how to address these issues going forward, Lazarus and colleagues carried out the research. In order to compile it, a multidisciplinary panel of 386 academic, health, NGO, government and other experts from 112 countries and territories took part in three rounds of structured consultation.
The result is a set of 41 statements and 57 recommendations across six major areas: communication, health systems, vaccination, prevention, treatment and care, and inequities.
Three of the highest-ranked recommendations are:
- Adopting a whole-of-society strategy that involves multiple disciplines, sectors and actors to avoid fragmented efforts
-Whole-of-government approaches (e.g. coordination between ministries) to identify, review, and address resilience in health systems and make them more responsive to people’s needs
- Maintaining a vaccines-plus approach, which includes a combination of Covid-19 vaccination, other structural and behavioural prevention measures, treatment, and financial support measures.
The panellists also prioritised recommendations for developing technologies such as vaccines, therapies and services that can reach target populations.
Other recommendations with at least 99% agreement were:
- Communicating effectively with the public
- Rebuilding public trust
- Engaging communities in managing the pandemic response.
Only six recommendations had more than 5% disagreement, including that which considers further economic incentives to address vaccine hesitancy or a symptoms approach to diagnose COVID-19 in settings with low access to testing.
The 57 recommendations are directed at governments, health systems, industry, and other key stakeholders. “To the greatest degree possible, our results place emphasis on health and social policy recommendations that can be implemented in months, not years, to help bring this public health threat to an end,” Quique Bassat, ICREA professor at ISGlobal, co-author of the study and member of the University of Barcelona, said.
He added that the study does echo some earlier recommendations, such as the Independent Panel for Pandemic Preparedness and Response and WHO’s 2022 plan on Strategic Preparedness.
“But what makes this work unique is the very large number of experts consulted, the wide geographical representation, and the study design, which emphasises consensus building and identifies areas of disagreement. It may prove to be a model for developing responses to future global health emergencies,” said Lazarus.