COVID-19 VACCINATION ROLL-OUT IMPLEMENTATION PLAN FOR SOUTH AFRICA

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COVID-19 VACCINATION ROLL-OUT IMPLEMENTATION PLAN FOR SOUTH AFRICA

A PROPOSAL TO THE SOUTH AFRICAN COVID-19 COMMAND COUNCIL & THE CABINET OF THE REPUBLIC OF SOUTH AFRICA. PREPARED BY: I.N. MDAKA 31st March 2021

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Wikipedia

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BACKGROUND ABOUT PROGRESS MADE

South Africa is the most hard-hit nation by Covid-19 in the Africa According to JHU CSSF COVID-19 DATA, South Africa has, as at midnight 30th March 2021, the following Covid-19 statistics: 1.55m cases, 1.47m recoveries, and 52 710 recoveries. The South African authorities are working hard around the clock to curb the spread of the virus. According to Martin Gustafsson of the University of Stellenbosch (17th April 2020), South Africa is one of 30 countries out of 139 countries in the world that has reached the maximum Covid-19 stringency level. All these measures in an attempt to rescue its nation from the Covid-19 virus. The current hope the nation has , as do other nations of the world, is in the vaccination of its population.

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FACTS ABOUT THE VACCINATION STRATEGY

Luckily, sourcing the Covid-19 vaccine doses is not such a mammoth task. According to the Department of Health (09 February 2012), the options available are the Covax facility (12m doses), Johnson & Johnson (9m doses), Pfizer (20m doses), and the latest Johnson & Johnson offer (30m doses) from the South African Production as announced by the State President about two days ago. If the above is anything to go by, then South Africa is potentially equipped to source 41m doses compared to its planned 43m vaccination plan. (Vaccination plan according to Business day 11th March 2021). If the recent 30m is not a duplication of the initial 12m doses from Johnson & Johnson, then the potential doses achievable are 71m. This is 6m more doses than the South African estimated total population of 65m people. Unfortunately, as with the introduction of any product or program in the market, the formulation of an effective Covid-19 rollout strategy in South Africa remains illusive according to the views of a sizeable number of journalists and political commentators in South Africa.

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PROGRESS TO DATE

According to the South African Strategy, the Covid-19 rollout will follow the following phases: Phase 1, targeting 1.25m health workers; Phase 2, targeting 17m people among essential workers such as police, teachers, retail workers, persons in congregate settings such as prisons and shelters, persons 60 years and older, as well as persons 18 years and older with co-morbidities; and Phase 3, the rest of the population and persons younger that 18 years of age. (Business Tech undated). According to Times Live 27th March 2021, the number of health workers vaccinated so far is 231 605 out of the 1.25m health workers envisaged.

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ESTIMATED SPEED OF VACCINATIONS

Whereas it is understandable that the speed of vaccination is dependent on an array of factors — among which the speed at which doses are delivered to the country — given the statistics available and assuming a month of implementation already, the 231 605 health workers doses given so far translates to 7 720 doses per day. (231 605 divided by 30 days). Assuming the same rate of vaccination will be maintained over the three phases planned , 5 570 days are required to cover the 43m target (43 000/5570). Assuming that vaccinations will be done 5 days per week regardless of public holidays, then there are 270 days to do the work in any given year. 5 570 days required to complete the vaccination program divided by 270 days in a year points in the direction that it will take South Africa 21 years to complete the vaccination program. Admittedly, the speed will not be as linear as illustrated as improvements will occur over time. Nonetheless, the projected term it will take is too scary to imagine.

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The above being said, it is also important to mention that South African Authorities are not oblivious to the potential dragging on of the roll-out strategy. Recent adjustments in the strategy aims to target 200 000 vaccinations per day done over 2000 vaccination centres throughout the country. (Sunday Times 27th March 2021). The recent adjustments translate to 54m vaccinations in 270 day. Assuming that the 200 000 vaccinations per day are possible, then there can be no concern regarding the dragging of the program as the program will be completed in one year.

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PROPOSED ALTERNATIVE STRATEGY

Considering that South Africa has a well-nourished national outreach machinery in the country in the form of the Independent Electoral Commission (IEC), it may just save South Africa time and money to consider the IEC facility as its machinery of its National Rollout Strategy in contrast to developing an alternative 2 000 centre machinery envisaged. Imagine, it takes about 2 minutes or so for a voter to collect a ballot paper from the IEC officials' desk and to mark it and place it in the ballot box. Those two minutes are more-or-less the same amount time it takes a nurse to draw the vaccine from the vaccine tube and to inject it into the shoulder of the patient. Bearing in mind that the national election takes one day to conclude, it can be deduced that using the IEC machinery, holding the availability of doses constant, will theoretically equally take 1 day to complete the national vaccination.

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HOW THEN COULD THE IEC MACHINERY BE ENGAGED

STEP 1. Parliament to sit virtually asap to approve the program and the IEC Act and the Disaster Management Act are amended instantly to give effect to the program as a temporal emergency measure. There may be other alternatives government may consider to expedite the process. Step 2. IEC officials resume their 2019 positions in the various polling stations. Step 3. All 231 605 health care workers already vaccinated are deployed to the 22 925 voting stations established for the 2019 elections. (IEC undated). This translates to an average of 10 health workers per voting station. It is likely to be less than 10 because some of the health workers vaccinated are not professional medical staff, but the principle holds. Step 4. Health workers deployed to voting stations vaccinate all IEC officials in their respective voting stations and assist IEC official to sanitise the voting stations professionally.

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Step 5. All heath centres in the country are encouraged to split their staff into five groups. e.g. A hospital with 200 healthcare workers will have five groups of 40 healthcare workers in each group while a private surgery with just 5 healthcare workers including the doctor will have 1 healthcare worker in each group. Step 6. Group 1s in each healthcare centre visit their nearest voting station at 8am. Group 2 at 10am and so on. (There may be another way of spreading the vaccination workload among voting stations. That too can be applied.) By the end of that day, all healthcare workers are vaccinated. In this way health facilities will always have a minimum of 60% of their staff at all healthcare centres while others go for vaccinations. Therefore, no total collapse of the healthcare centres will occur. Step 7. Increase deployment of healthcare workers in voting stations as shall be informed by the number of voters in the voters' role. According to IEC, the largest voting station had 8000 voters in 2019 while the smallest had 100. Deploy healthcare workers accordingly. Step 8. Invite everyone on the 2019 voters' roll for vaccination. Everything is done.

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THE PROCESS IN THE VOTING STATION

The process of identifying the voters by means of the voters' roll and the application of it to curb corruption applies as is done in the normal voting process. The only difference is that instead of the voter marking a ballot paper, the healthcare workers give the voter a jab. Advantages. No registration is required because the voters' roll is already in place. The vaccination program will at the most take a month to complete. The sooner everyone is vaccinated the sooner the country gets to Level 0 of Covid-19, everybody can go to work and everybody can focus on how best to rebuild the economy Disadvantage The voters' roll is 3 years outdated

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DEALING WITH PROBLEM AREAS

Step 9. Visiting disabled peoples at their homes to give disabled's and the sick their jabs at home. IEC officials assists healthcare workers to identify such people in the same manner they do during elections Step 10. In the following month, the IEC engages in updating the voters roll by all South African Nationals of the age range 16 to 20 who are not in the 2019 voter roll. Step 11. Vaccinate those in the voters' roll as per step 10. Step 12. Invite all foreign nationals to the voting stations to take their jab. IEC create a register of foreign national per voting station as vaccination continues. Such register will identify each foreign national by name and address in South Africa and home address of the country of origin. Advantage for foreign nationals. Home Affairs will be able to serve them better now knowing foreign nationals better.

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CONCLUSSIONS

The presentation made above is by no means intended to instruct government what-to-do or what-not-to-do but to make information what the author considers important for government to consider as another option in its Covid-19 vaccination rollout plan; just in case such information was not considered. The proposal made above suggests that South Africa's Covid-19 vaccination program can be completed in a period not longer than a month or in two months at the longest. Having observed Covid-19 fatigue in past Covid-19 programs, one is tempted to assume that any slow vaccination rollout could lead to Covid-19 vaccination waiting fatigue. Should such fatigue occur with great prevalence, the required percentage of the South African population required to take the vaccine in order to guarantee the country's immunity level could be missed. Missing such immunity level could lead the country to have difficulty in eradicating Covid -19. Eradicating Covid-19 faster as proposed , has a better chance to limit the spread of the third Covid-19 wave or any other potential future wave or waves.