Covid Covering

Covid Covering

Traveling to Africa this year? Tanzania, South Africa, Egypt? Start right now looking for the perfect mask. If you find the perfect fit, when wearing and when not wearing glasses, travel to Africa later this year can achieve a level of acceptable safety. But it will not be like it was before the virus.

EWT’s safaris later this year include South Africa, Egypt/Jordan/Israel and Tanzania, so this blog refers mostly to those destinations. Here’s what I see coming for all EWT travelers.

First of all, getting there and getting home won’t be as easy as before. Avoid all connections outside your home and destination. In other words, fly nonstop whenever you can. This avoids gambling with all the European countries’ regulations that currently confound simple transferring and connecting.

In addition to mask wearing throughout your trip, returning travelers will probably be required to provide a recent negative PCR test to re-enter the U.S. without quarantining regardless that they may also be vaccinated.

The reason for this is the variants. Only Pfizer has a study regarding its efficacy against a serious South African variant, and that’s quite an old study. I doubt the CDC will have collected enough data on the efficacy of our various vaccines vis-a-vis African variants before the end of the year.

So the only sure way to keep them from spreading into the U.S. is to ensure that none of us reentering the country is carrying one.

That, of course, begs the question about the safety of you going in the first place.

In mid-February the CDC released a number of reports that confirmed existing vaccines were up to two-thirds less efficacious against the existing South African variant (B.1.35.1.). One of these was Pfizer’s own study.

The number, two-thirds, seems alarming, but scientists were quick to add that even that much lower a level of efficacy is likely to keep the vaccinated from dying or being hospitalized.

So what about just getting really sick?

“Really sick” is subjective, but any potential incapacitation during a vacation isn’t exactly a positive sales tool.

Pfizer and Moderna are retooling their genetic arsenal to target B.1.35.1, and Moderna is the first to be administering actual trials. Non-mRNA vaccines like Johnson & Johnson cannot alter their virus targets as quickly and effectively as Pfizer, Modern or other mRNA vaccines.

That being said, the Johnson & Johnson non-mRNA vaccine has conducted more substantial studies in South Africa and makes a plausible claim that their vaccine is more protective against the variant than Pfizer or Moderna. At this point I’d take that as a half dozen teaspoons of marketing or six spoonfuls of science.

It’s likely that by the beginning of summer more and better studies regarding the vaccines’ efficacy against variants will be available, and that boosters from refined mRNA vaccines will also become available.

Still, the creation of new variants will continue until the petri dish is sanitized. In South Africa where possibly the world’s worst variant arose and which dominates the pandemic there the government has decent monitoring of the virus, but it’s lost control of what it all means.

With no good trend graphs or modeling from the South African government, I’m relying on WHO’s.

As advanced as South Africa is on the one hand, an enormous percentage of its population is dirt poor and greatly under served socially, so the data reporting of a huge section of the population isn’t done well and often doesn’t exist.

A private medical research organization, saMRC, has tried to fill in those gaps but I still find their results manifestly confusing. I think the reason for this is that they are still dependent upon existing government data and that is simply insufficient for good modeling.

However, combining WHO’s South African dashboard with a national media organization’s unverified compilation it’s plausible that South Africa has just ended a terrible spike (its second since the outbreak) returning to the plateau levels of August through early November last year.

It’s likely that the dangerous variant arose during that first spike of May-July. We won’t know if newer variants have just arisen out of this second spike for some time.

Strike Two against South Africa for its dismal failure on vaccination roll-out. Although the Health Ministry insisted at the beginning of the year that two-thirds of the country would be vaccinated by the end of 2021, most South African experts vociferously disagree:

“We’ve been caught napping,” a well-known national virologist told the country right after the government’s happy-face New Year assessment just as a series of mishaps including the aborted roll-out of the Astra Zenca vaccine began to tarnish government credibility.

That lousy public health response may have reversed last week with the government’s announcement that it will have 20 million vaccine doses “soon.” But the sloppy government roll-outs and poor compilation (relative to other middle-income countries) does not instill confidence.

Considering all the above the conclusion is that a traveler to South Africa this year will have to be cautious and prepared. Wearing masks that are self-protective (multiple layers, or N95) throughout your trip and acquiring a negative PCR test before returning look like essentials.

We can say so much less about East Africa or Egypt, simply because the data compilation both in terms of constancy and depth is exponentially less than in South Africa. About all we can say comes from WHO.

There’s good news and bad news in these less developed countries north of South Africa. The bad news is that the pandemic is likely as bad as or worse overall in Egypt, Tanzania and Kenya than in South Africa.

The good news — relative as it is — is that WHO reported last week that no variants of concern have been reported in any of those countries. This over simplification, though, hides the fact Tanzania is probably in the worst shape of all. We can’t rely on WHO because Tanzania stopped reporting any data relative to Covid last May.

The Vice-President of the country’s autonomous island of Zanzibar and just last week the President of the country have both died presumably of Covid, along with a number of other officials. My intelligence reveals a country in terrible shape. The fact, however, that the surrounding countries which WHO does monitor well show no indication of dangerous variants is circumstantial evidence that is probably also the good news for Tanzania.

There’s more of a positive bent overall as regards the state of the developing world, but it gets a bit weighty. In a lengthy article on March 1, the New Yorker tried to explain:

…immunities from a population beset by much more ordinary diseases, a strikingly younger population, and incomplete data compilation which under reports huge numbers of infections and deaths are likely the main reasons that many developing countries appear to be doing modestly better.

Combined in I hope not too simplistic a notion: the less developed countries of Africa are probably heading towards at least a facsimile of herd immunity simply by letting the virus run its course.

There’s even better news for Egypt.

Even during pre-Covid times Egypt welcomed far more tourists than any country to its south including South Africa. The travel companies in Egypt are way ahead of their colleagues to the south with mechanisms for getting travelers negative PCR tests before returning home.

In sub-Saharan countries the negative PCR testing will be an individual’s responsibility. In Egypt, the tour companies are providing it without even being asked to do so.

Vaccination and herd immunity attained otherwise is the only strategy against this thing. The race is on before the virus achieves more successful variants.

In countries like Egypt, Kenya and Tanzania, the natural acquisition of herd immunity is probably more advanced than in South Africa or Europe. The question becomes will it ever be achieved significantly enough to allow foreigners to travel as comfortably as they did before the virus.

In the more developed countries like South Africa and Europe mitigation efforts perforce impede natural herd immunity, because vaccination is presumed ultimately quicker and more effective.

In the long run mitigation whenever needed followed by vaccination will, indeed, prove more effective. It’s a more certain strategy for both eradication and deterrence. If enough of the populations get vaccinated, countries will effectively be as safe from coronavirus as they are from the flu.

Whereas I can imagine years down the line that the coronavirus in some form or another remains a threat to anyone traveling to East Africa or even Egypt.

All we can do is tell the story as it is today and predict in all its rough and inadequate ways the future. As I see it if you’re planning to travel to Egypt south to South Africa this year, get vaccinated, get boosters when available, and plan on mask wearing during your trip as well as organizing PCR tests for your return home. That’s how it looks right now.