The simultaneous scrapping of masks and the onset of monkeypox cases: why this is not an issue

One of the eagerly awaited announcements by the government took place last week – the scrapping of face masks and suspension of several lockdown restrictions.

What this translates to is that South Africans have finally been offered a bit of relief and some small measure of freedom following two years of donning masks and battling severe ailments linked to the emergence of the Covid-19 pandemic.

But many should not pop champagne just yet.

The country's healthcare system may have to gird its loins to fight off another potential evil – monkeypox with the US and other African regions having already experienced an outbreak of the viral disease.

In South African, the National Institute of Communicable Diseases (NIC) has already flagged that more cases may emerge with the country recording its second cases this week.

The case is thought to have been recorded in Cape Town while the first case of monkeypox – a 30-year-old man from Johannesburg – has been recorded last week.

Interestingly, the arrival of monkeypox in South Africa has brought about some form of curiosity around masks and whether they would assist in lowering the spread of the viral disease.

But experts maintain that masks won’t have much effect due to the nature of the viral transmission of monkeypox.

Unlike Covid-19, which is spread primarily through respiratory transmission, monkeypox is spread from person-to-person through direct, close contact.

Dr Alex de Voux, from the Division of Epidemiology & Biostatistics, at the University of Cape Town (UCT) says the timing of easing Covid-19 restrictions is appropriate amidst declining transmission.

However, he says that it wouldn’t be unreasonable to expect that mask mandates return in the cases of a subsequent wave.

“Since monkeypox is relatively rare and does not spread easily between persons without close contact, the lifting of mask mandates is likely to have a negligible effect on the spread of monkeypox in the general population,” he says.

De Voux also notes that while cases are expected to increase, the threat to the general population in South Africa at this time is low.

NICD principal medical scientist Dr Jacqueline Weyer, on the other hand, has said that the disease transmission is slow within a population and it doesn't transmit the same way as Covid-19 or influenza.

Monkeypox can spread to others through direct contact with an infectious rash, scabs or bodily fluids, kissing, cuddling, or touching parts of the body.

Dr Aida Sivro, senior scientist at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) says that disease may also spread through saliva and respiratory secretions during prolonged and close face-to-face contact.

“This type of transmission is uncommon and would mostly happen with close family and household members around whom you don’t wear a mask anyway,” she says.

Initial symptoms of monkeypox include fever, headache, muscle aches, backache, chills and exhaustion. Upon onset of a fever, a rash can develop that initially looks like pimples, but develops into a blister.

The rash can appear on the face, hands, feet, chest, genitals, or anus.

Global monkeypox cases have exceeded 3 400 in more than 50 countries where the disease is not endemic.

The World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus has previusly pointed that that while he is deeply concerned about the monkeypox outbreak, experts have advised that it doesn’t constitute a Public Health Emergency of International Concern.

“We need all countries to remain vigilant and strengthen their capacities to prevent onward transmission of monkeypox,” he says.

The name “monkeypox” itself could soon be renamed in an effort to minimise stigmatisation and racism.

The World Health Organisation is expected to make an announcement on the name change within the week.

Masks a thing of the past

While the scrapping of restrictions is a move back to what we considered “normal” prior to the onset of the Covid-19 pandemic, experts say that the threat of Covid-19 has not been eliminated.

Sivro says the best way to prevent further, potentially more dangerous viral variants from emerging is to reduce transmission.

“This requires many integrated public health measures, including increased vaccination. Another danger of accepting Covid-19 as the ‘new normal’ is that we are just now beginningto understand the true impacts and dangers of Long Covid,” she says.

Meanwhile, the South African Medical Association (SAMA) welcomes the removal of the regulation measures. The organisation says that medical professionals will still face patients who may or may not present symptoms of Covid-19 and other viral diseases.

“Due to the close proximity between healthcare workers, patients and/or patient biological materials, SAMA urges its members to continue to observe non-pharmaceutical Covid-19 measures in all healthcare settings. The wearing of face masks for patients and healthcare workers who are symptomatic should become the norm beyond the health care facilities. SAMA maintains that vaccination is still the most powerful weapon that society has against COVID-19,” SAMA says.

Over 20.1 million people or 55 percent of the adult population in South Africa are fully vaccinated against Covid-19.

A new vaccine joins the rank

So far, Pfizer has been the vaccine of choice for most South Africans, as about 60 percent of the vaccinated population have received the shot.

Meanwhile, 30 percent of the vaccinated population have opted for the Johnson & Johnson vaccine.

Now, South Africans will have the option to receive a third vaccine, Coronavac.

Last week, the CoronaVac vaccine received full registration by the South African Health and Regulatory Authority (Sahpra). The inactivated vaccine – which has already been administered to more than 2.8 billion people worldwide – was approved for use in the age group 18-59.

Manufactured by the biopharmaceutical company based in China, Sinovac Biotech, it will be distributed by their in-country South African partner, the Numolux Group.

CoronaVac works by stimulating the body’s immune system without the risk of causing disease.

Once the vaccine enters the body, the production of antibodies is stimulated, which makes the body ready to respond to a Covid-19 infection.

COO of the Numolux Group, Anton Arendse, says the full registration of CoronaVac is a victory for vaccine choice in South Africa.

“We simply do not know what Covid-19 variants may come to the fore in the future, and firmly believe that South Africans should have a choice of the type of vaccine they are injected with, as protection against severe illness, hospitalisation and death,” he said.

South Africans will be able to receive the shot once the vaccine is supplied and administered in accordance with the National Department of Health (NDoH) Covid-19 vaccination plan and applicable guidelines.

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