Omicron variant: South Africa battles vaccine hesitancy, conspiracy theories

Few countries have felt Covid-19 more forcefully than South Africa.

It has overcome three outbreaks of the disease, lost nearly 90,000 lives and endured crippling lockdowns that have brought parts of the economy to its knees.

On top of that, it has almost seen its health system collapse.

Now, South Africans have been told one of the most radically mutated versions of the virus could be the cause of a recent spike in cases near the nation's capital.

The World Health Organization (WHO) has designated the B.1.1.529 variant first detected in southern Africa as Omicron.

In an impromptu address to the country about the variant, Health Minister Joe Phaahla expressed frustration that so few South Africans had turned up to be vaccinated.

The country has a target of vaccinating 70 per cent of its adult population, but has only reached 40 per cent.

"We know that, if more and more people are vaccinated, we can limit the number of mutations," he said.

On 16 November 16, only 273 new cases were reported. Just a week later it had reached 1,275 then doubled to 2,465 the following day.

Dr Phaahla said that was when scientists told the government of their concern that Omicron was driving the spike in cases.

Bioinformatician professor Tulio de Oliveira explained Omicron had an "unusual constellation of mutations" that could make it more easily transmissible and better at evading the immune system.

"It is a reason for concern in South Africa," he said.

At the briefing, the Health Minister urged people to sanitise their hands, wear masks in public, avoid potential spreader events such as end-of-year parties, and get vaccinated.

Professor Charles Shey Wiysonge, director of Cochrane South Africa at the South African Medical Research Council, said there was one clear problem holding back vaccine rates: vaccine hesitancy.

The vaccine debate

The ABC spoke to Cape Town-based Uber driver Misheck Mabheka earlier this month, before Omicron was detected.

He said the vaccine was "working nice" for him, and that he told this to anyone who asked about the benefits of being vaccinated.

"I'm working every day with lots of different people. I'm not sick and I'm not even affected," said the Zimbabwean who now works in Cape Town.

Like many South Africans, Mabheka said he was troubled by the number of people resisting vaccination, despite the noticeable effect it has had on reducing transmission rates.

Earlier in the year, South Africa's vaccine programme stalled because supply was constrained.

Now the country has plenty of doses and not enough people showing up to be vaccinated.

At its peak in August, South Africa administered nearly 400,000 vaccine doses in one day. Over the past week, the daily rate has at times dropped below 10,000 doses.

To get people across the line, vaccines were offered at 1000 polling stations during recent municipal elections, people over 50 were offered supermarket vouchers when they had their first dose, and vaccination drives have been held on weekends in shopping centres and town halls.

Wiysonge said getting the vaccination rate up would be hard, but not impossible.

"It is going to be a high mountain to climb, but we can climb it," he said.

'In the hands of God'

On a dusty field, under a worn marquee in Ashton, about 200km from Cape Town, church-goers seemed unaware of the rising heat and the global pandemic at a recent Sunday service.

There was not a mask in sight, even though the spirited singing and dancing made this a high-risk event.

Elder Jonas de Koker tells his followers Jesus will help them overcome financial despair, family crisis or sickness.

De Koker told the ABC he did not discourage others from being vaccinated, but he has chosen not to be inoculated against Covid-19.

"It's your own democratic right to choose [but] I just say that life and death is in the hands of God," he said.

De Koker said he believed God had saved his life before and would continue to protect him.

"It's not that I'm against [the vaccine] but, for myself I said no, I'm fine," he said.

Stephen Smith preaches at a similar evangelical ministry, but takes a harder line on Covid-19.

He tells the factory workers and farm labourers at his services the pandemic was planned by powerful people.

"Some of them see this as an opportunity to get richer," he told the ABC.

Not only has he actively discouraged people from being vaccinated, he has also discouraged several people with Covid-19 symptoms from being tested.

Smith - who describes medicine as "common sense" - said he was unlikely to change his views.

When followers reach out to him when they think they've caught Covid-19, he prefers to offer prayer and a mixture of ginger, lemon juice, garlic and aspirin.

He said his views - which were based on research he did "on the internet" - were also influenced by a distrust of the government.

According to Wiysonge, vaccine uptake is high in the parts of South Africa where its citizens felt the government dealt with the pandemic effectively.

Meanwhile, in areas where people distrusted the government, vaccinates rates are low.

Corruption within the ruling African National Congress is also an issue.

President Cyril Ramaphosa has acknowledged corruption was rife under former President Jacob Zuma, but has struggled to clean up his own government.

A recent report by South Africa's anti-corruption unit revealed millions of dollars intended for the fight against Covid-19 were misappropriated, some of it by the former health minister Dr Zweli Mkhize.

As he drives around the suburbs of Cape Town, Mabheka said some passengers told him they didn't want to be vaccinated because they thought the vaccination drive was a ploy to line the pockets of corrupt officials.

The Uber driver doesn't want to see unvaccinated people shunned, shut out of work, or unable to attend events such as sport matches because he worries this will drive more division.

"Try to understand their side but, in the same sense, give them that side of yours," he said.

"By so doing, I think we can change the way they think, the way they see things."

Wiysonge also argues that the door should not be closed on people who resist being vaccinated.

"Engage them, listen attentively to what the issues are, what their concerns are, show empathy," he said.

"It's good to bring the evidence, but it's also important to just show that you care."

- ABC