COVID-19: Jeremy Nel on vaccines, returning to normal and ivermectin

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Background image: Gerd Altmann, Pixabay | Photo of Jeremy Nel: provided


My first question may be the worst: Will we ever return to a pre-Covid “normal” and if so, how long till then?

I think the closest we’ll come to a pre-Covid existence will be when all the adults have been vaccinated, provided the vaccine still appears to be working well enough against whatever variants of Covid are circulating at the time. Once all the adults in a particular group have been vaccinated then it must be okay to socialise together, or attend meetings together, or congregate together. Effective vaccines must be the key to getting back to normal, as we will have to learn to live with a virus that may not completely go away anytime soon. I do think there will be some changes that will persist, though. For one thing, Covid has shown us how possible it is for people in certain types of jobs to work remotely. I doubt many offices will be quite as full as they were before Covid hit. And of course many businesses have closed down, which is very sad.   

Many homes in South Africa see many generations living together, or in close proximity. May I sketch a scenario? Dad (60 years old and healthy, but asthmatic) and mom (55 with many comorbidities) live with their single daughter (32 and healthy) and granddaughter (7).  Let us say mom and dad both get the jab. How careful does the daughter still have to be with her social life? It could be many more months, possible a year, before she gets the vaccine.

South African guidelines haven’t yet been developed. But in my opinion, vaccines have to be enough to behave as if you’re protected. We know that’s not 100% true – there is always the risk of vaccine failure, but if being vaccinated doesn’t allow you get back to normal, what else would we be waiting for to come along? It’s important, though, to know that a vaccinated person may still be able to spread the illness to others sometimes, so until most of the rest of the public are vaccinated, vaccinated people should still wear a mask and maintain social distancing when they’re out in public, or around other unvaccinated people who are at high risk of severe Covid. This does also speak to the pressure we all need to put on the South African vaccine programme to vaccinate as many people as possible as quickly as possible. The quicker that is accomplished, the quicker things will go back to some version of normal.

How about grandchildren? Once grandma and grandpa have had the jab, should we encourage regular and close contact with little ones again?

Again, South African guidance hasn’t yet been developed. But the CDC guidelines suggest that this is fine. The vaccine should protect the grandparents against severe disease if they catch Covid from their grandchildren, and on the other hand, if the grandchildren catch Covid from their vaccinated grandparents, we can expect the disease to be very mild, as it almost always is in children. 

My understanding is that COVID-19 is unlikely to be eradicated in my lifetime, but we are going to get regular vaccine “updates” to minimise our risk, possibly once a year with our flu vaccines?

I don’t think anyone knows for sure what the future will hold with Covid. My own opinion is that we are unlikely to eliminate this virus any time in the next few years, and possibly ever. So we’ll have to learn to live with it, using vaccines and some common sense public health measures as the main ways to limit our risk. It’s not yet known whether we’ll need to be vaccinated again as a booster shot, or be vaccinated again with vaccines tailored to work better against newer strains. The vaccines haven’t been around long enough to tell, but I think it’s quite possible that will be the case.


We still cannot finish a conversation on vaccines without the YouTube alternative called ivermectin. Everybody with a cell phone seems to be an expert on ivermectin, but the first large controlled, double-blind test on ivermectin published by the Journal of the American Medical Association says, “The findings do not support the use of ivermectin for treatment of mild COVID-19.” Anyone can read the data (click for the complete article).

May I ask a number of questions based  on this article?

My understanding is that the methods used here to test ivermectin are the exact  same methods used to test the vaccines – neither the patient nor the medical practitioners administering the treatment knew which patient had received the real thing and which patient the placebo – am I correct?

Yes, you are correct. This is called “double blinding” and it’s a very important measure to take in good clinical trials, so that neither the patient nor the healthcare workers running the trial can influence the results either consciously or unconsciously. 

This is only the second double-blind study on ivermectin. The first was published in the Lancet and had the same outcome, but they ran it on an extremely small number of patients. Am I correct?

I haven’t gone back to look at every study, but that would be roughly right. Most of the studies were so-called “open label”, which is the opposite of blinded, and where the participants know they’re getting ivermectin and the doctors know they’re giving it. As you can imagine, this can introduce quite a lot of bias, even if it’s unconscious. Perhaps the patients who know they’re getting ivermectin report that they’re feeling better as the result of the placebo effect, for instance. 

Some members of the religious right would say that no vaccine is 100% effective. Can you explain why medical doctors, like you, advocate vaccines, but do not support ivermectin?

Of course no vaccine is 100% effective. But not taking a vaccine is 0% effective, so if the vaccine is better then that it’s worth taking – provided it’s safe, which all these vaccines are. The vaccines have been proven to work in very large studies using the most robust methodology possible.

This contrasts starkly with the ivermectin research, which consists largely of small and very poorly designed trials that aren’t capable of giving any clear answers. 

When is a medicine “effective” enough to administer if nothing seems to be 100% effective?

Both medicines and vaccines should be given only if there is good evidence that they work, and that they are safe enough to justify giving them.

See also:

Ivermectin, vaccines and science – a vet explains

Waarom ’n entstof jou lewe kan red, maar nie jou DNS kan verander nie

Oxford se breins, ’n siek sjimpansee en my linkerarm: Ons gaan COVID-19 dôner

Die etiek van inentings en toetsing: Izak de Vries as proefkonyn

Herman Wasserman en die infodemie: Disinformasie in die Globale Suide

COVID-19: Verdraaide feite wat so vinnig soos ’n virus versprei

Jy is ’n belangrike deel van die nuwe wapenwedloop

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  • As ek reeds covid gehad het, dan het ek mos teenliggaampies geproduce? Moet ek dan steeds inent?

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