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  1. Do low vaccination rates mean more variants?

    Rachel Schraer

    BBC Reality Check

    Lab worker with syringe and vaccine
    Image caption: Low vaccination rates might be one reason for variants

    The Omicron variant was first identified in South Africa, in a region with relatively low rates of vaccination. But making a link between the two is not straightforward.

    The virus mutates as it jumps between people as well as within a sick person. So in a population with a low vaccination rate, there will be more infected people around, and a greater opportunity for the virus to change.

    But potentially harmful mutations can take hold when the virus faces new challenges like vaccines – so a population with some immunity but with the virus widely present is a perfect environment for new mutations to emerge.

    It follows that a highly vaccinated population where infection rates are low probably provides the best barrier against potentially harmful mutations. The challenge is to get from a low to a high-vaccination environment as quickly as possible.

    “A mix is the worst thing, but unfortunately we all have to pass through having that mix to get to the other side,” Prof Rowland Kao, a veterinary epidemiologist says.

    Another factor is how many people in a population have suppressed immune systems and could be ill with the virus for a long time, giving it more chance to mutate.

    One theory is that Omicron emerged in an immunosuppressed person or population – possibly with untreated HIV which is a big problem in the southern African region. But this is very difficult to prove without knowing exactly where it first emerged.

  2. How sharply are case numbers rising across South Africa?

    Reality Check

    Woman being vaccinated in Soweto
    Image caption: A pop-up vaccination centre in Soweto, South Africa

    The Omicron variant appears to be driving a sharp increase in new infections in South Africa.

    Some 11,500 new coronavirus cases were registered on 2 December. That's a sharp rise on the 8,500 cases confirmed the previous day.

    "From the numbers over the last seven days and the curve depicting them, there is a much steeper upward curve than has ever been seen in the last three waves," says Health Minister Joe Phaahla.

    Gauteng province accounts for the highest number of coronavirus infections being reported in the country (about 70%). And last month, Omicron accounted for 74% of all samples sequenced in South Africa.

    But most of the sequencing to confirm the variant was done in Gauteng province, so it’s not yet clear just how prevalent the variant is in other areas.

    Gauteng is also among three provinces with the lowest vaccination rates. It has 32% of the adult population fully vaccinated, compared with the national average of 37%. But even some provinces with higher rates of vaccination have seen sharp rises in case numbers over the past week.

  3. Which countries have given the most booster jabs?

    Reality Check

    At the Downing Street briefing just now, Health Secretary Sajid Javid said: "We've delivered more booster doses than any other country, with the exception of the USA and China."

    He’s right in terms of the total number of booster doses given.

    China has given 66 million, the US has given 40 million and the UK is in third place with 18 million, according to Our World in Data.

    In terms of the number of booster doses given per head of the population, the UK is in seventh place, behind Gibraltar, Israel, Chile, Uruguay, Iceland and the United Arab Emirates – according to the same organisation's figures.

  4. Do travel bans really work?

    Reality Check

    Woman inside Tambo international airport on phone
    Image caption: A passenger at Johannesburg airport trying to find a flight

    South Africa’s President Cyril Ramaphosa has criticised the imposition of travel bans by countries around the world - including the UK - in response to the new Omicron variant.

    “The prohibition of travel is not informed by science, nor will it be effective in preventing the spread of this variant.”

    The World Health Organization (WHO) urges a “risk-based” approach to travel bans, taking into account other measures like face masks, social distancing as well as the extent of vaccine programmes.

    Its advice has shifted significantly from the early days of the pandemic in 2020 when it questioned the value of travel bans. At that time, the WHO said: “Travel measures that significantly interfere with international traffic may only be justified at the beginning of an outbreak, as they may allow countries to gain time”.

    Some scientific studies have suggested that these bans only work right at the start of an outbreak combined with other health measures, and that they could risk inducing a false sense of security in populations.

    Dr Deepti Gurdasani, an epidemiologist at London’s Queen Mary University, told the BBC that although travel restrictions might slow down the spread of disease, it was clear that the Omicron variant was already in other parts of the world now.

    “Rather than travel bans, you should have proper screening and isolation policies which would slow the spread,” she said.

  5. Which countries have the lowest vaccination rates?

    Reality Check

    Unloading of vaccine shipment at Goma airport, DR Congo
    Image caption: Vaccine supplies arriving earlier this year in DR Congo

    There have been repeated calls for wealthier countries who have fully vaccinated a significant proportion of their populations to share doses with others who haven’t.

    A WHO target for 10% of the world’s population to be fully vaccinated by the end of September was missed by dozens of countries, many of them in Africa.

    The average for Africa is currently around 7% fully vaccinated, with some countries as low as just 3%.

    There are some countries elsewhere in the world with very low vaccination rates - often in conflict zones - like Afghanistan, Yemen, Iraq and Myanmar.

    But Asia, Europe and the Americas have on average already gone past 40% of their populations fully vaccinated, which is the WHO target for the end of this year.

  6. Low vaccination rate a concern for South Africa

    Reality Check

    Pop-vaccine centre in South Africa
    Image caption: A pop-up vaccination centre in South Africa

    With the detection of a new variant, there is concern about relatively low vaccination rates in South Africa.

    About 41% of adult South Africans have received a single dose of vaccine with 35% of adults fully vaccinated, according to official data.

    South Africa has faced a challenge with fewer people turning up for the jabs.

    Daily vaccination rates have been dropping and are currently below the UK, EU and other countries.

    South Africa is doing fewer than 150,000 vaccinations a day against a target of 300,000.

    It recently asked Pfizer to delay vaccine deliveries because of the amount of stock that has built up.

    “We are worried [that] this outbreak is largely [among] young people…so this is a very high risk,” Health Minister Joseph Phaahla says.

    About 26% of those aged 18 to 35 years have had a single dose, with 21% fully vaccinated.

    Chart showing daily doses in South Africa and other countries

    The Department of Health in South Africa believes vaccine misinformation has played a role.

    Some of the anti-vaccination themes seen elsewhere in the world have found a particular resonance in South Africa.

    The introduction of vaccine passports in some situations has led to comparisons with the passes that black South Africans had to carry during the apartheid era, even though the passports are for all residents.

    Misinformation has also spread about vaccine safety - despite the large volume of evidence from clinical trials and the billions already jabbed showing complications are extremely rare.