SAGES Magazine

EDITORIAL The year of 2022 started with the final pangs of the 4th wave of COVID – driven now by the “Omicron” variant of SARS-CoV2. The BA.1 was dominant but now is being replaced by the BA.2 subvariant. Fortunately, it was evident early on that Omicron had a predilection for the upper airway epithelium (rather than the alveoli) thus producing clinical symptoms compatible with coryza, the more typical features of coronaviruses in general. It would appear that as this pandemic virus evolves, its infectiousness is increasing while its potential lethality is declining. This is what many predicted and we trust this trend continues. COVID vaccination remains a challenge with now almost 50% of South Africans vaccinated. Vaccine hesitancy remains an issue we will continue to struggle with. However, possibly counterbalancing this is the remarkable data from seroprevalence studies on the natural exposure to SARS CoV2. In some of our communities it exceeds 90% and highlights the extraordinary aggressive manner this virus has propagated across the planet and our country, despite many curtailment measures. In clinical practice, we are briskly returning to pre-pandemic normalcy with a significant uptick of patient loads being observed. SAGES has taken the decision to withdraw its existing advisory on endoscopy practice adopted 2 years ago to keep pace with changes. Individual practice based risk assessment should be considered and decided on as per evolving international guidance. Mandatory COVID screening pre-endoscopy is no longer advocated. SAGES has posted its position on the website. The current edition of the Journal is filled with a diversity of articles. Murindagomo and colleagues remind us of an important vaccine preventable illness, hepatitis A and its potential consequences. Bortz reviews incomplete optical endoscopy while Mnyombolo-Combrinck has reviewed their endoscopy outcomes. IBS remains a common problem and clinical challenge. Patients often resort to herbal remedies. Fong has performed a meta-analysis and systemic review on the role of Aloe usage in this setting. Digness has reminds us of iron deficiency in IBD and Cockeran and colleagues propose a case for a faecal bank for FMT in South Africa. Machiridza looks at extraintestinal manifestations of IBD in a comprehensive case report. In 2020 at the height of the pandemic I referenced Queen Elizabeth II from her April 2020 address where she quoted the Vera Lynne song “We’ll meet again”. Two years later, Queen Elizabeth celebrates her platinum jubilee, having had COVID recently, Vera Lynn sadly has passed (at age 103) and we are meeting again. The Gastro Foundation of Sub- Saharan Africa (GHASSA) has now had 2 highly successful fellows training weekends (at Spier, and more recently the Vineyard). Online content has grown massively, and locally Project ECHO meetings have grown significantly. However we miss contact and interaction so the SAGES Conference this year, jointly with ASSA, VASSA, and SASES will be in the Drakensberg and we shall meet again. We look forward to seeing everyone. Sadly not all will be there and we note the sad passing of a SAGES stalwart, Professor Hennie Grundling. Finally, a changing of the guard has occurred. Sandie Thomson has stepped down as a Journal editor, replaced now by Martin Brand. We extend our heartfelt gratitude to Sandie for his Journal (and many other) contributions. We welcome Martin and look forward to his editorship. May 2022 be good to you! Mark Sonderup Editorial THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 1 | 1