Fueled by the new variant first discovered in neighboring South Africa, the cases have inundated much of its health infrastructure, leaving many families to make agonizing choices, and exposed the danger of deep inequalities in Covid-19 vaccine distribution. According to official government data, the record for confirmed single day Covid-19 cases was nearly seven times higher at the very peak of this second wave compared to the first. In the first three weeks of January, the number of severe Covid-19 patients at Queen’s hospital shot up from 12 to 107 cases, says Doctors Without Borders (MSF.) Healthcare workers have been hit particularly hard. Before the pandemic, the impoverished country in Southern Africa could only just manage its healthcare. Now doctors and nurses are calling in sick and several have died from the virus. Malawi’s national vaccination plan is dependent on COVAX, the World Health Organization-backed facility organized to help poor countries access Covid-19 vaccines. Its government promised last week that the first consignment of the AstraZeneca vaccine will arrive by the end of February. But healthcare workers are preparing for a much longer wait, skeptical they will be delivered anywhere near that schedule because of regulatory red tape, and worried by an announcement Sunday by South African scientists that show the vaccine provides “minimal protection” against the variant discovered there.