Covid-19 has peaked and much of the lockdown has been lifted. That is the good news. The bad news is that fabrications have been used to misinform the public once again, poisoning the political arena.
On 15 August the National Coronavirus Command Council announced that South Africa would move to ‘Level 2 Alert’. At last, most sighed. Bans on alcohol, tobacco, inter-provincial travel, and social visits were lifted while restrictions on restaurants and bars were relaxed. But should this have happened sooner, or later, or was the timing right?
There have always been two arguments about unlocking our civil freedoms during the pandemic. One is that some liberties should not have been restricted in the first place, as they are either ineffective or the human cost outweighs the benefits. The other is that ‘lockdown works’, so it should be relaxed only once it has done its job.
President Cyril Ramaphosa, who has effectively been the Command Council spokesperson, has firmly been of the latter view, addressing the country on 15 August ‘amid signs of hope‘ that South Africa had passed the peak at that stage, in part due to the lockdown. The problem is that while the hope that irrational regulations would be lifted was real, Ramaphosa’s justification for doing so was false.
‘Fewer people are presenting with symptoms at our health facilities,’ he said when announcing Level 2, and ‘[t]he number of patients hospitalised has decreased from 10 000 at the beginning of the month to around 4 000’.
Yet National Institute for Communicable Diseases (NICD) data contradict the president. NICD surveillance of ‘select hospitals’ showed that the initial number was lower, while there were 6 584 Covid-19 hospital admissions on 15 August.
Undercount
Insofar as the ‘select hospitals’ did not cover the entire country, these numbers must be an undercount. Ramaphosa’s ‘4 000’ hospital admission figure on 15 August is therefore at least 39.2% less than the 6 584 accounted for at the time. Why was the president off by 40%?
Another question arises from the fact that NCID data shows that average ICU occupancy outside the Western Cape in the last week of July was 1 035. In the week leading to 15 August, that figure climbed 20% to 1 201. Average ventilator usage was up from 604 to 643 on the same basis.
Furthermore, the number of healthcare workers admitted with Covid-19 had just doubled in the week from 7 August to 14 August, from 116 to 249.
Given all that, how could Ramaphosa say that ‘pressure on our health facilities’ had been ‘significantly reducing’ since July?
The Command Council claimed to follow World Health Organization (WHO) guidelines (despite the WHO’s poor Covid-19 record), but the first guideline used to relax lockdown is that ‘evidence’ must show that ‘transmission is controlled’.
To answer the question, ‘is the epidemic controlled (Yes or No)’, the WHO offers several criteria. One is that ‘less than 5% of [test] samples’ come out positive ‘at least for the last two weeks’, if testing occurs at South Africa’s scale.
But on a smoothed daily rate basis, Oxford University data shows that more than 20% of tests were coming out positive from 4 July to 15 August. South Africa failed this test to relax lockdown by a factor of four.
In addition, the WHO stresses that ‘(trend) evaluation requires that no changes occurred in testing or measurement strategy’ in the relevant period. But the Command Council’s ‘community testing’ programme dropped from a peak of over 10 000 ‘active tests’ on 1 August to under 1 300 tests on 12 August, just before Ramaphosa’s Level 2 announcement.
WHO criterion
Another WHO criterion for ‘epidemic control’ is an observed ‘[d]ecline in the number of deaths among confirmed and probable cases at least for three weeks’. But smoothed daily deaths had only been observed for three days by 15 August, not three weeks.
It is hard to find a serious WHO epidemic control criterion that South Africa did meet on 15 August. Nor could the Command Council argue that it was explicitly willing to depart from WHO guidelines, which it repeatedly espoused. On 14 August, Health Minister Dr Zweli Mkhize had just welcomed a WHO team of experts to provide further ‘guidance’.
Mkhize explained: ‘We have received queries why there would be a need for the [WHO] surge team if we are past the surge. I would like to emphasize for our people that we are not past anything’.
That was on 14 August. On 15 August, Covid-19 hospital occupancy had supposedly dropped to a fake ‘4 000’, and epidemic control had been magically ‘proven’ for the last three weeks, suggesting the surge was long over.
Irrationality compounds irrationality
Having imposed irrational regulations to start with, the Command Council then used fabrications to justify lifting the irrational bans. Too many welcomed Level 2 without scrutinising the reasons, thereby letting the Command Council get away with the false narrative that lockdown worked.
The long-term good news is that the Command Council exposed its vulnerability to pressure, both public complaint and court attacks. The partial end of lockdown had very little to do with ‘viral control’ – it was just too unpopular and harmful to impose any longer.
The bad news going forward is that the game of charades of those in command of our liberties (and pretending to be in control of the virus) was largely mistaken for the real deal.
Why does that matter? Ask yourself that question next time the Command Council boasts of its ‘success’ in managing the pandemic to justify nationalising private healthcare permanently.
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