The lockdown is costing South Africa’s already crippled economy an estimated R13bn to R20bn a day. But, despite its heavy costs, it is unable to protect the millions of people who live in crowded townships and teeming informal settlements. Here, homes cluster closely together, many structures house families of four or more, scarce communal taps and toilets are shared among hundreds – and social distancing simply cannot be maintained.
That the lockdown cannot protect residents in these areas has been confirmed by detailed Covid-19 data from the Western Cape. This shows, for example, that confirmed cases in Khayelitsha grew from six to 44 in early April and then to 203 by 27 April. The lockdown was in place throughout this period, yet infections rose by 3 300%.
As Professor Alex van den Heever, health economics expert at Wits University, has pointed out, ‘if a lockdown doesn’t stop infections in SA’s high-density areas, it is largely ineffective’ and ‘equivalent to no intervention’ at all for millions of people.
Perversely, the people least protected by the lockdown are also the ones who suffer most from the hunger and deprivation that it causes. This is evident from a recent opinion poll conducted by the Human Sciences Research Council (HSRC) among some 19 300 respondents.
Among respondents as a whole, roughly a quarter (24%) said they had no money to buy food. More than half (55%) of those living in informal settlements also lacked the money to buy food. So too did two thirds of township residents.
A smaller opinion survey, carried out by Victory Research among 600 respondents, shows a similar picture. This survey asked people how easy or hard it was to buy essential supplies: a question covering both the costs and availability of food and other vital items.
Among black South Africans in general, 66% said it was hard or very hard to do. Some 65% of township residents agreed. Among residents of informal settlements, however, 79% said it was hard or very hard to find food and other essentials.
The Victory Research survey also shows that 54% of South Africans oppose any extension of the lockdown beyond the end of April. Yet this is what the government is determined to do. Some 75 000 soldiers have thus been deployed to enforce restrictions that many increasingly resent. This is a recipe for confrontation.
Lockdown restrictions arbitrary
Against this background, the government’s proposals for tapering off the lockdown over many months are far too slow, rigid, arbitrary, and subjective.
Too slow, because the government sees the lockdown as lasting for another six to eight months, albeit with reduced restrictions over time. Too rigid, in that bureaucrats will assign entire sectors to the ‘correct’ risk level (from 1 to 5), with scant regard for the varying businesses within them. Too arbitrary, because the criteria laid down are often vague and open to conflicting interpretation. And too subjective because decisions may be based on personal preference, rather than health needs.
The subjective element has been confirmed by trade and industry minister Ebrahim Patel, who says that ‘deciding who goes back to work’ depends not only on objective data (a given sector’s contribution to GDP, for instance) but also on ‘the making of a judgement call’.
Subjectivity is evident too in Mr Patel’s irrational decision that unfettered on-line shopping – which poses no health risks, is allowed elsewhere, and would help keep the economy alive – cannot be permitted in South Africa because it would result in ‘unfair competition’ for spaza shops and informal traders.
Government rulings on whether to move the country (or parts of it) from higher to lower risk levels will depend entirely on health criteria. Economic considerations will not feature and two health tests will rule. These, in essence, are whether Covid-19 infections are still spreading, and whether health systems are sufficiently ready.
If these health criteria remain the key deciders, the lockdown could last all the way into 2021. Even when a ‘low virus spread’ has been attained, health sector readiness could still be found wanting – which would further postpone the lifting of restrictions.
A prolonged lockdown could see millions of South Africans losing their jobs and homes, exhausting their savings, and going bankrupt under mountains of debt. Yet the government seems indifferent to mounting hunger, hardship, and economic collapse.
The lockdown must thus be scrapped – and with immediate effect. Three principles must, however, apply.
Lifting the lockdown – safely
First, all businesses should be allowed to return to work, but must also shoulder the burden of protecting their staff, customers, and suppliers as best possible. Second, those particularly vulnerable to the virus should practice social distancing and, if necessary, go into self-isolation or quarantine (with the help of tax-funded vouchers for those in need). Third, some 13 million children should be kept out of school until September. Little social distancing is possible in most schools – and a return to school in May is likely to undo whatever gains five weeks of lockdown have brought.
Some people may be afraid of the economy re-opening, but ‘following the science’ should help to temper these concerns. Most virus victims have zero or minimal symptoms. In the US, as many as 23 million people may have contracted Covid-19 without ever knowing it or seeking to be tested.
Early projections of likely Covid-19 death tolls were far too high and are being revised sharply down. This is true in South Africa too, where the SA Centre for Epidemiological Modelling and Analysis (Sacema) has revised its initial estimate of between 87 800 and 351 000 fatalities.
A more realistic estimate, says Professor Shabir Madhi of Wits University, is a total of some 25 000 Covid-19 deaths this year. This is significantly fewer than the 28 678 deaths from TB recorded in 2017.
However, the longer the lockdown lasts, the more the death toll from other diseases could rise. Increased hunger and hardship could push TB deaths in 2020 far higher than the norm. Deaths from diabetes, heart disease, HIV, cancer, malnutrition, and other non-Covid causes could rise sharply too, significantly outstripping the death toll from the virus.
This is why 19 doctors wrote to President Cyril Ramaphosa last week urging him to lift the lockdown, warning that time is of the essence, and stressing that Covid-19 fatalities must be balanced against the many avoidable deaths the lockdown is likely to cause.
The key issue confronting the country is not the crude one of whether ‘profits’ should be put before ‘lives’, as the EFF and some others have stated. The real question is how best to balance ‘lives’ versus ‘lives’.
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