PETER BRUCE: SA’s lockdown has reached its sell-by date

As much as it is possible to tell, the continuing coronavirus lockdown in SA is not serving much real purpose. Even the man who recommended it, Prof Salim Abdool Karim, the government’s chief adviser on Covid-19, believes it has already served its purpose. The aim was to push out what he believed the peak period of infection in SA (August to September). By September, he argued, the country would be better prepared to handle the volume of patients.

Or, to put it another way, as Prof Francois Balloux, director of the genetics institute at University College London, tweeted: “Infectious disease epidemiology is about minimising the numbers of years of life lost. It’s a numbers game and it’s not always pretty or nice. What may intuitively feel like an obvious strategy to reach that goal can be straightforward at times, at others, possibly less so.”

Following him on Twitter (@BallouxFrancois) has been a revelation. I take his definition to mean, as one respondent put it, that “it’s preferable to spend scarce resources to save, say, an otherwise healthy 18yo vs a 100yo with multiple comorbidities”.

Exactly. It was easy, and popular, for President Cyril Ramaphosa to argue the case for life over finance and economics when the first SA Covid-19 patient had died. It’s almost impossible to argue it now because we have a much better understanding of how utterly dependent we are on our economy to fight the epidemic.

The lockdown has become so counterproductive, and ministers like Nkosazana Dlamini Zuma so capricious and arrogant, that a toxic mix of a no-longer-appropriate health response and the free rein Ramaphosa has given ministers to make up any silly rule they care to impose on people and businesses is about to blow up in his face.

The cabinet met on Monday to decide where next to go with the coronavirus. Given the performances we have seen in the past week and a bit, the chances of them arriving at a coherent plan to reignite the economy and contain the virus must be virtually nil. It has already beaten them as it has beaten every other set of politicians who have tried to confront it. The virus will pretty much do what it wants.

The only thing we humans can do is to try to get out of its way. Washing hands has been standard epidemic advice from doctors for more than a thousand years. Keep your distance from others if you can. Wear a mask (for the sake of the rest of us) and wash your hands again. In the middle of that you have to be practical, like Prof Balloux above. Wait and hope for a treatment. And then a vaccine

Lots of people are going to die and we have a fair idea who they are — if you’re over 80 you’re in trouble if you get infected (though my 87-year-old mother-in-law, former ANC MP Judy Chalmers, has just pulled through). If you’re over 65 and you have co-morbidities like diabetes or respiratory problems — or you’re overweight, like most of the cabinet are — you’re in trouble.

And all the evidence points to the conclusion that a huge national effort to build or procure ventilators for the critical patients to come might be a waste of time. Experience abroad seems to be that by the time you’re on a ventilator for Covid-19 you’re not going to make it. What we may need more than ventilators is just plain oxygen. Has enough been secured?

I so enjoyed listening to this interview with Sweden’s former chief epidemiologist, Prof Johan Giesecke. He’s the guy who hired Sweden’s current chief, Anders Tegnell, whose relaxed and nonhysterical approach to the virus has won him praise and disapproval. I promise you won’t be disappointed. It isn’t that Sweden’s infection numbers look any worse or better for a European nation of its size. It just that not much you do seems to matter. Their attitude was to protect the elderly. Old-age homes are simply off limits to the public. But people practise social distancing and they wash their hands a lot. They go to work and the economy is on its feet and generating tax revenues for the state.

In SA the landscape is obviously different. Middle-class South Africans live middle-class lives like the Swedes do. Lockdowns may even work among us because we can work from home. But in the townships and shantytowns it’s another story. The lockdown almost guarantees the spread of infection unless you can test fast and widely enough to separate out the infected and quarantine and treat them.

I thought Mark Heywood at Daily Maverick did a great job introducing this paper from Prof Alex van den Heever of the Wits School of Governance. Heywood, famous for his Aids activism, preceded Van den Heever’s paper with a sensible editorial: “Up to this point,” he said, “Ramaphosa has done well. He has won the praise of the people of SA and many people internationally, who wish that they had a government that would act as decisively as ours. However, it’s early days and there is no glory yet to bask in. Therefore the last thing the president and his team need is uncritical praise, or to leave all decisionmaking to the group of experts attached to the national command council.”

Too bloody right, and here’s the Van den Heever paper — full of common sense and none of which, I suspect, will have landed well with the cabal of dictatorial crackpots to whom Ramaphosa appears to have left the running of the lockdown. He argues, so sensibly, for a strategy that impedes the virus while at the same time breathing some life back into the economy. But Ramaphosa just doesn’t have the quality in his cabinet to do that. It doesn’t walk and chew gum at the same time. Dlamini Zuma and Bheki Cele and Ebrahim Patel are making the rules and they only know one way to go when they’re digging: further down.

And while the cabinet was meeting, South Africans of all persuasions were trying to give it advice. In my experience, the ANC already knows everything, so there’s a sense that anyone who tells the government anything is wasting their time. But I thought a submission to a colloquium organised by the presidency last week, from my old colleague Stuart Theobald, was really good. Like some of the other contributors, Theobald suggests throwing the kitchen sink at the economy to get it going again — and without going to the International Monetary Fund.

I do worry a bit about how far you can stretch an already bruised central bank before you touch it on its independence. Three of the people Theobald credits at the start of his paper authored an op-ed in the Sunday Times last weekend which I thought stretched that elastic band too far.

There’s also (inevitably) been a thought-provoking response from the intellectual left, the folk who brought you the minimum wage. Like Theobald’s proposal, or any proposals for that matter, its unlikely to see the light of day, but an effort has been made and we should read it. It’s pretty good actually, but I warn you, it’s tough going and dense. Here’s an easy-to-absorb graphic version of it all. 

Whatever happens, we must try not to be frightened. Hunger is the worst of it. At home, we cooked over the weekend for people nearby who have nothing. So did most of our village. But it’s not enough. This is a problem for the state, though I hate to think of what Dlamini Zuma would subject people to if she were ever actually trying to help them. On Monday she formally announced that no hot meals can be sold under lockdown. The mind boggles. How fantastically stupid do you have to be to even think such a thing?

In 1347, the Black Plague arrived in Europe, carried by fleas from rats and in the air. It killed a third of the population between New Delhi and London. People went to sleep well and never woke up. They dropped dead in the streets, the rich and the poor.

But nothing changes. The rich headed for their country homes and social distancing, and the poor were stuck with each other. Doctors and nurses died in terrible numbers. It was bubonic plague though it didn’t have a name then and people assumed they were somehow to blame.

If you can, buy a wonderful book on the period called A Distant Mirror, by Barbara Tuchman. It’s teaching me a lot, especially about how little we change.

“Flight was the chief recourse of those who could afford or arrange it,” writes Tuchman. “The rich fled to their country places like Boccaccio’s young patricians of Florence, who settled in a pastoral palace ‘removed on every side from the roads’ with ‘wells of cool water and vaults of rare wines’. The urban poor died in their burrows, ‘and only the stench of their bodies informed neighbours of their death’. That the poor were more heavily afflicted than the rich was clearly remarked at the time, in the north as in the south.

“A Scottish chronicler, John of Fordun, stated flatly that the pest ‘attacked especially the meaner sort and common people – seldom the magnates’. Simon de Covino of Montpellier made the same observation. He ascribed it to the misery and want and hard lives that made the poor more susceptible, which was half the truth. Close contact and lack of sanitation was the unrecognised other half.

“In the countryside peasants dropped dead on the roads, in the fields, in their houses. Survivors in growing helplessness fell into apathy, leaving ripe wheat uncut and livestock unattended. Oxen and asses, sheep and goats, pigs and chickens ran wild and they too, according to local reports, succumbed to the pest … In remote Dalmatia bolder wolves descended upon a plague-ridden city and attacked survivors. For want of herdsmen, cattle strayed from place to place and died in hedgerows and ditches. Dogs and cats fell like the rest.

“The dearth of labour held a fearful prospect because the 14th century lived close to annual harvest both for food and for next year’s seed. ‘So few servants and labourers were left,’ wrote Knighton [Henry Knighton, canon of Leicester Abbey], ‘that no-one knew were to turn for help.’ The sense of a vanishing future created a kind of dementia of despair … with so few hands remaining to restore the work of centuries, people felt, in [Francis] Walsingham’s words that ‘the world will never again regain its former prosperity’.”

Well, guess what, it’s all happening again here in SA nearly 700 years later. The poor live in medieval conditions and the governing elite have forced them to pile even closer up against each other for five weeks while they figure out what to do. The rich are comfortable at home worrying about whether the world will ever be as fabulous again. Ramaphosa said in his weekly letter to the nation on Monday that “over the past three weeks, we have been confronted with distressing images of desperate people clamouring for food parcels at distribution centres and of community protests against food shortages”.

Of course he has. Sadly, the ministers and officials in charge of the food programme are still sorting out the paperwork. It must be such hard work. Meanwhile, when you come down to it, the answer was staring at us in the face the whole time. The lockdown bought time to prepare enough beds for the wave of sick people by August or September. So why didn’t we just go out and buy, who knows, 50,000 beds? There are lots of places to put them. Half the office space in Sandton is empty. Instead we are now going to spend every last cent we have trying to save the economy. Stupid us.