13 May 2020
The government did not respond to requests to explain the reasoning behind some of the Covid-19 disaster regulations. Archive photo: Ashraf Hendricks
Curfew, ban on sales of cigarettes, alcohol and hot food, limits to outdoor exercise: We asked government to explain the reasoning behind some of the more controversial disaster regulations. We got no answers, but public health experts and economists were very critical of the measures.
We sent detailed questions to the Government Communication and Information Services (GCIS) on 11 May at about 10am asking for the reasons for the regulations discussed in this article. We followed up. As of midday on 13 May we have received no response.
We also spoke to a lawyer who explained that in terms of the Promotion of Administrative Justice Act, the government has to explain, within 90 days (unless urgent litigation is brought), reasons for any legislation if requested by a person whose rights have been materially and adversely affected, a qualification every person in the country would meet for the regulations discussed here. Government can also give reasons to Parliament.
Here’s what the experts (some choosing to be anonymous) say.
Public Health Expert: This is potentially discriminatory, as many of the users of such services would be working class essential staff who rely on such services. The contrary argument seems to be based on the large numbers that would be expected to congregate at takeaways. A more subtle approach seems defensible, including drive-through pick-ups and managed queues (as for grocery stores), but applied equally to all food outlets, including restaurants. Again, if the intent is to sustain behaviour change over months rather than weeks, the current approach seems indefensible.
Prof Niccoli Nattrass, School of Economics, UCT: An open shop should be allowed to sell anything. It is how the shop runs — with social distancing, hand sanitisers, etc — not what it sells, that is important in limiting the transmission.
Public health expert: Despite all the good public health reasons for discouraging tobacco sales, conflating those with pandemic responses is indefensible. The evidence that smokers are more affected by Covid-19 than non-smokers is not clear-cut. The opposite has even been proposed (in France). The “zol” argument, and the potential role of saliva in home-rolled cigarettes, is facile. The risks of fuelling the illegal cigarette market are real, and evident already. There is a real irony to the impact on e-cigarettes, which have been ignored to date
Robin Wood, Emeritus Professor of Medicine UCT and Director of the Desmond Tutu HIV Foundation and TB aerobiology transmission expert: Political prejudice without a shred of evidence. Restriction of personal freedom worthy of a totalitarian regime.
Prof Alex Welte, public health, HIV/Aids and Epidemiology expert at the University of Stellenbosch: The banning of alcohol and cigarette sales appears, in the short term, to be improving people’s physical health, and, in some respects, their mental health – the closure of drinking holes is clearly reducing violent crime, of which we have plenty – but prohibition strikes me as a non sustainable way to reach these goals.
Nattrass: The supposed gains (healthier lungs) are likely to be insufficient in terms of limiting deaths from the virus to justify the costs of enforcement and this also encourages illicit trading.
Public health expert: This is a very tough one. There is good evidence of a positive effect on trauma admissions to hospitals. That helped to create space for Covid-related admissions, but it is unclear whether that capacity has been stretched to date. … What worries me more is the Level 3 proposals – what will be achieved by limiting sales to a few hours a day, and a few days a week, apart from overcrowding liquor outlets?
I’m reminded of a Scottish intervention in the mid-1980s – at that point Scotland had the shortest pub opening hours in the UK, and the highest drink-driving problem. They reduced public drunkenness, drink driving and accidents by lengthening the opening hours.
That South Africa has a problematic drinking culture, at least in some communities and some settings, is clear. Whether prohibition is likely, in the medium term, to address that issue is less clear. If a sustainable pandemic response is needed for months, then this ban will not work. A reasonable approach, which treats the population as partners in the national effort, is more likely to garner support. The alternative is increasing illegal distribution, and increased risk of methanol poisoning.
Careful consideration of the economic impact is also needed, not just in terms of tax revenue, but in terms of the impact on the wine industry, the craft beer and gin industries, and the impact on small businesses.
Wood: Political prejudice without empirical evidence. A superficial knowledge of the history of prohibition predicts the popular response and encouragement of criminal takeover of the alcohol trade.
Nattrass: There may be benefits in terms of lower levels of domestic violence from reduced alcohol sales, but even so, the rule seems overly draconian. No other country has gone this far.
Public Health expert: This seems to be potentially counter-productive, as it concentrates numbers of people in a relatively narrow time frame for no obvious benefit (except that it makes policing easier). There have been cogent arguments made for relaxing the times, or at least adding an after-work time slot.
Wood (who based his answers on an assumed strategic aim of creating herd immunity and flattening the curve): I do not think outdoor activities present a significant risk for transmission of airborne disease unless very close contact. I would allow but avoid groups. Cloth masks should be worn to stop transmission.
Welte: I am unaware of any plausible arguments that this limits transmission, and it’s easy to see how it might do the opposite, by crowding people together into a rush hour of sorts, which is exacerbated by forbidding us to use many open public spaces like parks.
I do have sympathy for the people who need to make these very tricky decisions, as we really don’t know the main routes of transmission, but we do know that if nothing is done to limit transmission, the outbreak will be an utter disaster – not that the lockdown effects are not, in themselves, disastrous for the economically most vulnerable.
My overall concern is a general lack of transparency, which is neatly captured in repeated references to “command councils” – which brings to mind the laughable terminology of the EFF student wing – the “student command”. It sounds almost like senior government officials are revelling in their newfound role as commanders in some great battle.
Nattrass: This is irrational and results in unnecessary and potentially harmful crowding. People should be allowed to exercise when it suits them and be advised to maintain social distancing.
Public health expert: The logic seems to be based on ease of policing, rather than risk of transmission. Congregations at swimming pools are likely to be more difficult to manage, and allowing people to spend time on beaches (or swimming), as opposed to walking on the beach might also be problematic. However, as with parks and nature reserves, it seems that the predominant logic is the ability of the police to monitor public behaviour. The risks, though, seem low and manageable, if the public is trusted to change their behaviour over a long period.
Nattrass: The ban on walking on Table Mountain is absurd, It results in unnecessary crowding of people exercising in the limited spaces available.
Public Health expert: No reasons for this decision seem to have been provided, but it is possible that the concern was about high-density areas (townships and informal settlements), where social distancing was not possible, and behaviour change was not being observed. Whether the curfew results in greater adherence to social distancing recommendations is open to debate.
Wood: This has nothing to do with transmission. It relates to ease of police monitoring and population control.
Welte: Where I live this is becoming a club with which to beat the homeless – at last we can actually report them to law enforcement for blighting out suburban bliss. Since we can only go out between 6am and 9am anyway for any reason other than transacting with an allowed business, I don’t think we need the extra “command” structure of a curfew.
Of course the government does not want to fail to do something useful – but there should be much more emphasis on information on infection control, public investment in masks, soap, clean water. Some of which has happened, but really it seems to me to be deserving of a barrage of public service announcements, billboards etc. Treating it as a problem to be addressed by commanding us how to behave is surely most likely to bring out the tendency to comply in the most minimal way, and to buck the system at every turn.
Public Health expert: This one is really complex, as the evidence regarding carriage and spread by children is incomplete. A number of competing considerations will need to be taken into account, but evidence for one option over another is probably lacking.
Wood: The risk to young children is very low so the restriction on schooling relates to risk of transmission from children to adults. While the data is scarce, it does seem as though Covid-19, in contrast to influenza, does not significantly transmit from children to adults.
Welte: School closures are hard for parents on all levels of the economic ladder. For poor parents, it becomes difficult to work when children are not effectively taken care of, even fed, for several hours at school. Home schooling is tough even for the more well-to-do parents, but especially for parents who did not get much education because of apartheid. That said, the transmission potential of schools seems explosive and devastating – so I frankly agree that schools should be kept closed for the foreseeable future.
To address the more immediate gaps this leaves in terms of childcare becomes the immediate challenge.
Rather than somehow trying to coach or cajole all parents into becoming confident home-schoolers, we should accept that this is not going to happen. We should also reflect honestly on our appalling education system. Not only the inequality, but also our obsession with coaching for exams, in order to access further education, has left us with a curriculum that is largely an empty shell. I usually encounter students no earlier than their master’s programmes – and they are usually selected for being bright and eager. What is clear, almost without exception, is that they lack experience with tackling real problems, and that they have not been given basic pointers on how to break down complex tasks, how to check their work systematically. We should not delude ourselves that our schools are doing important work everyday, patiently washing away ignorance and building intellectual fibre by grinding through the curriculum. With some sensible messaging, and support to parents, we can write off the academic year and regroup later.
Public Health expert: As you say, it is unclear whether restrictions are in operation. It would seem counter-productive to hamper rapid development of services which will be increasingly important for months, and which can assist some firms weather this crisis. It is true that e-commerce is probably most important for the middle class, and largely (but not totally) irrelevant for the working class. Enabling e-commerce may also compromise some small businesses, but I am not sure that is sufficient reason to intervene. A more important question is whether a continued restriction on the sale of “non-essential” items is warranted.
Wood: Electronic commerce should be encouraged not discriminated against. Workers in the industry however, should be protected in the workplace and transport.
Nattrass: There are no obvious reasons why online orders and delivery should not have been allowed.
Natrass: There is no valid argument for basing the economic lockdown on sectors. The focus should have been on activities and on making them safer, rather than on sectors. The government has been extremely slow to provide support for businesses, workers and the poor during this lockdown.
Welte: There need to be formal regulations to protect workers of various kinds – not just “frontline health care workers” but also tellers, packers, drivers and many others – and soon, probably, teachers.
Neva Makgetla, senior economist at Trade and Industrial Policies Strategies: I think it’s kind of unfair to cherry pick the sillier restrictions unless it’s framed in an acknowledgement that there still needs to be extreme social distancing if we want to avoid a spike in the pandemic. In that context, it would to me make more sense to be far more rigorous in the main risk areas – especially (a) public transport, (b) retail and (c) quarantine centres, since the single most risky place for catching COVID-19 is in your home. In that context, it would make more sense to distinguish between sectors for re-opening based on the extent of interactions with the public rather than the nature of the product.
Currently the incidence of COVID-19 in SA is low, although rising rapidly in Cape Town. But it is just going to rise over the next few months. People need to understand that opening up does not mean the risk is less, but rather that we are trying to manage it in a more targeted way. Emphasising that the lockdown has been undertaken in an unnecessarily rigid and arbitrary way is only useful if we make it clear that the aim is not just to end physical distancing and limitations on social contacts.
CORRECTION: An earlier version of the article misinterpreted what the lawyer explained to us.