South Africa: Tough 'Balancing Act' As Government Decides On Future of Lockdown

A resident of Mamelodi in South Africa during the COVID-19 lockdown.

As the end of the extended nationwide lockdown approaches, deliberations on whether to extend the lockdown or relax it have brought about pertinent issues for the government to consider.

It has a tough decision to make.

Last week, the chair of government's advisory committee, infectious disease specialist Professor Salim Abdool Karim, explained that assessments would be made on the effectiveness of the lockdown based on the rate of infections recorded in that week.

This time frame has passed, leading the government to now assess the result and consider the impact of the lockdown.

On Tuesday, President Cyril Ramaphosa announced that he would address the nation on "additional economic and social relief measures that form part of the national response to the Covid-19 pandemic".

There are factors the government will need to take into consideration when deciding the fate of the lockdown, in a balancing act to get the pandemic under control, according to Dr Glenda Gray, a leading South African scientist and a member of the government's advisory committee.

"You are sitting with a fragile economy, a fragile health system and an epidemic that can get out of control, so you have to balance all of those things - it's a balancing act," Gray explained.

The dire social situation

"The question the government has to answer is how many more infections can lockdown prevent, so that there can be an adequate medical response.

"There will be an overlap because the longer the lockdown, the more control you can have over transmission. But the longer the lockdown, the more unintended consequences of the lockdown start to emerge," said Gray.

In his weekly letter on Monday, Ramaphosa explained that they had to consider the impact the lockdown would have "on an already floundering economy in both the long and short term, and the impact of this substantial disruption on the livelihoods of millions of people".

These factors would also have to be discussed to find a way forward, Gray said.

"People start to get hungry, depressed, angry and they become incredibly poor. Already before the lockdown, we had high rates of unemployment, we had an economy that was shrinking, and we had been downgraded by the major entities."

Gray added that these decisions would have consequences, making the government's choice harder.

"As doctors, we would obviously like to keep everybody locked down, so that we can control the epidemic, but that's not practical and feasible for poor people in an economy that's struggling."

Gray said there needed to be a plan for what might happen after the lockdown. Strategies had to be created to minimise the transmission of Covid-19, including continuing with the approach the government had already taken, like physical distancing, the wearing of masks and reducing gatherings.

"Transmission will occur, and the important thing is to track where the transmission is going and contain it wherever it is. You have to look at who should be kept in - should we keep sick people or people over 60 isolated?"

Adequate medical response

The government will also need to make sure hospitals are able to cope with an influx of patients and that public and private hospitals coordinate to maximise response efforts, Gray said.

"The whole point of flattening the curve is to extend the epidemic, so that you don't get the kind of peak that you'd see if we did nothing.

"No intervention gives you a very high peak and, when you have this high peak, the capability of the medical assistance to respond can't happen," she explained.

In countries with a high number of Covid-19 cases and death rates, health systems have reached near collapse as they run out of hospital beds, ICUs, health workers and personal protective equipment (PPE).

"Lockdowns try and control it by trying to prevent transmission, so that when cases happen you have enough human resources and hospital facilities to manage," Gray explained.

Economic impact vs rate of transmissions

The government will also have to grapple with how they open up the economy while preventing an increase in Covid-19 transmission, Gray explained.

News24 previously reported that a national effort to do this was under way, on a scale "unprecedented in democratic South Africa".

The government and expert leaders, under a new umbrella organisation called Business for SA, announced an initiative to mitigate the negative impact of Covid-19 on the economy, the public health sector and livelihoods.

The government would have to consider the interplay between the dynamics of Covid-19 transmission, medical preparedness and economic and social factors to find an appropriate outcome after the lockdown.

Source: News24

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