An association representing major alcohol industry players has poked holes in a peer-reviewed study that found the government’s periodic bans on alcohol sales during the Covid-19 pandemic were associated with a significant reduction in deaths from non-natural causes.

Unnatural deaths are those due to accidents and violence, while death from natural causes comes about from disease or other health conditions.

The SA Liquor Brand Owners Association (Salba), a trade association representing liquor manufacturers and distributors including Distell and Heineken, raised several concerns about the study published in the SA Medical Journal in July. The study, which was led by Tom Moultrie, a director of the University of Cape Town’s (UCT’s) Centre for Actuarial Research, assessed the effect of bans on alcohol sales, partial restrictions on sales, and curfews (using Google mobility data) on deaths from unnatural causes.

Citing recent research and a critique by independent data expert Ian McGorian and Prof Mike Murray from the University of KwaZulu-Natal’s School of Mathematics, Statistics, and Computer Science — which was not funded by the alcohol industry — Salba maintains trauma admissions likely dropped because people were at home under curfew rather than being out. 

In addition, the industry analysis also considered several countries that did not impose alcohol bans as part of their response to the Covid-19 pandemic but which still achieved the same level of reduction in trauma admissions as SA (60%). These included the UK (57%), Italy (57%) and Ireland (62%). The article the industry cites was independently analysed  by Prof Graham Barr from the department of statistical sciences at UCT.

“The key point in this debate is that it is impossible to attribute changes in unnatural deaths to a particular cause, in a setting in which multiple potential death-causing factors are concurrently operative. This challenge is central to statistical analysis and must be confronted by any empirical investigation attempting to ascribe a causal relationship between two variables,” Barr says. 

The government’s periodic bans on alcohol sales, intended to reduce the alcohol-related trauma load on hospitals and free up desperately needed resources for Covid-19 patients, have left the liquor industry reeling. On Sunday, President Cyril Ramaphosa extended the recent ban imposed two weeks ago by another 14 days.

Three separate bans in 2020 over a total of 20 weeks resulted in R38bn in lost liquor sales, R27bn less tax revenue for the state, job losses and billions in cancelled investments, according to the liquor industry.

The industry is fighting the fourth liquor ban in court, with SA Breweries arguing there is no scientific evidence that banning alcohol sales reduces the number of Covid-19 infections.

Salba said the SA Medical Journal study tries to show that it is alcohol restrictions and not issues of mobility/curfew that drive the reduction in unnatural deaths.

“It is clear that both of these factors will have some impact on unnatural deaths. The only argument could be which is the predominant cause? But, because in almost all cases both mobility restrictions and alcohol restrictions are imposed together, it is statistically problematic to distinguish between these two effects. Statisticians say the two variables are ‘confounded’ in their impact on unnatural deaths,” Salba contends.

According to the SA Medical Journal study, total sales bans were associated with a significant decline in unnatural deaths, ranging from a 49% fall below usual during the level 5 lockdown, which began on March 27 2020 and included a stay-at-home order, to a 26% decline when a subsequent booze ban was accompanied by a curfew of between four and seven hours. During the six-week level 5 lockdown, there were on average 517 fewer unnatural deaths than usual per week, more than 3,100 in total.

Moultrie said he will respond to the critique in due course.

With Tamar Kahn 



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