JOHN STEENHUISEN: A smart lockdown model will get SA through Covid-19
Prof Abdool Karim gave the vital metric needed to come up with a flexible, quick-to-react model to open SA’s economy
On Monday evening, Prof Salim Abdool Karim took the nation into his confidence about the coronavirus crisis. With politics firmly on the back seat, Karim laid out the reality that Covid-19 will be with us until a treatment or vaccine is developed, which will likely only happen in 18 to 24 months. He confronted us with a simple truth: despite the initial success of the hard lockdown in buying us some time, SA is unlikely to escape the worst of this pandemic.
Given this daunting reality, Karim also acknowledged that our country cannot remain under the current hard — and often brutal — version of lockdown much longer. While his presentation did not directly focus on the lives and livelihoods that will be lost as a result of the economic devastation unleashed by the lockdown, Karim challenged us to “think and plan for a systematic easing of the lockdown”.
It is a challenge the DA has met head on. Our suggestion for a “smart lockdown” approach answers Karim’s call by proposing a model that offers us the flexibility to adapt to changing data by moving us between four different stages of lockdown as the epidemic develops, in a way similar to the different levels of load-shedding that many of us are used to. In this way, we can not only continue to save lives by containing the outbreak, but also ensure the revival of our ailing economy.
The only sustainable way forward for SA is to ensure that we save lives from both Covid-19 and from destitution
Under the smart lockdown, if, for example, the testing and case-finding data tells us that the curve is about to spike, we move to a stage four hard lockdown. If the data tells us the curve is stable and showing signs of declining, we move to stage three, where a few of the restrictions are eased. If the data later confirms that people are adhering to the social-distancing rules in stage three and the transmission rate is still declining, we move to stage two or one, where yet more restrictions on movement and economic activity are lifted.
Importantly, if the rate of transmission increases again, the smart lockdown enables us to move back to a stage three or four harder lockdown. Throughout all four stages, wearing face masks and strict social-distancing in public spaces will remain compulsory, and the lockdown will only be completely lifted once the disease has been completely defeated.
However, until Karim’s presentation on Monday night we were still missing one crucial piece of the puzzle. Without clear metrics in place, it would have been difficult to decide when to move between the four different stages of the smart lockdown. After all, we need to be absolutely sure that the curve is flattening before we move to softer stages such as two or one. Conversely, we need to be absolutely sure the transmission rate is increasing when shutting down our economy under a stage four hard lockdown.
Thankfully, Karim provided us with that missing piece of the puzzle during his presentation: the metric he proposed is that we need to keep the rate of transmission, or R0, below a value of one. This means each person who is currently infected with the virus should infect no more than one additional person. If the rate of transmission moves above one, the number of cases is growing. If the number is at one or lower, the rate of transmission is stable or declining.
Based on our current caseload and the objective of keeping the rate of transmission rate below a value of one, in his presentation Karim described the specific criteria that will help us decide when to move between the different stages of a smart lockdown.
If there are, on average, more than 90 new, self-reported cases per day during a full week, he recommends that we continue the hard lockdown. If cases grow by between 45 and 89 per day, and community healthcare workers, through active screening, find that less than 0.1% of the screened population is infected, he recommends easing the lockdown, in all likelihood to stage three under the smart lockdown model.
Finally, if there are fewer than 44 daily new cases on average, Karim also recommends easing the lockdown, perhaps even to stage two of the smart lockdown model.
The only sustainable way forward for SA is to ensure that we save lives from both Covid-19 and from destitution. We can only do this if we adopt a flexible model that enables us to continually adapt and strike the right balance between containing the spread of the coronavirus and preventing avoidable economic destruction.
The answer to striking that balance lies in combining Karim’s objective criteria for measuring the rate of transmission of the disease with the smart lockdown model. By feeding Karim’s criteria, based on the data gathered by the health system and community healthcare workers, into the smart lockdown model, we can answer the question that will define our lives for the foreseeable future: what stage of lockdown is most appropriate today?
That is why the DA has already sent our smart lockdown proposal to President Cyril Ramaphosa. We have done so in the interest of saving lives from the twin threat to South Africans: the spread of infection and a grinding economic recession. The way forward is to marry Karim’s objective criteria with the complementary smart lockdown model as the only sustainable, flexible and data-driven model for overcoming this crisis.
• Steenhuisen is DA leader.
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