Employers in SA and around the world, in industries as diverse as advertising, mining and trucking, are grappling with the same issue: how to return to full production after a Covid-19 shutdown without jeopardising the health of staff and other stakeholders.

However disparate their businesses and daily tasks may be, a common thread affects their efforts: human nature. After months of social distancing, sanitising and mask-wearing, Covid fatigue, or burnout, is widespread. Our professional colleagues in industrial psychology globally are examining how to counter it amid fears — and in many cases, evidence — of a resurgence of infections.

There’s a dissonance at the centre of that. As one commentator noted, when SA had 10,000 infections we went into hard lockdown, and now that we have had more than 750,000, people are out partying. One incident in Cape Town, where at least 89 people, 37 of them matric pupils who visited a popular nightspot, were infected with Covid-19, highlighted how critical the need for vigilance remains.

Obviously we want to avert an upsurge in infections and a return to a hard lockdown. How to do so is likely to require stringent adherence to the precautionary measures stipulated when Covid-19 first hit us. But we’ll need to go about that first in ways that counter the onset of Covid burnout, and second in ways that do not impede the desperately needed economic revival.

In March, when concerns grew about a global pandemic, Ford’s global operations rolled out an operational manual that we internally call our Covid-19 playbook. This ensured legal compliance with protocols but also stipulated the need to go further in safeguarding staff, dealers, suppliers and other stakeholders.

It included social-distancing measures, more than 130 automated hand sanitisers in our Silverton plant, and permanently installed thermal scanners. The department of employment & labour instructed employers to have a Covid-19 isolation room: we went beyond that and built a fully equipped flu clinic in four days, solely for suspected Covid cases. This keeps the main clinic and its patients free of possible contamination. It also allows comprehensive evaluation and management of suspected Covid-19 cases, as well as contact screening of on-site contacts.

Other role players in business, government and civil society committed similar resources, citizens complied with lockdown measures, and as a result the country has fared comparatively well in managing infections. Even so, for ordinary people, especially the millions in difficult economic circumstances, it has been an incredibly difficult time, and has affected and challenged each of us in different ways.

Dr Michael Kelley, chief medical officer of behavioural health at St Mary’s Health System in Lewiston, Maine, showed considerable foresight in an article  published on the health portal WebMD: “When humans endure prolonged periods of stress of any kind they go through phases. First fear. Next rallying. Then you get into this plateau of exhaustion, the ‘is it ever going to end?’ phase, and that’s really where it’s at. There’s hopelessness — ‘I don’t see an end in sight.’ This is also the phase where people say ‘I’m going to stop fighting. I’m not going to wear a mask or social distance.’ It might lead to a second wave of Covid-19. People will give up doing what they need to do to take care of themselves and others.”

That sentiment appears to have taken hold in parts of the world: the World Health Organisation believes compliance has given way to rising fatigue, apathy and resignation over Covid-19 worldwide, and in Europe, for example, that outlook has reached 60% of the population. This shift in attitude has been accompanied by a resurgence in infections. But Keeley believes there are ways health practitioners can counteract this trend and encourage compliance. He suggests regular “pulse-taking” of attitudes towards compliance and encouraging community participation. After all, those we work with are part of a community with which we spend half our waking hours.

“A courageous approach, with empathy at its core, will get us through this crisis. Despite the hardships, Covid-19 is urging us to move beyond biomedical science in our response,” Keeley says. “We have an opportunity to maximise our community insights into behaviour, to integrate real community participation into public health policy on a scale that has not been done before.”

Gretchen Chapman, a professor of psychology, and George Loewenstein, a professor of economics and psychology, both at Carnegie Mellon University, believe part of the problem with Covid compliance, and creeping Covid fatigue, is the intangibility of the pandemic.

“As scholars who study health-related behaviour change we’re sceptical [about the likelihood of long-term compliance]. While continuing to wash your hands and stay six feet away from others doesn’t seem so hard for an individual, the problem is that people are unable to ‘see’ the benefits of their actions — and thus often don’t recognise how important they are.

“It is, in fact, remarkable to us that efforts to promote hygiene measures have been as successful as they have been. That’s because they are almost the embodiment of the types of protective measures people are especially bad at taking. The most obvious reasons are that maintaining physical distances and constantly washing hands are inconvenient and require constant vigilance. The costs of these behaviours are immediate, but the benefits are delayed.

“However, a more subtle and equally important reason is that the benefits are intangible: you can’t touch, taste, feel or see the benefits of, for example, wiping your doorknob. Another reason the benefits of prevention seem intangible is that we don’t get useful feedback about the effects of our actions. The microbes are invisible, so we have no idea whether we had them before we washed our hands or have got rid of them after we have done so.”

The solution, suggest Chapman and Loewenstein, is simply consistent adherence to precautionary measures: “The longer these behaviours are maintained the more likely it is that they’ll become habitual, overcoming the problem of their benefits being intangible. And society will be able to get back to some semblance of normal while keeping the lid on the coronavirus.”

In SA we need to do more than “keep a lid” on it. We need to revive a bludgeoned economy and build a socioeconomic environment that addresses poverty, inequality and unemployment.

The success of President Cyril Ramaphosa’s economic recovery plan depends on many factors. One may be our individual and collective capacity for self-discipline in observing Covid-19 measures in the coming months, and enabling and encouraging our colleagues and community members to do so too. The stakes could not be higher.

• Dr Grobler is occupational medical practitioner at Ford Motor Company of Southern Africa’s Silverton assembly plant in Pretoria.

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