Confronting confinement: how long will the lockdown last?
Open up the country and risk a public health disaster of unprecedented proportions, or leave it locked up and risk an even greater economic crash and the potential for escalating social unrest?
When Cyril Ramaphosa came to power on February 15 2018, he thought he would be leading a reform agenda of delicate political purging and subtle, structural economic reform. Instead, he now finds himself confronted with questions ordinarily faced by wartime presidents. There will be losses, with different forms of calamity in every direction — which is the lesser evil?
In the countdown to when the clocks strike midnight on April 16 2020, Ramaphosa will be on the horns of the ultimate dilemma. Open up the country and risk a public health disaster of unprecedented proportions, or leave it locked up and risk an even greater economic crash and the potential for escalating social unrest?
Putting ourselves in the shoes of the president, and his command council, these are the options he faces, combined with our assessment of the outcome of this, the next test of his ability to make tough decisions under the most intense pressure:
1. Open it up — likelihood ±5%
While many South Africans may be crossing off the days until they can head back to the bars and the beaches on April 17, in truth this is the least likely option. Covid-19 isn’t going anywhere for a while, and in all probability, neither are you. Not until a properly tested and approved vaccine is developed and widely rolled out will the idea of a return to life as normal be a viable one — here and across the world.
While some countries, such as Sweden, are toying with a more open approach, those countries have a stronger pool of resources to handle the health crisis. The combination of SA’s strained public health-care system, its vulnerable immune-compromised population and its congested habitation areas and modes of working-class transportation renders it vulnerable to a rapid spike in infection rates. The government knows this, hence the radical measures imposed to date. Don’t expect it to jump from one extreme to the next.
2. Keep it shut (extend the lockdown) — likelihood ±50%
When the initial lockdown was announced, the government likely expected that it would need to be extended — three weeks is just not enough time to flatten the curve. While a lockdown is arguably the most effective measure to achieve a radical intervention into the trajectory of the virus, it is no silver bullet on its own.
A lockdown is a means to an end, not an end in itself. To be successful, it needs to be coupled with the “Four T” strategy of “Trace, Test, Track and Treat” that the government has developed in the past fortnight. Essentially, the government needs to use the lockdown period to get on top of the virus and understand just how severe it is and in which areas it is prone to spreading fastest. While the 4T strategy is now admirably clear, the government hasn’t yet been able to roll out the programme in a manner that is cast sufficiently widely to achieve the main purpose of the lockdown.
3. Open the country up for a bit, then shut it again in 1-2 weeks — likelihood ±15%
Ironically, the government probably wants some Covid-19 cases to start coming through the health-care system now. What we don’t want is a situation where the peak is simply delayed, coming later in the winter months with the same or more force. Better to allow some flow of cases now to an extent that we can manage, thus generating some degree of “herd immunity” in doing so.
This is why it has been suggested that the government will lift all restrictions for a week or two before going back into a full lockdown. The problem with going from one extreme to the other and then back again is that it’s logistically difficult and makes enforcing social compliance even more of a challenge.
4: Phase out some restrictions, but be ready to return to full lockdown — likelihood ±30%
This is the other most plausible option. The ostensible recent decline in the growth of infection rates in SA, even though highly contestable, may make this a more tempting idea for the government than it previously was. In an attempt to allow some cases to continue trickling through the system (rather than all at once), we may see a situation where some economic activity is restored, and some of the most restrictive measures are relaxed — to try to avoid the economy ossifying completely. For example, this could involve curfews, regional variations in measures and a more liberal classification of essential goods and services while still providing for social distancing and banning large gatherings.
There is no perfect solution and no easy decisions, and South Africans can expect encroachments into their normal civil liberties for a while to come. So far, we think that the measures taken by the government are both bold and in line with scientific models, though implementation has, as always, presented challenges.
The next step is big, and there is no room for complacency. The initial expectation that the lockdown would be extended has been somewhat watered down by the case numbers reported in SA since the start of the lockdown. During this period, SA’s “curve” hasn’t followed the same exponential trajectory as many other countries — confounding expectations. But it is still relatively early days and until testing is rolled out sufficiently, we cannot be sure exactly why this is and whether SA simply has a bigger “lag time”. Hence, the government is likely to err again on the side of caution: health crisis first, economic crisis second.