Picture: 123RF/ Puhhha
Picture: 123RF/ Puhhha

Almost a year after SA reported its first official case of Covid-19, the country is recovering from its second surge. The curve is flattening, restrictions are being eased — and our vigilance is subsiding.

This time around, we understand that Covid is not over. It will be with us for at least another year. At the same time, the new, more contagious variant raises concerns of reduced time between surges, and more heavy-handed interventions to contain the spread of the virus.

The year ahead will be pivotal for a country walking a fiscal tightrope over a ravine of deepening social need.

Without a clear path to population immunity via vaccinations, we will have to rely on adherence to key preventive behaviours: mask wearing, hand washing, physical distancing, staying at home and avoiding crowds.

Our research focused on the threat of "Covid fatigue" (a perceived reduction in infection risk as individuals tire of preventive behaviours) using data collected from the three waves of the Nids-Cram survey.

The same sample of respondents was interviewed three times last year: in May and June, July and August, and November and early December.

As we saw a dramatic leap in Covid cases between May/June and July/August, we saw more concerns about contracting the virus, and increases in mask wearing.

It was both surprising and encouraging that the steep drop in daily Covid cases between July/August and November/ December did not coincide with a decrease in self-reported mask wearing and concerns about contracting the virus.

At the same time, though, there was a strong decline in other forms of preventive behaviour.

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This is a worry, because mask wearing was always part of a broader strategy of complementary measures; it was never intended to be the sole barrier between us and the pandemic.

We found a strong and robust relationship between Covid fatigue and people who believed they were likely to contract Covid. A decreased perception of risk is associated with an increased likelihood of mask-wearing fatigue. Conversely, an increase in perceived risk is associated with a decreased likelihood of handwashing fatigue.

As preventive behaviours are more likely among people who believe themselves at risk of contracting Covid, it is very concerning that half of the respondents in November/December did not perceive themselves as being at risk, and a third did not believe this in July/August and November/December.

These findings have at least two policy implications. First, we may be able to extend the time between surges by introducing campaigns that create awareness of the continued risk of infection — even when cases are low — and call for sustained vigilance and preventive behaviours.

Second, it is plausible that risk communication can bolster preventive behaviours. So it is vital that South Africans are informed about the virus and how transmission occurs so that they can take responsibility for their own safety through practical combinations of preventive approaches.

The year ahead will be pivotal for a country walking a fiscal tightrope over a ravine of deepening social need

With uncertainty over the Oxford-AstraZeneca vaccine and worries about how long SA’s vaccine rollout will take, the importance of preventive measures needs to be underscored. This is especially so given that about 40% of respondents in some areas said only "a few people" wore masks when on the streets in their neighbourhood in October.

Practically, it means the government needs consistent messaging on mask wearing in particular.

While the government kept abreast of rapidly changing prevention protocols in its presidential and ministerial briefings, there were some missed opportunities in highlighting these on web portals and in online messaging.

At the time of writing, for example, no fewer than three government websites providing Covid-related resources and advice — including sacoronavirus.co.za — do not mention masks in the list of preventive measures.

The problem is not only that the information is updated too slowly, but also that it takes the user several clicks to find information on prevention.

There is no attempt to maximise the reach of this information by giving it prominence and priority.

The health department’s Covid-19 WhatsApp line does provide up-to-date information on prevention measures, but this information is not shared with other government communication channels. Given our reliance on prevention— and the stakes we face — consistent and updated messaging across all platforms is vital. We need to hold the government accountable on this front.

*Christian is from the University of the Western Cape; Rossouw is from Wits University; Burger and English are from Stellenbosch University; and Maughan-Brown and Köhler are from the University of Cape Town

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