SHIRLEY DE VILLIERS: Will we just have to learn to live with the virus?
Without behavioural change, there’ll be no ‘when this is over’ utopia to look forward to
There’s a strange dualism that’s attached to life under lockdown. With an almost unfaltering belief that normality will return, we make plans for “when this is over” – the friends we’ll see, places we’ll go, things we’ll do. Lurking alongside that optimism is the much darker, more unsettling knowledge that life will never be the same.
Perhaps it’s an irrepressible belief in the power of science that informs the former; the macabre metronome of infection, the latter.
This week, SA passed the 100,000 Covid-19 case mark – we’re now at 118,375 cases with 2,292 deaths. But Latin America passed the 100,000 fatality mark this week.
The US tally reached 120,000 – more Americans than were killed in World War 1. Globally, we’re nudging 500,000 deaths. And the World Health Organisation has warned that we’ll hit the 10-million infections mark next week.
Equally disconcerting is the resurgence of the virus in places where it previously seemed to be tapering off.
South Korea has been a model of containment. At its peak in February, the country was reporting 900 new cases a day. It brought that down to single digits by late April, only to face a resurgence after a holiday weekend in late May. Sunday marked the first time in a month that new daily infections dropped below 20.
Germany has put 360,000 people back under lockdown after 1,700 workers at an abattoir and meat-processing plant in the North Rhine-Westphalia Gütersloh district tested positive for the coronavirus.
In Portugal, authorities have reinstated a curfew in Lisbon and cracked down on mass gatherings in an attempt to bring a spike (of a few hundred new infections a day) under control. Israel’s Knesset has approved the reintroduction of a controversial tracking programme to contain a surge in cases since it eased restrictions a month ago. And Iran is preparing to reimpose a lockdown, targeted by province, after recording 2,500 infections on Wednesday, and 131 deaths (the largest single-day increase since April).
‘I don’t think we can eliminate the virus’
A Guardian analysis of data from the University of Oxford’s coronavirus government response tracker makes sense of some of these numbers.
Of the 45 countries that have recorded more than 25,000 cases to date, 12 remain in hard lockdowns, but only three of those (Ecuador, Qatar and Peru) are flattening the curve. Of the 12 in moderate lockdown, seven – including SA – are seeing an increase in cases. And 10 of the 21 with “relaxed restrictions” are experiencing a resurgence in cases.
Perhaps more interesting – particularly given SA’s position on the curve – is seeing what measures are being put in place to manage the ebb and flow of the virus in countries that are opening up. This article in The New York Times provides a great round-up. From Boris Johnson’s “Whac-a-Mole” strategy in the UK, to South Koreans carrying different types of face masks for different social situations, and Germany locking down localities once infection rates reach a particular threshold, the measures are all a tacit acknowledgement that Covid-19 is going nowhere fast.
In fact, Australian epidemiologist Simon James Thornley tells the newspaper: “I don’t think we can eliminate the virus long term. We are going to need to learn to live with [it].”
As the writers point out, all the strategies “call for giving governments flexibility to tighten or ease as needed”. This, in addition to aggressive testing, monitoring and tight border control.
All of this suggests that SA’s risk-adjusted strategy is the right way to go – it provides flexibility to shift the rules as required, and to lock down different locales as particular thresholds are breached.
More depressing, in the SA context, is the importance of “lightning-fast response times”, co-ordination between national and local levels of government, and devolution of responsibility to local authorities.
Our cabinet, making recommendations to itself in the guise of the national coronavirus command council, before having a hearty debate to reach consensus in the spirit of collective responsibility, is hardly the picture of agility.
Nine days after President Cyril Ramaphosa announced that restaurants would be opening under the absurdly named “advanced level 3”, for example, there’s yet to be any movement on when – or how – that may happen.
And, if anything, the commissars of the command council seem less inclined to share power, and more inclined to concentrate and centralise it.
Not that you can really blame them, when you consider the disaster that is local government in SA. Most municipalities are unable to govern their way out of a paper bag, let alone respond nimbly to the ravages of a global pandemic – which is why it’s so infuriating when councillors budget above-inflation increases for themselves as the economy tanks.
On Wednesday deputy auditor-general Tsakani Maluleke related the tale of woe – also known as the local government audit outcomes, for 2018/2019 – to the National Council of Provinces.
The good news: there was an increase in the number of clean audits received by the country’s 257 municipalities. Less good: there were still only 20 of those 257 that got a clean bill of health.
Together, local councils squandered R2bn through fruitless and wasteful expenditure in the year under review. And R12bn was spent without authorisation. (The report isn’t available on the AG’s website yet, but Daily Maverick has a pretty comprehensive overview here).
The financial and governance failures at local level have a very immediate knock-on effect in the delivery of services to residents – something that is crucial in the current situation.
What it means is that our charge against the coronavirus is to be spearheaded either by the lumbering machine of central government – which put in a great early effort and then lost the plot – or the venal incompetence of local authorities. Neither inspires great confidence.
Of course, a final, important leg of the New York Times analysis is that governments need to persuade their citizens to change their behaviour voluntarily – in particular, masking and maintaining social distance. You don’t need to travel particularly far down any road in this country to see how well that’s working out here.
If mask delinquency and social-distancing loutishness bring out your inner schoolmarm, you may be interested in this advice from Harvard Medical School epidemiologist, Prof Julia Marcus, for “the dudes who won’t wear face masks”: “Trying to shame people into healthier behaviour generally doesn’t work – and actually can make things worse.”
Marcus draws parallels with the early fight against HIV/Aids in the US, and the various misguided attempts to encourage condom use among the gay community to stem the spread of the virus. In short, it was about understanding the roots of people’s resistance, and fostering compliance through empathy. “Moralistic fear-mongering messages fell flat,” she writes.
Without behavioural change, there’ll be no “when this is over” utopia to look forward to.
In the end it’s not simply about the efficiency of central government, or the efficacy of local government – it’s about the effectiveness of the message. To a large extent, the containment of the coronavirus – and a return to some semblance of normality – lies in our hands.
*De Villiers is the features editor of the FM
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