Guest Column

OPINION | Inability to comprehend complex arguments hampering credible analysis of Covid-19

2020-05-21 12:08
Western Cape Premier Alan Winde thanks nurses and healthcare workers during a recent visit to Ceres in the Cape Winelands. (Twitter, Premier Alan Winde)

Western Cape Premier Alan Winde thanks nurses and healthcare workers during a recent visit to Ceres in the Cape Winelands. (Twitter, Premier Alan Winde)

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The gleeful cheap shots taken at the Western Cape say more about our inability to comprehend nuanced reasons that may have contributed to these numbers.

South Africa declared its first confirmed case of Covid-19 three months ago.

During this time, we have been faced with a pandemic that has wreaked havoc across the globe and held the most developed countries in a choke-slam while we beavered away trying to prepare for the worst.

And while global trends are helpful with understanding the pandemic’s behaviour, we have unique South African circumstances which have exposed themselves over the past 12 weeks.  

It has been an undoubtedly tumultuous time that has seen many aspects of South African society stretched to their absolute limits.

We have seen an overwhelmed social assistance system as millions of people were forced to depend on the state for food due to halting of economic activity. 

We have seen the cracks in our public health system start to widen under the pressure of responding to the virus - a trend which is bound to get worse as we head towards the peak of our infections.

We now know that we have 4 000 ICU beds across the country while between 25 000 to 40 000 beds will ultimately be needed.  

We have seen a government regulate movement, economic activity and even one’s ability to purchase long pants in an effort to contain the spread of the virus.

Many of the regulations have been ill-thought-out, badly drafted and impossible to implement.    

That being said, we have also seen - albeit short-lived - an unprecedented cooperation of political parties and government united in the purpose of fighting a common enemy.

We have seen great generosity from all corners of society which culminated in the formation of the Solidarity Fund which would go some way to funding our response to the pandemic. 

Nothing about how this virus is being dealt with has been perfect but many aspects of the efforts and strategies have been commendable.

We saw government delivery ramped up in great efficiency, almost as if we were living in a pre-election bubble.

Water tanks were delivered, shelters provided and food parcels delivered and stolen at the same time. It has been a uniquely South African response to the pandemic.  

In all of this, one thing became clear: South Africa, its people, leaders and opinion formers battle with nuance.

We have seen simplistic analysis of the complex issues that are associated with dealing with a pandemic as insidious as Covid-19.

This first began with the deliberations around the economic meltdown that would come with shutting down the country for weeks, in order to delay the spread of the virus while capacitating the health system. 

Those who dared to ring the alarm about the devastation that would hit a South African economy already on its knees, were chastised and characterised as heartless capitalists who have no regard for human life.

It is only after weeks of witnessing the humanitarian crisis brought on by sheer hunger than many now understand that a credible health response and saving the economy aren’t mutually exclusive, but in fact intricately linked.

Many have and continue to draw a false dichotomy from this question. This has robbed the country of the ability to make interventions for both aspects with equal vigour sooner than we have.  

The second tell-tale of our refusal to understand the complexities of dealing with a global health crisis, is how we have sought to vilify and find fault in provinces, regions and metros which have had spikes in infections and deaths due to Covid-19.

The Western Cape has been a victim of this phenomenon. Those who have thrown political jabs questioned the province’s handling of the pandemic.

It has been disappointing to see political leaders' inability to engage in meaningful analysis of the Western Cape numbers. 

The truth isn’t a simple one. It isn’t one dimensional. It lies in a myriad of possible theories which experts have tried to advance.

The Western Cape has conducted more tests per 100 000 people; they have adopted a targeted approach to their testing which means that they draw more positive results than they would in a generalised approach; and they have also seen an explosion of cluster outbreaks in places like supermarkets and various communities.

The province has, along with Gauteng, played open cards with the public regarding their data. They have provided numbers of positive cases, tests conducted, screenings completed, in a detailed fashion that has been broken down in sub-districts for several weeks now. 

It has also been touted by experts that it could very well be that the Western Cape is further ahead with the pandemic curve than the rest of the country.

This could be due to the large number of tourists who were in the province before the country’s borders were sealed and subsequent community transmissions that took place.

It has also been argued that the province is actively conducting posthumous tests for Covid-19, especially on those patients who presented with co-morbidities at health facilities.

Experts have projected that the province is likely to reach its peak in June while the peak for the rest of the country is projected for later in the year.

Once again, this is the nature of viruses.

The gleeful cheap shots taken at the province say more about our inability to comprehend nuanced reasons that may have contributed to these numbers.

This is done at the expense of thousands of healthcare workers who place their lives on the line to serve in spite of this political jostling. 

Finally, we must prepare ourselves for the peak of the virus which is about to hit us in the middle of our winter season. The rise in cases and the fatalities which will come will never be palatable.

We have started to see how devastating it is to lose loved ones to this virus, even with a death rate that is below 2%. 45 000 to 48 000 deaths are projected by November this year. We must never be glib about the impact that this pandemic has had and will continue to have.

Behind those daily figures are people, a fact we must be mindful of as the exponential curve approaches. 

However, we must abandon the attitude of exceptionalism we often adopt.

We too, like the rest of the world, are vulnerable to this virus. It will leave in its wake devastation. The only thing that will save South Africa is how prepared we are and the steps we take for the next several months.

The shortfall of ICU beds, ventilators and staff to manage that operation is a looming crisis. Unless the health system is capacitated significantly, we will experience a catastrophic loss of life in a short space of time.  

As we open up the economy towards the end of this month, we must ensure that we protect employees, their families and the most vulnerable.

We should by now, have readied our health system to respond to the spike in infections and serious cases in every single province, region and sub-district.

This will require brutal insistence on excellence from the Health Minister to all his Health MECs in the provinces. It will also need urgent interventions such as thousands of "step-down" or field facilities that can provide care where ICU beds are not available.

Vacant critical posts should have been filled to ensure that we look after healthcare workers who must at all times have the requisite personal protective equipment.

We urgently need to change entrenched behaviours as a country. Non-pharmaceutical strategies such as mandatory mask wearing, impeccable hygiene and social distancing need to be the new normal.

This requires us all to make the mental shift. This is a critical moment in the fight against this pandemic. If we do not manage this now, the past eight weeks would have come at a great cost and yielded little results.  

Critically, Parliament and its members must never forget the role that the legislature must play at a time like this. We must hold the government to account.

That needs to be more than just a slogan - it requires action.

We need to ensure that government fulfills its core mandate of delivering services to all its people; public money is spent prudently and constitutional abuses are stopped before they take root.

The national legislature’s work has never been more crucial.  

South African history will record this time regardless of how things unfold.

Leaders in society - politicians, academics, experts and analysts - should be seized with ensuring that we are not consumed by simplistic blame shifting.

Now is the time to step up. South Africans require more from us all.  

- Siviwe Gwarube, Member of Parliament, DA Spokesperson on Health  



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