Since the outbreak of Covid-19 in December 2019, the world has been bombarded with messages about how to curb the spread of the virus.
Governments have activated legislation enabling them to shut down public spaces and force people into self-isolation. As civil society organisations working on human rights and social justice, we have been grappling with the societal and community crisis the Covid-19 pandemic poses. We believe that, while we build an activist led campaign for protecting human rights and social justice during this time, we should work from the principle of supporting the public health message from the National Department of Health for increased hygiene and limited physical interaction.
There has been concern about the issue of social distancing and what this means for communities and mobilisation. We need to see this concern in the context of how the SARS-CoV-2 spreads and how it will impact our communities and health system. As health activists, we think we should be practising what we call physical distancing while building social solidarity over the next period.
The Covid-19 virus is easily transmitted and is very contagious. We know that most (85–90%) of those infected will have a mild infection. However, up to 15% of people infected will be so sick that they require admission to hospital and 5% might require admission to ICU. The mortality rate is between 1% and 6%.
Fifteen percent will become very sick
The issue is that if we have a sudden increase of the number of people infected with the virus, the number of people that need admission to hospital will rise exponentially. It will be a very steep curve and our health services will be overwhelmed. What we have learned from other countries is that the mortality rate ranges from 1% to 6 % depending on how well the health services can respond. The more overwhelmed our health services will be, the less likely we will be able to treat people well. This means we need to find a way to slow down the transmission of the virus so that there is more time for our health services to respond to the sick.
People will get sick and they will recover but there will be that 15% who will become very sick. Fifteen percent of 100 people is very different to 15% of 10 000 people and 15% of 500 000 people. Our aim in the next couple of weeks should be to make sure that we all, together, reduce the amount of physical contact between groups of people while, at the same time, building social solidarity. This means limiting all social engagements, meetings and large gatherings. We commit to only meeting people when we really have to. We will stay at home as much as we can. We will do as much as we can online.
Of course, we are aware that millions of South Africans are living in cramped and crowded accommodation where isolating themselves from their families is virtually impossible. Isolation is different to physical distancing and is specifically if someone has tested positive for Covid-19. Government sponsored accommodation needs to be arranged to meet this need.
Two key public health messages
However, for the rest of the population, decreasing contact outside of our immediate households is critical because every single contact between people is a potential space where the virus can spread. That is really what physical distancing is about. This does not mean we stop mobilising as a community and society. In fact, we need to mobilise more as social solidarity is so important in times of crisis. Nevertheless, we do need to maintain physical space between us at least for the next few weeks, possibly month or two, until we can contain this virus.
Two key public health messages need support: regular hand washing for at least 20 seconds, and physical distancing. We all need to be doing this and all need to be promoting this in our community. Do not meet if you do not need to, and try to stay home during this period so that we do not break our health system during this epidemic, and let us mobilise creatively to promote community spirit, social solidarity and health for all during this time.
*The civil society organisations calling for social solidarity are Health Enabled, People’s Health Movement South Africa, the Rural Health Advocacy Project, SECTION27 and the Treatment Action Campaign. Dr Cairncross is a surgeon at Groote Schuur Hospital and member of the People's Health Movement, South Africa.
Note: SECTION27 and the TAC are mentioned in this opinion piece. Spotlight is published by SECTION27 and the TAC, but is editorially independent, an independence that the editors guard jealously. Spotlight is a member of the South African Press Council.
*This article was produced for Spotlight – health journalism in the public interest.
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