ANALYSIS | Covid-19: What the smart countries do ... and we don't

The testing regime in South Africa to date, has excluded generalised testing, which is hugely problematic, says the writer. (Getty Images)
The testing regime in South Africa to date, has excluded generalised testing, which is hugely problematic, says the writer. (Getty Images)

We need a plan and action, not warnings of our impending doom. The actions pursued also need to do more than just shut South Africa down, writes Alex van den Heever.

The Covid-19 pandemic is a bit like a rain shower on an old house.

All the roof leaks are soon exposed.

In South Africa many of the leaks are the result of sustained government incompetence and corruption.

To address the threat requires intelligent concerted action in the public interest.

It is therefore no wonder that many question the ANC-led government's capacity for leadership at a time of dire crisis.

While the urgent action taken by the president on Sunday is clearly necessary, it cannot be regarded as anywhere near sufficient to address the crisis.

There are two clear fronts to this crisis: the public health threat; and the economic threat.

While there has been some action on the former, nothing of substance has been proposed regarding the latter.  

But let's first address the adequacy of the public health threat.

A number of real concerns emerge.

While the general social distancing strategy is appropriate, we have a virus testing regime that only identifies a sub-group of those infected - many will be sent home without a test.

The testing regime, to date, has excluded generalised testing - a major feature of the successful South Korean strategy.

What this does, quite simply, is undermine our ability to detect community-based outbreaks, and quite frankly puts the entire prevention strategy at risk.

Government has furthermore, sought to centralise the dissemination of information regarding the outbreak to official structures - limiting the free flow of useful information.  

On the supply of services, very serious concerns arise.

Where is the contingency plan to make critical-care beds and ventilators available at scale?

The silence on such plans is deafening, and raises the natural concern that no such plans are being readied for rapid deployment. Such a plan requires both national and regional strategies.

It requires coordinating public and private sector resources.

It requires leadership from a competent task team that can deliver, and not just sit in front of cameras and tell people to wash their hands.

While the early social distancing strategy may prevent the need to use these resources, it would be comforting to know that such a contingency could be rapidly implemented as required.  

According to my estimates the public sector only has around 2 238 critical care beds in total, and possibly only around 448 beds available.

By way of contrast, the private sector has 4 957 critical care beds and potentially spare capacity of 2 479 beds.

In other words, the spare capacity in the private sector is greater than the total critical bed supply of the public sector.

Self-evidently, therefore any contingent strategy requires public and private coordination.

To date there is no evidence of such a strategy. If South Africa has an outbreak scenario equivalent to that of China, we will have a supply shortage of critical care beds in the public sector of 795 beds during the periods of peak demand.  

South Africa also does not appear to have a strategy to requisition tests, the required equipment and the protective clothing for frontline healthcare workers.

South Africa is vulnerable to selfish hoarding by those countries that typically export these products to us. So, what is our strategy? There is nothing but silence on this front. 

Despite the public health threat posed by the Covid-19 virus, many public health and socioeconomic threats will erupt if an economic meltdown is allowed to occur, while government stands by.

While such conduct has become almost expected of government when the domestic social and economic crises are not as acute, such luxurious dithering won't be tolerated by society under these conditions.

Government needs to have a competent economic strategy within days - and by this is meant a credible plan that they have the capability to implement rapidly.   

While it could be argued that this government has painted itself into a fiscal corner, nothing could be further from the truth.

Anaemic proposals to allow for a contribution holiday for UIF contributions make little sense when the UIF sits on an unusable pot of money, sitting with the PIC, that it has built up over the years from over-priced contributions relative to benefits.

This pot stands at roughly R200 billion.

This fund should never exist and has no coherent public interest rationale.

Legislation needs to be rapidly introduced that adds those funds to an emergency stimulation package.   

The emergency stimulus should have two arms.

One that focuses on the supply side of the economy, and one on the demand side.

On the supply side: emergency measures are required to protect small businesses for at least 30 days; lending institutions must be underwritten by the Reserve Bank when they continue to lend to stressed small and medium-sized businesses.

On the demand side and government should consider: high multiplier one-off transfers to low-income households through the social grants system; and the creative use of the UIF to provide interim salaries to staff in key industries (such as those involved in tourism an hospitality), without their being laid off.

It would be comforting to know that such measures were well underway. This is what the smart countries do.   

While the need to communicate effectively is plainly necessary at a time such as this, often very little of substance is communicated at extended news conferences.

Worryingly, these exercises are coming across as pure public relations exercises, mere performances to generate the impression of competent action.

At a time such as this, however, news conferences should be held to convey actual relevant actions that address both the health crisis and the potential and rapidly materialising economic crisis.

We need a plan and action, not warnings of our impending doom.

The actions pursued also need to do more than just shut South Africa down.

Now more than ever we need a government that can build something that works for all South Africans and not just the patronage networks of the ruling party.

I guess we are all holding our collective breaths.

But not for long.       

- Prof. Alex van den Heever is Chair in the field of Social Security Systems Administration and Management Studies, Wits School of Governance 

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