OPINION: Prolonged lockdown may not be effective in containing the contagion

Pensioners line up to apply for Sassa grants during the lockdown. (News24, Azarrah Karrim)
Pensioners line up to apply for Sassa grants during the lockdown. (News24, Azarrah Karrim)

At present, the lockdown is paradoxically reducing our ability to monitor the spread of the disease until patients fall sick and require medical attention, which puts a strain on our healthcare system, writes Lorenzo Fioramonti.    

The Covid-19 pandemic has caught most governments off guard, although similar epidemics - such as SARS and MERS - had already occurred a few years ago.

Based on previous experiences, we should have had protocols in place, but unfortunately we didn’t, and much was left to improvisation.

In the face of an unknown threat, it is understandable that governments imposed lockdowns, which can be better described as a knee-jerk reaction aimed at buying time in order to figure out a real policy strategy.

Now, after several months and much research, we are in a better position to assess the way forward, as evidence is mounting that prolonged lockdowns may be doing more harm than good.   

In Europe, after much improvisation and lack of coordination, governments are now lifting restrictions, worried by the prospects of facing the worst economic depression since the 1930s, with millions unemployed, businesses (especially SMEs) shutting down permanently and inequality rising to unprecedented levels.

Despite strong welfare mechanisms, the consequences of the lockdown are already fuelling social unrest and widespread resentment among the population.

Needless to say, in countries with fewer welfare provisions such as South Africa, the impact may be much worse, dealing a fatal blow to an already divided and unequal economy. 

A prolonged lockdown is not only impossible to implement, but may not even be effective at restraining the contagion.

We have all seen the footage from informal settlements where thousands of residents were lining up to get food aid. These people are not allowed to work and earn an income allegedly to enforce social distancing, but are then expected to stand in line for hours, next to each other, without protective gear.

It’s obvious nonsense, which spreads the virus and aggravates its death toll.

We have seen similar contradictions also playing out in some European countries, where Covid-infected people were amassed in hospitals, thus infecting hundreds of chronically-ill individuals and multiplying the number of casualties, instead of being treated at home, where they could have been isolated from other patients.

In Italy, a number of illogical panic-driven decisions were taken, including moving Covid patients to old age homes, next to the elderly, who are notoriously more vulnerable to the disease, thus causing a massacre with thousands of deaths.

Moreover, forcing people to stay indoors for too long weakens their immune system, which makes them more vulnerable to the infection once social activities are re-established.

As in a vicious circle, prolonged lockdowns tend to become self-fulfilling prophecies, undermining any chance of recovery.  

South Africa should not look at Europe for inspiration, but rather further afield, to countries like Taiwan.

Despite its proximity to the pandemic’s epicentre in China, Taiwan did not impose a lockdown, which would have been anyway difficult to implement, but adopted an array of targeted measures, such as enforcing the use of masks among the population, sanitising public places and means of transportation, isolating the elderly, reducing commuting and checking kids' temperature in schools.

Granted, Taiwan is a small island and can more easily insulate itself. But it's also a country with a much higher population density than South Africa.

Having learned the lesson after SARS in the early 2000s, Taiwan knew that the world may continue being subjected to waves of viral infections, making repeated lockdowns impossible to adopt.

As a consequence, they immediately introduced measures to manage the contagion and co-exist with the virus. In Taiwan, only a handful of people died. 

As scientists indicate, we may experience multiple waves of Covid in the coming months and years.

In this regard, the only way forward is through achieving the so-called herd immunity.

This can be done with mass vaccinations but, while we wait for a vaccine, the only feasible option is to manage the contagion with a view to minimising the fatality rate. 

The youth are the least likely to be affected by the disease, therefore reopening schools would be critical to return to social life while limiting risks (especially if outdoor spaces are more systematically used).

Besides, checking pupils' body temperature may be useful to track down which families and communities may require temporary isolation. The same can be done at gyms, sports grounds and the like.

At present, the lockdown is paradoxically reducing our ability to monitor the spread of the disease until patients fall sick and require medical attention, which puts a strain on our healthcare system.

It is expected that many people may have already contracted the virus without showing symptoms and may have developed antibodies: checking them with quick blood tests (which can be administered at the local level, especially in poor communities) may be useful to monitor the spread of the disease and the level of immunity. 

Moreover, there seems to be growing evidence that reducing the "viral load", that is, the amount of virus in a person’s blood, is critical to limit the severity of the infection.

As a consequence, we should not limit all social activities, but mostly those in which vulnerable people - especially the elderly - may be exposed to an infected person for a prolonged period of time.

Thus, organising extra transport in townships in order to reduce overcrowding should be a priority (and possibly a permanent policy, so as to resolve a traditional dysfunction affecting the poorest).  

South Africa can learn from other countries’ successes and failures to turn this crisis into an opportunity to tackle our society’s profound injustices, which Covid has simply brought into sharp relief.  

- Fioramonti is a professor at the University of Pretoria  

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