Level 3: Trauma cases rise at 2 Cape Town hospitals just days after easing of regulations

(Getty Images)
(Getty Images)
  • Trauma cases at two Cape Town hospitals have effectively doubled since the economy was reopened at level 3.
  • A Cape Town activist explains how she had to deal with her first alcohol-related domestic violence case on the first day of the Level 3 lockdown.
  • A leading expert in alcohol research says the government should reconsider allowing its sale at places such as restaurants, bars and taverns for off-site consumption.

Trauma cases at two Cape Town hospitals have spiked substantially since the easing of lockdown regulations under Level 3.

The Western Cape Department of Health confirmed to News24 that at least two hospitals already witnessed significant increases in admissions this week, and at one of them, the majority of cases was alcohol-related trauma.

At Groote Schuur hospital: "We have seen an increase in trauma patients since [Monday]. Last week, we saw, on average, eight patients per day and [on Monday] alone this increased to 20," spokesperson Mark van der Heever said.

Helderberg Hospital reported this on Monday: "100% increase. [Previously,] in a 12-hour period, we saw 28 patients. On Monday, in a 12-hour period we saw 50 patients of which the majority was alcohol-related trauma," van der Heever said.

On Monday, three people, including two children, were shot in separate incidents in Manenberg, News24 reported. On Wednesday, a two-year-old boy was shot and a man killed in Bonteheuwel.

One Cape Town activist, who is against gender-based violence, has damned the legalisation of the sale of alcohol under the Level 3 lockdown, amid her community's first case of domestic abuse on day 1 of Level 3.

And a leading alcohol research expert has also suggested the government should reconsider the increased access points to alcohol under Level 3.

'We had our first emergency case in our community'

Lucinda Evans, speaking on behalf of non-governmental organisation Philisa Abafazi - "Healing the Women" - told News24 this week from her base in Lavender Hill, on the Cape Flats: "I'm livid. We had our first emergency case in our community. A woman sat for six hours in a police station. She was badly beaten, and she refused to leave the police station because she knew her husband would be drunk if she returned home."

Evans said it was common practice, in her experience, for some men with social grant cards to leave these cards at alcohol sellers "as collateral".

"When Sassa pay day comes, someone from the shebeen will then accompany the person to get their grant, and ensure they are paid back," she explained. "So, ultimately: What is the difference between the 'dop system' and now? Pay becomes alcohol."

Evans said she believed the alcohol sales ban from 27 March to 31 May had yielded positive results and she called on the government to "reverse its decision".

"When we were without alcohol, some of the perpetrators of domestic violence were forced to sober up. Some families were reconciling," she said.

She believed alcohol should have stayed banned "until we were over Covid-19".

"It's so ironic that the ban was lifted on the first day of Child Protection Month. How do we protect our children, when the very evil that leads to their harm has been unbanned?"

'What we are seeing is not surprising'

Professor Charles Parry, Director of the Alcohol, Tobacco and Other Drug Research Unit at the South African Medical Research Council (MRC) told News24: "There's been a huge drop in non-natural deaths, until recently - during levels 5 and 4 of the lockdown. We know that alcohol causes approximately 171 deaths a day - about 62 000 a year - and of those, about 18% are trauma-related deaths - about 32 trauma-related deaths a day."

The MRC's data showed that a substantial portion of these average daily deaths had dropped during the lockdown.

Parry said he had received data from several hospitals. Based on the numbers at Groote Schuur and George hospitals, there had been a 59% drop in violence-related trauma, a 65% drop in traffic accidents, and a 64% drop in other injuries.

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At least 40% of trauma cases were usually alcohol-related, said Parry. This led them to believe that many of these massive reductions could be partly attributed to the non-availability of alcohol, during levels 5 and 4.

The two highest levels of the lockdown also restricted movement, resulting in a dramatic reduction in traffic and crime.

Parry said they had warned, before Level 3 was introduced, that the number of hospital admissions could increase by 5 000 each week if the sale of alcohol were to be legalised again.

Since Monday, Parry said various violent incidents had been reported to him by various hospital authorities. In cases reported to him, these included allegations of an alcohol-related stabbing in the stomach, an axe-wound to the head and a pedestrian who had been run over by a suspected drunk driver.

"What we are seeing is not surprising," Parry said.

Government should reconsider on-site access points

He had anticipated that cigarettes would be legalised and that sales of alcohol would remain banned. On the legalisation of alcohol, he said: "I think we could have done it in a way that would have prevented some of the harms that we are seeing."

Parry said South Africa had around 23 000 off-consumption licences - bottle stores - and about 65 000 on-consumption licences, such as restaurants and bars. Holders of either licence have been permitted to sell alcohol, under Level 3 - presumably under pressure from the industry "to make up for losses, and to keep jobs alive".

"From a public health point of view, you could make a very strong argument that you could have kept the ban. But if you did lift it for economic reasons, I think the government went way too far," Parry argued.

Because on-consumption licences had been permitted to trade as well, South Africa had 90 000 outlets selling alcohol in full force again, not only bottle stores.

He also said that the selling at informal shebeens would add to that number.

"We're also bringing alcohol back into the household, which increases the potential for gender-based violence. And, as we are already seeing, we are creating more pressure on the hospitals' trauma units - including the need for treatment in ICU, like the Cape Town cases. We shouldn't really be spending too much time on alcohol-related trauma, which is largely preventable, we should be reserving our resources for Covid-19 patients."

Asked for his opinion on what the government should do next, Parry said: "I don't think we should rush to ban the sale of alcohol."

Instead, he proposed that other steps be taken by the government, such as only allowing sales at off-consumption vendors, like bottle stores, and not restaurants, taverns and bars.

He also said there should be a zero percent blood alcohol limit for drivers, greater policing of unlicensed points of sale, and measures to address ultra-cheap alcohol.

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