- After booze was unbanned on 1 June, trauma-related deaths went up by 307% and road deaths by 260%.
- These and more alcohol-related harms filled hospital beds - already needed by Covid-19 patients.
- This led to the Western Cape health department urging national government to re-ban alcohol sales.
Hard-hitting statistics have been released by health authorities, which reinforces President Cyril Ramaphosa's announcement that alcohol will be banned again.
Ramaphosa on Sunday laid down the law in emphatic style, announcing a tough raft of restrictions on civil liberties to battle Covid-19.
These included an alcohol ban: "As we head towards the peak of infections, it is vital that we do not burden our clinics and hospitals with alcohol-related injuries that could have been avoided.
"This is a fight to save every life, and we need to save every bed.
"We have therefore decided that, in order to conserve hospital capacity, the sale, dispensing and distribution of alcohol will be suspended with immediate effect".
On Tuesday, the "Sentinel Trauma Report" was made public by national Minister of Health Zweli Mkhize.
The report was compiled by the Western Cape health department, initially after alcohol sales were legalised on 1 June. The report has since been updated with July's statistics.
The report concludes with recommendations, which were submitted prior to the recent re-banning of alcohol.
"As we approach the peak of the Covid-19 epidemic, our hospital emergency centres are being inundated with severely ill Covid-19 patients requiring stabilisation, emergency management and admission for further care.
"The lifting of the alcohol ban has effectively resulted in a 62% increase in daily trauma cases presenting to emergency centres. In addition, we have seen trauma admissions increase by 54%, trauma ICU admissions increase by 350% and trauma deaths in the [emergency centres] increase by 308%!
"This increase currently has and will continue to stretch [emergency centre] capacity; it has increased the number of admissions to wards; and it is depleting our ability to effectively manage and prevent the mortality from the double burden of Covid-19 and trauma deaths as we approach peak.
"We would like to maintain the firm recommendation that the alcohol ban be reinstated to minimise the impact on our health services in their ability to manage Covid-19 in the Western Cape," the recommendations concluded.
The report itself comprises a series of slides, each accompanied by hard-hitting findings. These are:
- The data showed that the lockdown regulations and alcohol ban effectively reduced the number of trauma presentations to the order of 40-50%.
- Prior to lockdown, there was a consistent trend of weekend spikes of 140-160 trauma cases across the five facilities sampled. The average (median) across the period was 89 daily trauma cases.
- During lockdown and the alcohol ban, this reduced to approximately 60-80 trauma cases at the weekend spikes. The average across the period reduced to 46 daily trauma cases.
- One month prior to the release of the alcohol ban, the average over the period was 50 daily trauma cases.
- Of the total number of trauma patients seen in emergency centres, 40.8% were admitted.
- After the lifting of the alcohol ban, the absolute number of trauma cases requiring admission in the five hospitals sampled over one month were 363 additional admissions (54.2% increase in admissions).
- After the lifting of the alcohol ban, the number of trauma deaths increased by 307%.
- After the lifting of the alcohol ban, the average number of daily deaths from road traffic accidents increased from 1.44 to 3.77, an increase of 260%.
- The Western Cape health department reported that "when comparing the current data to previous analysis done in the province, the picture is not surprising".
In 2016, alcohol tested positive in :
- 50% of homicide victims
- 60% pedestrian fatalities
- 47% motor vehicle accidents
- 65% fire fatalities
- 47% drownings
'Short-term', 'blunt mechanism'
Western Cape Premier Alan Winde on Monday agreed the new alcohol ban would have a "short-term" impact, but was unsustainable in the long term.
Instead of the ban – which Winde described as a "blunt mechanism" – he called for a "smart" intervention on alcohol harms, which did not simultaneously harm the economy or cost jobs.
"During Alert Level 4 and Hard Lockdown, when alcohol sales were initially banned, the Western Cape saw a marked decrease in the number of murders in the province - particularly stabbings. We also saw a significant decrease in the number of admissions to our hospital facilities for alcohol-related trauma events.
"However, after sales were unbanned on 1 June, we saw an almost immediate and notable increase in the number of murders and a surge in trauma admissions again.
"This has put additional strain on our healthcare system, especially in our high care and ICU units, where we are trying to save the lives of those people infected with Covid-19.
"The link between alcohol and violence is well established and a ban on alcohol sales may result in a reduction in incidents of murder, gender-based violence and trauma events, such as road accidents and assaults, and for this reason can have an immediate impact on hospital capacity.
"However, this is a blunt mechanism that will negatively impact the Western Cape economy and the Agri-processing sector, and will result in job losses across the province. It will also push the sale of alcohol 'underground', with less control over registered sales by our liquor authority.
"To put it simply, while this may help in the short term, the problem is not going to go away and a long-term ban is not feasible.
"That is why we support 'smart' interventions that understand that, like with Covid-19, we need a behaviour change approach if we are going to make a difference. We need to think outside-of-the-box, and this needs to be done whether there is Covid-19 or not," Winde said.
The premier explained that the Western Cape government had already initiated a project to consider long-term behaviour change.
Winde said he hoped this would "be a pilot for the country".
"I will be raising this proposal with the president during our next engagement," Winde said.