The trickiest part of dealing with the coronavirus pandemic is the period between becoming infected, thereby spreading the virus to others, and actually getting sick or showing symptoms. Similarly, there is a lag between the disruption and the world’s response to the pandemic – now amounting to lockdowns of different levels of severity – and our underlying assumptions about the world we live in.

There is too, it would appear, something of a lag in understanding the purpose and objectives of the lockdown itself. We should be clear. The lockdown in of itself, doesn’t save lives. Assuming the South Africa lockdown is largely successful (everyone staying at home and complying with the regulations), it gives us time to figure out what to do about the pandemic while the infection rates are still apparently low.

We should be clear. This pandemic will not be over until either we achieve herd immunity through infections or a vaccine is developed and becomes widely available. Herd immunity is the end strategy of every country. We should remind ourselves that the 1918 “Spanish Flu” (the H1N1 pandemic) and the 1957 (H2N2 pandemic) virus strains are still in circulation today, but are not particularly lethal as most of us are partly immunised.

The most optimistic forecast for a vaccine is around 18 months from now: The Covid-19 vaccine development landscape. There is no conceivable scenario where the whole country is kept in lockdown for much longer than its current extension to 30 April. Our effort to contain the disease will continue for at least another year beyond that date.

For the present, the different responses of countries have resulted in some sort of early ranking of their efforts to stem the spread of the pathogen. There are those countries that have responded early with decisive actions in implementing some version of a lockdown and there are those that responded much later in the steepening infection rate curve.

The early outcome of these decisions seems to be clear: those who acted early and firmly seem to have a grip on the disease and those who didn’t are now facing enormous numbers of fatalities and health systems stretched beyond breaking point. The countries for which we have reliable data that seem to have done well tend to be at least one of homogenous or consensus-based societies, small or out of the way places. The countries that seem to be doing poorly are bigger, more diverse, multicultural, metropolitan, open and with an individualist cultural and economic orientation.

Within countries, most infections and certainly those needing hospitalisation tend to be in the larger metropoles and immediately surrounding areas. In Italy, it was the industrial Lombardy region; in Spain, Madrid and Barcelona; in the UK, London and the new epicentre in the US is centred around New York City.

Taiwan, South Korea, New Zealand and several countries in Europe show that it is possible to restrict new infections and flatten new infection curves and provide guides for others. The failure of political leadership in not taking the threat seriously enough is another topic. One obvious failure is the buffoonish conduct of US President Donald Trump. Yet, within the US there is a huge difference in the progress of the disease in New York State, New York City in particular, and California, which seems to be doing as well as the best jurisdictions elsewhere in the world. Can we ask how New York Governor Cuomo or New York City Mayor de Blasio failed to follow the South Korean example?

Perhaps we should withhold judgment for a while yet. This pandemic finds us how it finds us. One thing we can learn is that a detailed 2019 study undertaken by Johns Hopkins and the Economist Intelligence Unit which sought to rank different countries in terms of their preparedness for a pandemic and which placed the US and the UK in first and second position respectively is wrong: 2019 Global Health Security Index.

New York City is probably the densest, most dynamic, diverse and energetic city in the world that draws in people from everywhere. As the song goes, “If you can make it here, you can make it anywhere”. 

New Yorkers live in densely packed high-rise apartment buildings, get around or commute by using the public transit system and eat out. It’s a perfect environment for the coronavirus to spread even after social distancing measures were put in place. So why couldn’t New York have taken the example of South Korea? Well, because it’s New York, not Seoul.  

That which puts New York on most of our bucket lists of places to visit and experience also made it particularly vulnerable to the spread of the virus. Seoul, perhaps unkindly, is the opposite. Maybe the suburban sprawl and its reliance on private cars to get around in Los Angeles had as much to do with its apparent success in containing the spread of the virus as the lockdown measures put in place in California?

Spare a thought for Singapore. It is a very disciplined place with an authoritarian government supported by widespread surveillance. It took the decision to lock down early – Coronavirus: Most workplaces to close, schools will move to full home-based learning from next week, says PM Lee – and appeared to have the infection under control. But it is now back into full lockdown for the second time. The problem for Singapore is that its very existence is based on it being a trading/shipping hub.  That is what it does and so it will be consistently plagued by new imported infections until there is a vaccine.

There is no point in debating the merits of the initial three-week lockdown or its extension. What we now need is an assessment of our return on investment. What can we reasonably expect to have gained with the time we procured?

First, we would want to understand how the lockdown itself worked. This can be assessed against the epidemiological measure of whether the infection rate was slowed or brought to a standstill. But there is a more important measure which is less about data points, graphs and charts. What was the impact on people living in different communities? What are the mental health and social implications including gender-based violence? What works in the traditional suburbs and formal settlements of different types? What works in the informal settlements and some of the rural areas?

There is quite a bit of evidence that the government is not interested in the answers to any of these questions. An example of this is the decision to prohibit the selling of liquor and cigarettes. Now, alcohol consumption and smoking are very big health issues and rightly deserve attention. Alcohol abuse is connected to high levels of violence and the carnage on our roads – both putting enormous pressure on our health system. But the prohibition on the sale of these items championed by the swaggering and frankly clueless Minister of Safety and Security “General” Bheki Cele threatens the whole effort. That it is enforced by a police service with a reputation for corruption gives further reason for concern.  

It just pushes yet another part of our already lawless society underground into the black market. The lockdown experiment is far too important on its own to have to carry the opportunistic load of some minister’s personal views on the sale of liquor and cigarettes.

How does one best secure the support of poorer communities for the restrictive measures? And how is this best advanced by the presence of the police and security forces? The heavy-handed tactics we have seen even in the shadow of the Marikana disaster suggest that the government is not inclined to learn. If President Cyril Ramaphosa has forgotten, perhaps he can ask his old friend Roelf Meyer what happens when heavy-handed military force is used in communities that have decided that they don’t want the military around.

The second thing we want to know is what preparatory work has been done to prepare for the post-lockdown period. This would include the rollout of a test, trace and tracking regime. If all or nearly all those who have been infected are identified during the lockdown process, then it ought to be possible to implement a workable testing, tracking and isolation regime. How this would be implemented and work in practice remains to be seen. 

We are not alone; the US is yet to confront exactly how it can emerge out of its lockdown: Coronavirus economy plans are clear: No return to normal in 2020. We do know that testing, tracing, tracking and isolation can only work with a massively intrusive surveillance protocol and acceptance of these intrusions into their privacy. Regulations to provide for this are already in place, see: Coronavirus: South Africans are worried about cellphone privacy.

This circles back to the police minister’s alcohol and cigarette ban which just creates another unrecorded sector of the economy. How does one square seeking extraordinary levels of surveillance through a test, trace, track and isolate regime while at the same time putting regulations that create another illegal black market which does not want any kind of state surveillance of its activities?

Whether the government plans to keep the epidemic under control will become clear when the details of the test, track, trace and isolate plans are disclosed. If these do not include fully funded and staffed programmes, then we should understand that these efforts are simply providing cover for the real but undisclosed policy of herd immunity through a somewhat controlled process of infection with the coronavirus.

Recent reports based on the reluctance of government to disclose information – Adriaan Basson: The government is treating information like cigarettes in a time of crisis – and redacted presentations by the acting director-general of the health department, show that the current lockdown and its extension are primarily directed at giving the government more time to procure ventilators, personal protective equipment and field hospitals to prepare for an inevitable crisis in September: SA government plans for Covid-19 to peak in September but questions about data remain.

A pandemic with a 1% mortality rate halted only when we reach 60% herd immunity will account for as much as 65% of South Africa’s total mortality rate: South Africa death rate, 1950-2019. It is easy to imagine that this outcome would lead to a major adjustment in our social and political structures. The truth, however, is different. South Africa has already experienced its own HIV/AIDS pandemic without any apparent harm to the governing party. Recent polls in the US show a surprising boost in support of incumbent politicians: Poll: Americans’ fears of COVID-19 explode in four devastating weeks.

It is hard to make sense of all of this but since most of us will make it over to the other side, we need to be careful of mindlessly sacrificing our constitutional rights and democratic values to the pandemic. We need to start thinking about what happens when all of this is over. DM