GROUNDUP

Covid-19: Has the alcohol ban helped?

By Michael Cherry 19 January 2021

Groote Schuur, like all hospitals, has been under enormous strain during the Covid-19 surges. (Photo: Ashraf Hendricks)

A study at Groote Schuur Hospital suggests it has freed up much-needed beds.

First published in GroundUp.

What has been the effect of the alcohol bans?

Groote Schuur Hospital trauma surgeons and Medical Research Council researchers have provided some answers using health records from the hospital’s trauma unit — which treats patients from the western part of Cape Town — between February and June 2020.

The study allows comparison between the months of February to March (pre-lockdown), April to May (hard lockdown), and June, when liquor sales were resumed, although not over weekends, and not for on-site consumption. The average total number of trauma patients decreased by 53% during the hard lockdown period but returned to pre-lockdown levels in June.

The authors analysed two categories of patients seen in trauma units: those injured in road accidents and those who have suffered violent trauma. The latter group is by far the larger and remained constant at 38% of trauma cases seen across the three periods. The former comprised 16% initially, fell to 9% during hard lockdown and rose again to 11% in June.

The total number of victims of violent trauma halved during the hard lockdown but returned to pre-lockdown levels as soon as alcohol sales resumed, and people were allowed out of their homes in June. There are three main causes of injury in this category: gunshot wounds; stabbing wounds; and those from blunt instruments or no instrument, as is common in domestic violence cases.

Gunshot injuries had only a moderate reduction of 15% during hard lockdown, but each of the second and third categories more than halved. In June, each of these two categories reverted to 84% of their levels in February and March, while gunshot injuries soared to levels 80% greater than their pre-lockdown levels.

The reduction in patients injured in road traffic collisions is partly attributable to there being fewer drivers on the roads (this was true for both hard lockdown and to a lesser extent in June); partly to those who were on the road being less likely to be over the alcohol limit.

In re-banning alcohol sales, government clearly hoped that both road injuries and violent trauma would fall again. By all accounts this has already been happening, allowing redistribution of both doctors, ward space and other resources to Covid patients.

The authors concede that the reduction in violent crime during hard lockdown was probably not due only to the alcohol ban, but also to people staying in their homes and high-visibility policing, including the presence of the army.

A problem associated with home confinement is an increased potential for gender-based violence. This was not specifically investigated in this study, although instances of it would have been included in violent trauma.

The study’s lead author, Pradeep Navsaria, says that relatively few cases of gender-based violence are referred to a tertiary trauma centre such as Groote Schuur, as these are mostly dealt with at regional hospitals. But interestingly, a recent study conducted at Grey’s Hospital in Pietermaritzburg (also a tertiary referral centre), did report an increase in female trauma admissions during hard lockdown. DM

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All Comments 11

  • Agree with the previous comment – curfew will have had an enormous impact – which you can see from decreased uptake of other health services during hard lockdown. The current curfew is very likely to be the main reason for the current decreased levels of trauma because it is clear that people have pretty good access to alcohol – the only way to really distinguish would be to retain the curfew but allow alcohol sales again

  • The txes losy would have paid for far more beds than the ban made free. Why is eveyone in government missing this point. Even SA Brews in their court case. ???

  • From all of this we can conclude that if you were going to shoot somebody, you were going to shoot somebody, regardless of regulations…

    Nobody believes that the alcohol ban worked more effectively than the tobacco ban did not. These kind of studies confuse cause and effect. I would wager that during lockdowns, the odds of getting a police and ambulance call-out were a lot lower than before. What proportion of “minor” assaults never got into the stats? What proportion of people that after sharing a zol and being beaten over the head with a beer bottle (as one does) never went to hospital? Probably a similar proportion to the people that did not go to clinics for TB and ARV and host of other such as knee surgery.

    I can therefore conclude that the covid regulations halved knee surgery.

  • The question is, could the same effect have been achieved by other means? One additional factor that few of these studies focus on is the impact of bans on overall attitudes towards the state, and towards lockdown especially. My guess is that the turning point of social rebellion came about mainly due to citizens’ disgruntlement over cigarette and alcohol bans. You can’t win a lockdown without winning hearts and minds. The reasons may ultimately have been sound, but bans come at a cost of losing support for a project such as lockdown, which may or may not translate into a loss of political support.

  • Keep the curfew, loose the booze ban. Go back to closing liquor stores from Friday-Monday. Maybe have more police patrols on the ground in those areas that are known to be “hot spots” as far as violent alcohol related accidents or incidents are concerned. The dangers and consequences of alcohol abuse should be introduced into the Life Orientation curriculum at high schools as well.

  • There could have been a better approach to controlling alcohol if that indeed was what was required to help with the fight against covid: imposing higher taxes (to bolster the funds available to wage the war) or restricting quantities to reasonable levels (at point of sale for instance). However, all this talk tends to mask one obvious truth, and that is that decades of underspending in the public health sector, both in improving existing facilities as well as the roll out of new ones, has left the State woefully exposed in the light of a major public health emergency. That exposure the Government sees fit to blame on high levels of trauma, and so curtailing the trauma is the sure way to fix it. Whilst it is true that any nation should seek to reduce incidents of trauma, doing so at the expense of tens of thousands of jobs, and billions of Rand in lost revenue, is really shooting yourself in the foot. And this, so that those who choose to disobey the simple rhetoric to protect themselves (as well as others who do) can find a warm bed to recover in, or die.

  • There are some good comments here, but the one glaringly obvious fact that appears to be ignored is the compulsive consumption of alcohol by the national population, causing problems of road accidents, violence etc. Banning alcohol products causes huge losses to the fiscus, jobs, businesses etc. We have the cheapest booze and fags in the world, so do what the rest of the world does, and massively increase sin taxes. That would cut down the alcohol abuse, and greatly help with the cost of the vaccines. I am both a smoker and drinker.

  • Now the only question I would love to have answered by the “Command Councel” —
    How many stabbings, shootings, car accidents and wife bashings which have contributed to a shortage in hospital beds on weekends, have been perpetrated by people like myself and many of my friends who order our wine in cases from wine estates and drink it at home, a few glasses per day?
    We all know who the miscreants are, so why not close the shebeens, bars and open air bottle stores, keep up the curfew and allow honest people owning and working at wine estates to carry on with their business?
    Not rocket science is it, even if you are not too good at forward planning

    • Agree totally. The few abusers is a fraction compared to the bulk of redponsible consumers of wine & beer.
      An intern revealed that some alcohol related cases are not coded as such because Medical aid will then not pay.

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