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View from Afar: Coronavirus – how to think about the unthinkable

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Saul Musker works for the Project Management Office in the Presidency. He writes in his capacity as a South African.

There is a lot that government must do, but even more that is in our hands as ordinary citizens. We have to pull together as South Africans to prevent the worst of this pandemic.

It took only a few days last week for the Covid-19 pandemic to become a constant, ethereal presence in our lives. Since the first outbreak in Wuhan in January, we have known that the virus would spread elsewhere and eventually reach our shores. While the actual scale of the epidemic remains uncertain, how should we think about – and plan for – what has previously been unthinkable?

Over the past week, some have made apocalyptic predictions about the extent and impact of the Covid-19 epidemic in South Africa. Others have insisted that these claims are alarmist, and that we may yet escape the worst effects of the virus. Indeed, there is a morbid, almost Freudian fascination with disaster that compels many of us to frighten ourselves.

The question remains: in a context of extreme and rising uncertainty, and in a world where we have unprecedented access to the views of others through social media, how should we separate truth from hysteria?

Nobody wants to predict a catastrophe only for this not to transpire. Likewise, however, nobody wants to insist that everything will be fine only to discover in a week’s time that it is not.

This conundrum extends to government policy decisions. A disproportionate response risks creating public panic and causing unnecessary damage to the economy. The consequences of an inadequate response, however – of underestimating the seriousness of the pandemic – are arguably far worse. 

What we know for now is that there are multiple possible scenarios, with varying degrees of probability. This is the right way to think about the next few weeks and months – not by trying to predict exactly how the future will play out, but by considering multiple possible futures and preparing fully for each of them.

Some countries, most notably Taiwan and Singapore, have successfully contained the epidemic despite their proximity to its epicentre. By restricting travel from affected areas, implementing widespread and effective screening and testing, isolating suspected cases and tracing contacts to prevent transmission, and ensuring that people adhere to good hygiene and avoidance practices, these countries have demonstrated that the virus can be stopped.

In other cases, including northern Italy and parts of the United States, containment has been less successful. Cases in these parts of the world continue to rise, offering a stark warning of the different scenarios that are possible here too. 

The nature of an epidemic requires that we act well before it becomes obvious that there is any reason to do so. This is because the actual number of cases is likely to be significantly higher than the confirmed number, meaning that the virus is spreading before its effects become clear. Moreover, the exponential nature of its spread is such that action taken even one day sooner can have a significant effect on cumulative infections.

If we wait until it arrives, or until the crisis is apparent, it is already too late.

The fight against climate change has a similar dynamic. We need to take action now, while the climate appears (relatively) normal, to prevent or mitigate the extremity of a climate disaster in decades or even centuries to come. It is an illusion to think that because there is relative calm in the present moment, there is less urgency to intervene.

The long and short of it is that we need to act immediately, through swift and urgent measures, to contain the Covid-19 epidemic. It is wrong to imagine that the virus is still coming, that it has yet to hit South Africa in the way that it has affected other countries.

We are not merely preparing to deal with an epidemic. We are acting to fight it, now.

This sense of urgency motivated President Cyril Ramaphosa’s proclamation of a national state of disaster and a range of decisive emergency measures to stop the spread of the virus. These actions will buy us time, allowing us to control and mitigate the impact of the epidemic. 

In the words of the President: “It is true that we are facing a grave emergency. But if we act together, if we act now, and if we act decisively, we will overcome it.”

The good news is that South Africa has robust institutions and mechanisms to succeed in this effort. The National Institute of Communicable Diseases is a highly capable, world-class organisation staffed by experts who are renowned in their fields. 

It escaped the predations of State Capture because it was not an obvious target for looting, and we would be in a very different situation today if it hadn’t.

We have built important muscles through our responses to the HIV epidemic, as well as to TB and listeriosis. We rank in the top 30 countries in the world on our preparedness for epidemics and pandemics, according to the Global Health Security Index – above New Zealand and Kuwait. We rank 23rd in our capacity to respond. 

Yet there is no exaggerating what is at stake. The fragility of our economic recovery, the vulnerability of poor South Africans without accumulated savings, and the large number of immunocompromised individuals in the country mean that the risks here are serious.

There is a lot that government must do, but even more that is in our hands as ordinary citizens. We have to pull together as South Africans to prevent the worst of this pandemic.

Again, as the President said: “I have great trust that the people of South Africa will respond positively to this call for common action. This epidemic will pass, but it is up to us to determine how long it will last, how damaging it will be, and how long it will take our economy and our country to recover.”

The scale of the pandemic may seem terrifying, even debilitating. It is hard to escape a feeling of fear and anxiety about the future. But this is equally an opportunity for us to show the very best of ourselves, the characteristics that have allowed South Africa to survive and to thrive. 

Most of all, our individual responsibility is to stay calm, maintain perspective, and follow instructions. The mantra of Be Safe, Be Smart and Be Kind is a good one to keep in mind.

We will get through this, and we will get through it better and faster if we act appropriately now. The President set an example yesterday for us to follow. We are going to be okay, if we stick together.

In a time of crisis, it is easy to succumb to fatalism and terror. In his recently revived essay, How to Live in an Atomic Age, CS Lewis leaves us some helpful advice:

I am tempted to reply: “Why, as you would have lived in the sixteenth century when the plague visited London almost every year, or as you would have lived in a Viking age when raiders from Scandinavia might land and cut your throat any night; or indeed, as you are already living in an age of cancer, an age of syphilis, an age of paralysis, an age of air raids, an age of railway accidents, an age of motor accidents.”

In other words, do not let us begin by exaggerating the novelty of our situation. Believe me, dear sir or madam, you and all whom you love were already sentenced to death before the atomic bomb was invented…

This is the first point to be made: and the first action to be taken is to pull ourselves together. If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts — not huddled together like frightened sheep and thinking about bombs. They may break our bodies (a microbe can do that) but they need not dominate our minds.

We may not be able to attend church, work and school (or chat to our friends over a pint), but we can still respond to this challenge with thoughtfulness and calm. That is all of our task now. DM

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