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What we have learnt: 19 lessons from the Covid-19 pandemic

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Professor Mark Tomlinson is co-director of the Institute for Life Course Health Research in the Department of Global Health at the Faculty of Medicine and Health Sciences at Stellenbosch University. These are his personal views.

The Covid-19 pandemic has been a tough teacher, and we are still learning. We have learnt many lessons, among them, we forgot to feed our children. Oh, and we forgot to feed our children.

South Africa is now in Level 1 lockdown. Other countries are also loosening restrictions, while some are moving in the opposite direction – imposing stricter lockdowns following some respite during the northern hemisphere summer. As we emerge from our own catastrophic six months, I offer 19 lessons from the Covid-19 pandemic:

We forgot to feed our children. Let me say that again – we forgot to feed our children. When we went into a hard lockdown in March and schools were closed, school feeding programmes also came to a halt. What this meant for thousands of children across South Africa was that they lost their most nutritious meal of the day. Not only did we fail to make a plan, but it took court action to force the government to find ways to extend the feeding scheme.

When President Cyril Ramaphosa addressed the country on 23 March 2020 and announced the lockdown, support from South Africans was near total. He was empathic, the messaging clear: his manner communicated that we were all in this together. Unfortunately, this did not last long with the suspension of Communications Minister Stella Ndabeni-Abrahams for breaking disaster regulations barely two weeks into lockdown, while Nkosazana Dlamini Zuma continued to clumsily and repeatedly defend the inane and pointless tobacco ban. The horrific death of Collins Khoza at the hands of SANDF soldiers and the arrests of 250,000 people in the months that followed only hastened the rapid shift from cooperation to scepticism and, finally, to anger.

The pandemic has ravaged our poor communities in terms of infection, death, unemployment, poverty, hunger and violence. Without a Marshall Plan of sorts, the future is bleak for our country.

South Africa had no flu season – hand washing and mask wearing works.

We have a problem with data. It is a near certainty that the official figure of 17,248 Covid-19 deaths (as of 8 October 2020) is the tip of the iceberg. Our excess mortality rate (33,000 as of the beginning of August) suggests that closer to 50,000 people have died from Covid-19.

Going back to Level 5 lockdown in South Africa is not an option.  The economic, social, personal and mental health costs are simply too high to bear. The country’s economic output shrank by more than 50% in the second quarter of 2020. As a society, we will simply not survive another strict lockdown.

We have learnt that lockdowns in different parts of the world have different costs. Rich countries such as the UK, US and Germany can afford to pay the salaries and supplement the incomes of millions of their citizens. South Africa and other developing countries cannot afford such assistance. In thinking about our future, we need responses tailored to our context, our reality: responses that are fit for our purpose. We cannot blindly follow a one-size-fits-all approach and imagine that what worked in Tuscany or Stockholm will work here.

We are currently being told that perhaps as many as 40% of people in the Western Cape have been infected with the SARS-CoV-2 virus and that we will soon (or may already have) reached herd immunity. This is dangerous. Nobody knows what this “magical” number is. Herd immunity is a concept, not a number. There has never been a disease that’s been eradicated through herd immunity. When somebody tries to reassure you that South Africa has reached herd immunity, enjoy the sentiment if it provides some light and hope for you in a dreadful year. But if you plan to use the argument for “herd immunity” as a justification for changes in your mask-wearing or physical distancing behaviours, you may be in for a painful shock. Speculation about herd immunity is deluded at worst and premature at best.

Covid-19 offers us profound lessons for the future if we are prepared to pay attention. It has shown us how to prepare for the next pandemic (it will happen), how we need to learn how to live in harmony with nature (burning forests is bad and wet markets are risky places), and perhaps most importantly, that what we are experiencing now is a mild dress rehearsal for the future horrors of climate breakdown.

There are no silver bullets. Even a vaccine that is 100% effective will not eradicate this virus in the short or even medium term. The polio vaccine was invented in 1955 but polio was only successfully eradicated from Africa in August 2020. Strong health systems, communities, behaviour change and solidarity are going to be as important as any vaccine.

Now that we are in spring and moving into summer, the misinformation will start. We will be told that because summer is here, we will all be safer – or even that the virus is killed by the sun. Of course, as it gets warmer and we spend more time outdoors, there will be fewer opportunities for person-to-person spread. But it has nothing to do with the sun killing the virus – just ask California and Arizona.

We have not put children at the centre of our response. In fact, at times it has appeared that they have hardly even been a consideration. Cigarettes and alcohol received considerably more airtime than did South Africa’s children. The short, as well as long-term welfare of our children, did not, for example, govern decisions to close or reopen schools for the most part. Decisions we make today will affect our children for the next half-century.

Evidence suggests that our “first wave” was particularly brutal and that if there is a second wave it is likely to be less severe.

In the early months of the lockdown, we learnt about the unfathomable depths of goodwill that still exist in our country. Soup kitchens sprang up and communities rallied. Community Action Networks and other initiatives worked tirelessly and were the key drivers of much of the behavioural change we saw. But we also learnt that people get compassion fatigue. When fatigue sets in, the government needs to act and take up the slack.

We learnt that the corrupt among us are utterly shameless and will stop at nothing. Of course, it was utterly naïve, if not delusional, to believe that a global pandemic and considerable numbers of people dying and losing their livelihoods would make an iota of difference to the agents of corruption. One could almost hear the gleeful rubbing of hands by the rancid vultures of corruption as President Ramaphosa announced the Solidarity Fund in late March.

We have a hunger pandemic in South Africa. The future of any country begins with its ability to ensure its citizens, and especially its children, have enough to eat. Children experiencing prolonged under-nutrition will become stunted, with profound implications for their functioning in school, and later in their capacity to become productive members of society. If we cannot do better in this regard, perhaps we should simply switch off the lights.

Between 2009 and 2019 South Africa created 2.4 million jobs, and in the past six months we lost somewhere between two and three million jobs. Poor people and women took the brunt of this. Inequality remains one of our stickiest problems.

We are seeing the increasing signs of complacency with less mask wearing and fewer indications of physical distancing. This does not bode well.

We forgot to feed our children. DM

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"Information pertaining to Covid-19, vaccines, how to control the spread of the virus and potential treatments is ever-changing. Under the South African Disaster Management Act Regulation 11(5)(c) it is prohibited to publish information through any medium with the intention to deceive people on government measures to address COVID-19. We are therefore disabling the comment section on this article in order to protect both the commenting member and ourselves from potential liability. Should you have additional information that you think we should know, please email [email protected]"

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  • Richard Breytenbach says:

    Very good summing up, but some questions remain:
    1. What is meant by ‘excess deaths’ of 33,000? If these are simply those deaths not formally attributable to Covid-19, then a great majority of them are going to be from TB and so on. If they are in excess of the formal Covid-19 deaths as well as other known causes (again such as TB, influenza etc.), the still the question remains as to whether many of the excess deaths were the knock-on effect of more people dying from untreated other illnesses which were untreated because of Covid-19 restrictions and the fear of going to clinics, hospitals etc. To quote the BIG ROUND number is simply wrong without a proper explanation.
    2. Yes, we should ‘live in harmony with nature’ – and the only way we can do that is by not isolating ourselves from it. It seems to me that each individual one of us is the successful descendant of over 4 Billion years of evolution; consequently, our immune systems are integrated into the ecosystem and have adapted continuously to its ever-changing microbial challenges. The consequences of attempting to isolate ourselves from this very necessary ecosystem have only succeeded in ‘saving’ a relatively few lives while weakening our natural immune responses to this and other threats, and have caused devastation to lives and livelihoods for many years to come. Where was the reasoned and effective discussion of risks, impacts and contingencies in the first 3-6 weeks of the South African lockdown?

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