As South Africa braces for a fourth wave of the Covid-19 pandemic, one imagines that there are members of the National Coronavirus Command Council (NCCC) itching to reimpose a ban on alcohol sales.
South Africa’s vaccination drive, while painfully slow compared with rates in more advanced economies, should make the country immune to the need for such a blunt and frankly draconian policy.
President Cyril Ramaphosa made the right call on Sunday night when he addressed the nation and refrained from imposing any new restrictions on an economy that can ill afford a harsher lockdown.
The main justification for the previous bans was to free hospital beds in emergency and trauma units to deal with the surge in Covid-19 infections. And there is no doubt that South Africa has a booze problem which is linked to trauma incidents stemming from domestic violence, car crashes and bar brawls.
A study published in September by University of Cape Town and Stellenbosch University researchers found that South Africa’s total alcohol bans had significantly reduced the number of trauma cases, while added restrictions such as no weekend sales had a far more muted impact.
“Periods where the selling of alcohol was completely banned had significantly less trauma cases than periods with alcohol sale restrictions. This trend remained significant during the alcohol ban under Level 3 where most of the economy was active again.
“A significant decrease in assaults was associated with the alcohol ban and supports the causal role of alcohol in violence-related injuries. The restriction of selling alcohol on certain days and times had a limited effect,” concluded the authors of the study, which was published in the peer-reviewed African Journal of Emergency Medicine.
The bottom line was that the study found that the booze ban reduced trauma cases by 18.7%.
Findings such as this will no doubt be held up by the control freaks on the NCCC, whose worst tendencies have been bottled up for the past few months.
No one can say precisely when the fourth wave, which seems to be emerging, will peak. But amid a sharp rise in Covid-19 cases driven by the new variant Omicron — which South African scientists detected last week — expect the passion for prohibition on the NCCC to come uncorked.
A sober look at the facts suggests such a measure would be misplaced.
Take for example the latest update on 17 November from the South African Covid-19 Modelling Consortium. Its focus was on hospital admissions.
“The numbers of infections and detected cases may be comparable to earlier waves, depending on the scenario; however, the ratio of admissions and deaths to infections and cases is expected to be substantially lower than in previous waves, as a result of the vaccination coverage, particularly among the elderly, and protection from prior exposure,” it said. (Italics added.)
“Even in the hypothetical scenario of a complete abandonment of a behavioural response to resurgence, the size of the 4th wave in admissions is projected to be smaller than the 3rd wave, in the absence of a new variant.”
There is obviously a new variant now. But a lot is still unknown about Omicron, and early indications are that it causes a milder illness than other Covid variants. And the vaccination drive, sluggish as it is, has made prohibition far less necessary.
The president pointedly noted the vaccination drive in his Sunday address — it has helped to reduce the need for more stringent lockdown restrictions, not least because it has greatly reduced Covid hospitalisation and death rates.
“Since the first Covid-19 vaccines became available late last year, we have seen how vaccines have dramatically reduced severe illness, hospitalisation and death in South Africa and across the world,” the president said.
“Vaccines do work. Vaccines are saving lives. Since we launched our public vaccination programme in May 2021, over 25 million vaccine doses have been administered in South Africa.”
We still do not know how effective current vaccines will be in the face of Omicron. But it is a safe bet that the vast majority of the vaccinated segment of the population will not require hospitalisation in the event of a fourth wave: the science on this is crystal clear.
A report published on 19 November by the US Centers for Disease Control and Prevention found that, “Covid-19 hospitalisations were rare among fully vaccinated adolescents and young adults” and the mortality rate among the unvaccinated was seven times higher than it was among the vaccinated.
With more than a third of adults in South Africa fully vaccinated — there have also been more than 2.9 million positive cases to date, and repeat cases are very rare — the country should have enough hospital beds and facilities to contend with the fourth wave. Admission rates should fall by close to a third of what would have been obtained without the vaccines.
There are reasons, after all, behind the vaccination drive. First and foremost it is to save lives. But it is also aimed at a return to normality and to ensure that the harsh restrictions of previous lockdowns are not required.
If the anti-booze brigade on the NCCC does reimpose prohibition, it will be transparent because of an agenda rooted in social conservatism. It will have nothing to do with science or common sense, which is what one has come to expect from social conservatives around the world.
One would also expect the Department of Health to have been making plans for more hospital beds any way, but queries about this remained unanswered.
The private sector is stepping into the breach regardless. According to the Minerals Council South Africa, more than two thirds of the industry’s 450,000 employees and contractors are fully and partially vaccinated, and its member companies have made hospital beds available to its host communities and the wider public.
Prohibition will hammer vulnerable sectors of the economy, sectors that have been battered by the previous booze bans. There is no vaccine to prevent many small businesses from going belly-up in the event of a new ban.
According to estimates in February by the South African Liquor Brand Owners Association (Salba), the cumulative impact of the first three bans included 200,000 jobs at risk, lost sales revenue of R36.3-billion, and tax revenue loss from the value chain and excise tax of R36-billion. There have also been small business closures and cancelled investment projects worth billions of rands.
“The alcohol bans have caused extensive job losses and income cuts within the alcohol value chain. Moreover, existing evidence indicated that the poor and those at the lower end of the earnings distribution had been disproportionately affected by the economic backlash of the pandemic, mainly among labourers, warehouse and retail staff,” Salba’s chairperson, Sibani Mngadi, said at the start of October after the lifting of the most recent restrictions.
The booze sector and its wider value chain — such as restaurants, bars and bottle stores — are labour intensive, and the impact of the bans and restrictions take their biggest toll on the working class and lower-income households. South Africa’s unemployment rate is 34.9% and poverty and inequality have been on the rise.
Another extensive round of prohibition will accelerate those trends at a time when the vaccination roll-out has clearly jabbed a needle into the main reason given for the policy. These are simply the facts of the matter.
Retailer Pick n Pay said in October that its recovery from the repeated alcohol sales bans since 2020 would be undermined further by another ban.
Prohibition also provides opportunities galore for the illegal trade to gain a foothold and flourish. What has decades of cannabis prohibition achieved? And adults like to be treated as adults. Such a notion is at odds with social conservatism, but its advocates need to grow up.
This is not to deny the scale of South Africa’s alcohol problem. But there are sensible measures that can help to address this without the smothering instrument of prohibition.
Hiking excise or “sin” taxes is one. The National Treasury needs all the help it can get right now and an increase could curb consumption while still delivering revenue to state coffers.
Public education campaigns are another route. Their effectiveness may be questionable, but politically it would probably be a hit with the nanny-staters in Cabinet.
More effective policing would also help, but South Africa’s Keystone Cop force has proven itself again and again to be incapable of delivering on its core mandate of protecting the public. Remember the July riots? (Bottle stores, revealingly, were also a prime target then).
Yet, on a range of fronts, notably domestic violence, proper policing would surely remove some of the sting that alcohol inflicts on South African society.
So when the fourth wave does become apparent — and it does seem to be emerging — expect there to be a push from some at the top to reimpose prohibition. But their case, which was never airtight to begin with, has been undermined by the vaccination roll-out. DM168
(This is an edited version of a column that first appeared in DM168).