South Africa - Problems and Options

This is the personal perspective of Bernhard Kirschner

My fear, and one of the main motivations for preparing this website in late March 2020 has been my belief that due to the endemic poverty in South Africa will not be able to handle a lockdown.

Strict restrictions have not helped
Stopping "old aunties" from selling their baked mealies and vetkoek on street corners is one way to worsen the situation. Less food, less resistance to chronic diseases. And chronic diseases are not only HIV/AIDS and TB. The down surge in an economy increases poverty, a deepening in poverty that cannot be quantified yet. Daily Maverick 18 May 2020.
There is no buffer between working and starvation, so within three weeks of the lockdown, by the 16 April 2020, many of the poor are starving, then rioting. Hunger, hunger, everywhere.
3 May 2020 Update. Fortunately my fears of uncontrollable riots have not materialised, unless the news has been suppressed, but that of hunger have.
Click here for link to report of "Protests and looting have broken out all over South Africa in recent days in response to one issue: hunger."
The South African Social Security Agency (Sassa) is responsible for social support for the poor in South Africa in the lockdown. But Sassa's offices were closed for the first four weeks of the national lockdown.
Complicating matters were allegations that wards that voted ANC and families that hide drugs for the gangs are getting preference.

When Dr Grey, a member of the Government Advisory Council Council slams the SA Government lockdown strategy she was in deep trouble. Report
Dr Glenda Gray, a member of the Ministerial Advisory Committee (MAC) and chairperson of the South African Medical Research Council (SAMRC), said the lockdown should be eradicated completely, and that non-pharmaceutical interventions (NPI), such as handwashing, wearing masks, social distancing and prohibitions on gatherings, should be put in place.


A household survey out on 15 July reveals that there was an almost immediate net loss of three million jobs between February and April and women accounted for two million of the people who lost their livelihoods as the economy was shut down. "One in five respondents reported that someone in their household went hungry in the last seven days, and 1-in-7 reported that a child had gone hungry in the last seven days." Source.

Let's get it into perspective

Every life is valuable, and none should ever be wasted. However when it comes to a choice between losing some, even many of our old, our sick, and unfortunately also our overweight, choices have to be made.

The choice was to try and save a limited number of the old and/or sick, and destroy our economies, or to lose a relatively few lives compared to the lives lost to vehicle accidents, TB, Aids, and even flu by introducing lockdowns and compulsory restrictions like masks, hand washing and distancing.

Our leaders, and supported by the mislead public choose the "saving lives" because it sounded so noble, but damaged our society, maybe for a generation, precipitated the worst economic downturn in history.

We are beginning to see the results of our stupidity.

The below graph from an excellent set of statistics by PANDA a collective of leading actuaries, economists, data scientists, statisticians, medical professionals, lawyers, engineers and business people working as a collective to replace bad science with good science. Link to table source here..

Financial Facts and Government ineffectiveness

The realistic expectation for the South African Revenue Service - SARS - was to collect about R1,300 Billion this year. It is estimated that the response to CO-19 is costing SARS R1 billion a day.

SA’s business confidence plunges to a record low, bank transactions fall 20%.
Dramatic plunges in the the RMB/BER Business Confidence Index (BCI) and the BankservAfrica Economic Transaction Index (BETI) underscore the scale of the economic havoc wrought by the Covid-19 pandemic and South Africa's lockdown measures to contain it. Daily Maverick 11 June 2020.
The government has offered to spent R500 billion in helping South Africans during the lockdown. I hope they have a rich relation to help them. They seemed to have found an even simpler solution - don't pay!

Poverty - The collision between the lockdown intent and the inequality reality

The government claimed that the objective of the lockdown was to save lives and to provide relief to the public.
What meaning can "to protect and provide relief to the public" have for the homeless initially expected to remain house-bound: or for the often large numbers of people - especially children - living in small homes; or for the millions whose homes are shacks that, at best, provide little more than minimal protection from the weather? How is the "public" expected to maintain physical distance in the townships and slums, or in the taxis transporting essential workers? Or to carry out handwashing without water? Or to buy facemasks and sanitisers when they can't afford even enough food?
"It is difficult to avoid the conclusion that the national government had no plan, shut down its massive school feeding programme and impeded its regular food parcel scheme, has failed to provide much funding for food parcels and has played almost no part in delivering them to poor people."

The second example concerns the R350 grant the government said it would pay all those people who had no income, either from employment or state benefits. The number of people in this category is unknown - which itself is very telling - with the government acknowledging 6.3 million valid and completed applications. Lockdown was implemented on 27 March. On 27 May the government asked the very people it recognised as having no income to "give the payment process more time". The supposedly good news came on 6 June: "Over 100,000 grants of R350 paid out, nearly 1.6 million declined." Ten weeks for a notoriously dysfunctional bureaucracy to say "no" to 1.6 million people! Of the other approximately 4.5 million valid applications received, only a further 1.2 million are still waiting to be finalised by a bureaucracy predisposed to saying No. Suggestive of the urgency given to providing money for people defined as having no income is that it took until 22 May for the grand total of 10 people to be paid this special Covid-19 grant. Source.

Increase in Gender Based Violence

Police Minister Bheki Cele on 5 April clarified to the media that the South African Police Service had received 2,320 complaints of gender-based violence during just the first week of the lockdown. This is 37% higher than the weekly average for the 87,290 domestic violence cases reported to police during 2019.
The national Gender-Based Violence Command Centre said they had triple the usual number of calls.

Source https://www.dailymaverick.co.za/article/2020-04-06-how-might-the-covid-19-lockdown-affect-public-safety-in-sa/

State abuses could match the threat of CO-19 itself

There have been reports of rather heavy-handed policing. Just five days into the lockdown, by 31 March, police had reportedly killed three people, the same number dead from CO-19 during that time.
"For the urban poor, in particular, abiding by the lockdown regulations can mean spending weeks in a single room with numerous others. As one resident of Alexandra in Johannesburg told Sky News, this isn't possible; people must get out."
Judging from the article describing the conditions in poverty areas of SA, the lockdown barely exists.
This article describes the situation in the teeming settlement of Masiphumelele in the Cape Peninsula. If you read anything today, this is the reality in South Africa

Click HERE to go to the article in the Daily Maverick.

Disease and Poverty

South Africa is an almost unique situation not only due to the poverty of many of its citizens, but also due to the large number of HIV cases, about 7.7 million by some estimates.
"In 2018 90% of people living with HIV knew their status, while 62% of people living with HIV were on treatment." Click here for UNAIDS source.
Could most HIV suffers NOT be more vulnerable to CO-19?
It is believed that people living with HIV who have achieved viral suppression through antiretroviral treatment and not have a low CD4 count will be affected by CO-19 similarly to a person without HIV. Other coronavirus-caused disease outbreaks such as SARS (caused by SARS-CoV-1) and MERS (caused by MERS-CoV), where only a few cases of mild disease were reported among people living with HIV.

Covid-19 sets HIV treatment and testing back.
Update 3 May 2020. In over 100 fatalities to date, only one has been found to be HIV positive.

Source https://www.iasociety.org/covid-19-hiv

CO-19 could prove catastrophic to the 38% of patients not on antiretrovirals treatment numbering about 3 million. 

There would need to be an urgent program to get them on antiretroviral or they would need to be isolated.
Abdool Karim reiterated that their main concern was for the two million to 2.5 million South Africans who are HIV-positive but not on antiretrovirals and especially an estimated 500,000 of them who have low CD4 counts.
I don't know whose figures to believe!
Tuberculosis is a serious public health issue in South Africa. In 2014 about 450,000 people developed the disease every year, and 270,000 of those are also living with HIV.
TB is South Africa's leading cause of death. Between 63,000 and 89,000 people die from it every year; that's over TEN people every hour. 

 Source https://www.copenhagenconsensus.com/publication/south-africa-perspective-tuberculosis

FOOD

The requirements include:

All cooked or uncooked food parcels to be inspected and approved by environmental health inspectors prior to distribution;

Food parcels cannot be distributed without a permit. Source.

Clear details of what is being distributed, when, and to whom, must be provided to the municipality for sharing with the security cluster.

Could SA by some miracle dodge worst of Covid-19 curse?

A new study has found Countries with mandatory policies to vaccinate with bacillus Calmette-Guerin (BCG) against tuberculosis register fewer coronavirus deaths than countries that don't have those policies.
It may just turn out that most South Africans are safer because it's mandatory to have a Bacillus Calmette-Guèrin (BCG) vaccination when they are born to prevent life-threatening TB later on.

Source By Alan Knott-Craig at https://www.biznews.com/inside-covid-19/2020/04/07/alan-knott-craig-covid-19-curse plus more here.

Click here for report that SA doctors and nurses may soon be testing to see if another BCG jab helps against CO-19.

another BCG jab helps against CO-19.  "There are observations that this BCG vaccine does something to the immune system that we don't really understand," TASK founder professor Andreas Diacon said. Children immunised with BCG tend to suffer less from respiratory illnesses, including asthma, he said. 
"It makes the immune system cope better with respiratory retract infections," said Diacon. "No one actually really understands why it works".
Diacon and his team want to determine whether BCG could have an effect on coronavirus by reducing the risk of infection or easing symptoms.
Eye Witnes News 4 April 2020. https://ewn.co.za/2020/05/04/south-africa-starts-coronavirus-trial-of-tb-vaccine

How might the CO-19 lockdown affect public safety in SA?
Total Lockdown

South Africa decreed an effective total lockdown from 26 March for three weeks, extended by two weeks on 9 April until 30 April 2020.

As at 9 April there were less than 2,000 CO-19 cases with 18 deaths, about the same number who die from TB every TWO HOURS.

"(i) every person is confined to his or her place of residence, unless strictly for the purpose of performing an essential service, obtaining an essential good or service, collecting a social grant, pension or seeking emergency, life-saving, or chronic medical attention;
(ii) every gathering, as defined in regulation 1 is hereby prohibited, except for a funeral as provided for in subregulation (8); and .......
(b) During the lockdown, all businesses and other entities shall cease operations, except for any business or entity involved in the manufacturing, supply, or provision of an essential good or service.... and

(c) Retail shops and shopping malls must be closed, except where essential goods are sold and on condition that the person in control of the said store must put in place controls to ensure that customers keep a distance of at least one square meter from each other, and that all directions in respect of hygienic conditions and the exposure of persons to CO-19 are adhered to.

(d) Retail stores selling essential goods is prohibited from selling any other goods."

The future

How SA can get back to normal with the least CO-19 mortality
All people in all lockdown levels would have to understand and follow the below behaviour rules.
However from statistics worldwide as at 3 October 2020 these precautions would appear to be almost ineffective at preventing virus spread, except maybe the first three, while they are just damaging to the economy and health of all.

  1. Don't go out if when feeling sick or have any cold or flu symptoms and you will not be allowed anywhere if you show any such symptoms without a doctors certificate to prove that you have a recurrent harmless behaviour.
  2. Stay at least 6 feet (2 meters) away from anyone who is coughing or sneezing, and tell them to stay home.
  3. Cover your mouth and nose with the inside of your elbow or preferably a tissue whenever you sneeze or cough. Throw away any tissues you use right away.
  4. Wash or disinfect your hands correctly on entering and leaving every premise which must offer disinfectant at the entrance and exit.
  5. Wear a shield, mask or facial covering and be encouraged not to touch your face.
  6. In public, even in open areas keep at least 1 meter away from everyone else except your own household.
  7. Follow social or personal space distancing with everyone, which means no touching, limiting physical contact with anyone or their clothes outside your household, effectively limiting contact to everyone.
  8. Clean any objects you touch a lot. Use disinfectants on objects like phones, computers, utensils, dishware, and doorknobs.
  9. All public transport must have limited specified capacities to ensure that passengers that are not part of your household limit contact, either by separation or some form of partition.
  10. Taxis and other public transport should also be allowed to charge a surcharge based on their limited passenger loads, and any employer who wishes to operate should be encouraged to pay this extra charge to their staff to get them to work.

There should be different lockdown levels, not so much as to prevent spread, but to prevent public anger who might realise that the whole lockdown effort was a wasteful exercise compared to any benefit. Different areas could have different lockdown restrictions as small as an address, a block a suburb or a council area.

Although we cannot expect everyone to follow these rules exactly, after having been locked down since 26 March 2020 the public may understand and have learned to follow most of these rules for their own safety.
Which business types should start operating first? All would need to follow the above prevention strategies.

1)The industries that should be permitted to operate first are those that generate the most income and productivity, such as mining, manufacturing, building and construction, and of course transport, otherwise workers cannot travel to work.
2)The next stage a few days later would be wholesale and retail workers, with priority to shops that supply other industries, such as hardware; otherwise, they cannot function properly.
3)The next stage would be service industries since these are often close contact.
Restaurants that wish can open, but with tables and seats separated to follow social distancing rules.
4)The last group would be the domestic workers
5)There should be only limited fines for businesses that don't follow opening rules, with heavier fines for those that don't follow prevention and limit social distancing properly

Any suggestions will be appreciated to info@endco19.com

Statistics, suggestions and comments

Official Email

info@endco19.com

Our Website

www.endco19.com

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http://chng.it/pbrmD7JQPy