Past dragging of feet puts lives in jeapordy

South Africa is lauded for its timely response to the outbreak of coronavirus.

We had the advantage of being in the Southern Hemisphere which gave us the time to observe the unfolding emergency and the effectiveness of the measures taken by other countries.

The lockdown was announced by President Cyril Ramaphosa early on in the course of the disease, and his approach and statesmanlike presentation of the hard facts drew international praise.

Unfortunately, that favourable impression was not supported by the office-bearers tasked with devising the details of the strategies so desperately needed to save lives.

Lockdown as a strategy, will always be a huge challenge in a country where so many people are living below the breadline, in ramshackle housing with poor or no provision of water and sanitation.

They also have poor access to basic necessities, such as food.

They are forced to use overcrowded public transport.

Clamping down on public transport and the changing requirements for travelling in a taxi does not make transmission less likely.

On the contrary. Requiring every taxi passenger to wear a mask (either unaffordable or unobtainable for many), simply means that masks are passed on between passengers.

Wearing a mask in a taxi has become a sort of “ticket-to-ride”. This flies in the face of common sense precautions, and greatly increases the infection risk.

After years of pleas, demands and even violent service delivery protests about the lack of water and sanitation in many communities, water tanks are now being delivered to some of those low-income communities.

That means that water is now available closer to home, but people will still gather at those water points to get water numerous times a day.

And there is absolute silence about the availability of soap to wash hands for the millions who cannot afford it. Rinsing hands without thorough washing with soap is useless in keeping the virus at bay.

No mention is made of improved sanitation, so the scarcity and dreadful state of public toilets in many areas, where so many people congregate, are not addressed at all. This simply underscores how past dragging of feet in the provision of these basic services will now put lives in jeopardy.

According to the new regulations, areas with high numbers of cases will maintain lockdown, while others will be relaxed to level 4. More vigorous testing will produce more cases. So in order to avoid total lockdown, Cape Town simply has to scale down on testing. That is absurd.

In public health, one of the first principles for instituting a rule or law to cope with a dangerous situation is that there must be a clear connection between what you ask people to do (or not do), and the risk facing individuals or communities in general.

If that connection is not obvious to all but the most oblivious, then the connection needs to be explained in many ways, using many avenues so that people can understand what is needed to make informed decisions when faced with situations that are out of the ordinary.

The present prohibition on selling any goods that are deemed “not essential” is mindless in its reasoning. Cooked food is one obvious example. This is happening in a country where huge numbers of people have not eaten a square meal in days.

I am seriously concerned about the availability of nutritious food for the underprivileged under the present lockdown regulations.

Poor people are faced with unreasonable choices. They cannot use delivery services.

They are subjected to restricted movement, cannot go out to buy cooked food and also have to leave their homes to gather wood or other fuel to cook raw food over open fires.

Such short-sighted rules without a clear relationship to virus protection leaves the general public with a growing disconnect between the “government” and their daily lives.

I am seriously concerned about the reasoning behind these regulations. This casts a long footprint into the future. South Africa already has a large and growing segment of the population who pick-and-choose the laws that they find convenient to obey.

This will cast a long shadow into the future when other crises need to be managed. Creating contempt for the law is a double-edged sword.

Management mistakes are only to be expected. How such mistakes are handled is crucial.

The reluctance to correct those missteps and contradictions is ominous. It leaves me distinctly uneasy. We need to learn from this disaster. The virus does not discriminate; its consequences, however, do.

Our world will never be the same again. If anything, we need to learn to make better provision for health disasters, and ensure that the health services are not an expensive drag on the fiscus.

It will mean our survival in an increasingly dangerous world. South Africa has wonderful people.

They deserve better.

Dr Jo Barnes is senior lecturer emeritus in the department of global health in the faculty of medicine and health sciences at Stellenbosch University. She writes in her personal capacity.