A group of Professors and other faculty members from the University of the Witwatersrand says an extended lockdown in SA will result in unacceptably high health and economic consequences.
The group says that an extended lockdown will have unintended economic and health consequences like the undermining of other health services such as the immunisation of children and losing a reported R13 billion rand per day in economic capita.
In an article for The Conversation, the group says according to studies, the containment of the COVID-19 disease through a lockdown is but a short term solution. The focus should be moving toward “aggressive community-wide screening, isolation of the identified cases and quarantine of their close contacts for at least 14 days.”
Stipulating a proposed blueprint for the replacement of SA’s lockdown, the group writes that what we need is “a unified health and economic strategy that allows for some economic activity while inhibiting the uncontrolled spread of the virus.” Meaning health and economic measures should be implemented in a coordinated manner.
In summarising three intervention strategies from a recent article by leading Australian health academics James Trauer, Ben Marais and Emma McBryde, the group believes the third option to be the best paired with SA’s needs. However, they warn, “the details of its implementation matter”
- Option 1: Relax lockdown measures completely and return to normal.
- Option 2: Continue lockdowns to limit community transmission and ensure case rates remain low until a vaccine is introduced.
- Option 3: Relax some measures and manage infections in a very controlled manner while protecting the vulnerable, until community immunity emerges or a vaccine is introduced to accelerate community immunity in approximately 60% of the population.
The health and economic risks of option 3 include an increase in the cost of testing and isolation as well as an increased need for careful control to ensure low risk of infection in high-risk groups such as those older than 65.
Health Recommendations
To reduce the rate of infections, the country must have the capability of mass virus testing and efficient contact tracing.
For a high success rate, the level of testing needs to be at least equivalent to that in South Korea meaning 17,322 tests per day, or at best it must be equivalent to that carried out in Germany meaning 36,399 tests per day.
A test should be available within 12 to a maximum of 24 hours. Followed by immediate isolation and contact tracing. Isolation of infected individuals and contact quarantine must last for at least 14 days, either at home, if suitable, or in designated isolation and quarantine facilities.
The annual cost of conducting 17,000 tests per day is approximately R5 billion, with an additional annual cost of R4 billion for contact tracing and quarantine. These costs compare favourably to the daily economic cost (R13 billion) of the generalised lockdown.
Economic Recommendations
Economic activities must be allowed in a way that is consistent with the aim of preventing the uncontrolled spread of the virus. Within the constraints of the health strategy, a risk-based economic strategy is required for a balance between economic and health imperatives.
Making decisions on which different parts of the economy to open first can be “made in line with the criteria proposed in a recent paper by German researchers.”
Examples of what to open first will include, opening sectors with low risk of infection (highly automated factories) and less vulnerable populations (child-care facilities) first.
It could also include areas with lower infection rates and less potential for the spread of COVID-19.
“To do this, the country will need excellent data on the extent and location of any community outbreaks of the virus. Such data will be generated by mass testing, and accurate information about the ability of certain sectors of the economy to reopen safely and in compliance with the health protocols.”
The health and economic strategy will thus need to be implemented in a spirited fashion with response to the latest evidence.
This article was originally published on The Conversation with contributions from:
- Shabir Madhi – Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand
- Alex van den Heever – Chair of Social Security Systems Administration and Management Studies, Adjunct Professor in the School of Governance, University of the Witwatersrand
- David Francis – Deputy Director at the Southern Centre for Inequality Studies, University of the Witwatersrand
- Imraan Valodia – Dean of the Faculty of Commerce, Law and Management, and Head of the Southern Centre for Inequality Studies, University of the Witwatersrand
- Martin Veller – Dean of the Faculty of Health Sciences, University of the Witwatersrand
- Michael Sachs – Adjunct Professor, Economics, University of the Witwatersrand
