Health experts call for changes beyond the alcohol ban – including raising the legal drinking age and higher taxes

Medical experts at the South African Medical Research Council (SAMRC) have warned that alcohol abuse will continue to have a serious impact on the country’s healthcare sector, even outside of a peak in coronavirus cases.

Presenting in parliament on Wednesday (15 July),  the SAMRC’s Professor Charles Parry showed how that around 31% of South Africans drink alcohol, with approximately 43.2% of males being drinkers and 19.4% of females.

The average South African drinks around 65 grams of alcohol per day, which equates to about five or six drinks per drinker each day. 59% of drinkers binge drink at least once a month.

In addition, 6-8% of all deaths in the country can be attributable to alcohol – the equivalent of 171 deaths a day or 62,300 deaths a year.

Modelling 

Parry also presented models on how a temporary ban on alcohol under the country’s level 3 lockdown will impact coronavirus cases in the country and the healthcare sector.

He highlighted the below graph which shows the cumulative number of Covid-19 cases in the country up to 13 July, with the red lines showing the various lockdown levels.

The model shows that there was a clear increase in the number of coronavirus cases from the start of June when the country moved to lockdown level 3 and allowed alcohol sales.

Parry said that was also clear evidence of the effect of alcohol on the healthcare sector pre-lockdown (19 – 26 March) when liquor sales were only somewhat restricted.

Looking at the direct impact of the most recent prohibition on the sale of alcohol, the SAMRC’s data shows that there would be around 22,212 fewer trauma presentations to hospitals over four weeks.

This extends to just under 50,000 trauma presentations taken out of the system over an eight week period, Parry said.

“Trauma patients presenting to a health care facility and not requiring admission contributes to overcrowding and therefore increasing the risk of transmission of Covid-19 between patients and staff in ER,” he said.

“Trauma patients requiring surgery consume resources such as theatre time, and skilled staff – such staff can potentially be deployed to other areas of need in the hospital.”

The modelling also shows that there will be a significant decrease in other resources, Parry said.

“Using data in level 3 from five Western Cape hospitals to indicate the spread of trauma presentations across different injury types, there would be approximately 50,000 fewer presentations.

“This would come to 124,000 fewer days spent in general wards and 46,000 fewer days ICU bed occupancy – saving of about R1.3 billion.”

Crucially, this additional space would enable the treatment of about 17,755 Covid-19 patients in general wards or  about 12,947 patients in ICU wards over the eight week period.

 

Alternatives

Parry also presented information on possible alternatives as well as further restrictions to the full-blown ban on alcohol sales which has been introduced.

He said that this could include limiting the availability of alcohol, reducing the drunk driving limit and changes to advertising.

However, he also noted that there are also problems with these proposed restrictions.

“In contrast to a ban on alcohol sales, a combination of strategies is more challenging to implement; likely to have lesser impact even if used in combination,” he said.

Parry added that these restrictions should have been introduced at the start of level 3, instead of now when there is a shortage of hospital beds.

“Strategically, we did push with the MAC that it might be useful to consider taking such an approach to prevent push-back from the public and the liquor industry and associated businesses.

“It might also make it easier to defend legal challenges because then the government could say they initiated less intrusive strategies first.”

New normal

While South Africa is not going to have on ban on alcohol forever, Parry said that the country needs to be ready so as not to see the return of trauma cases.

This should include further taxes on beer and spirits as well as the introduction of further long-term restrictions such as increasing the legal drinking age to 19.

He said that the government could also look at some of the above alternatives such as the implementation of stricter drunk driving rules and much stricter rules.


Read: Ramaphosa on South Africa’s big issues – including closing schools and why it’s not a ‘ban’ on alcohol

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Health experts call for changes beyond the alcohol ban – including raising the legal drinking age and higher taxes