While South Africa saw a massive decline in trauma cases in hospitals during level 4 and level 5 lockdown, medical experts from the Universities of the Witwatersrand and KwaZulu-Natal are hesitant to give all the credit to the alcohol sales ban.
Instead, it’s more likely that the reduction of trauma cases was as a result of restricted movement under the ‘hard’ lockdowns, which prevented people from interacting and getting into trouble and kept more people off the roads.
Speaking to Rapport, the experts said that the better move from the government in recent weeks would have been to again look at tighter restrictions on movement and around the sale of alcohol, rather than an outright ban.
Using the example of Chris Hani Baragwanath in Johannesburg, Rapport investigated the number of trauma cases reported during lockdown. In March, before the lockdown came into effect, the hospital recorded 2,217 trauma cases.
In April, under lockdown level 5, this dropped to 1,151 cases. In May, under lockdown level 4 – where restrictions on movement were loosened – this increased to 1,623.
In June, when restrictions on movement were loosened significantly, and the sale of alcohol was again allowed, trauma cases at the hospital increased by over 1,000 cases, the paper said.
Further, it was noted that South Africa’s drop off in trauma cases under hard lockdown was in-line with other countries which also implemented tight lockdowns, but did not ban alcohol.
“It’s evident that where physical movement and coming together are involved, the chances of car accidents and violence are higher,” the experts said.
“According to tracking data recorded by smartphones, the movement of South Africans during hard lockdown decreased by 80%. Simply put, this means that limited movement presents fewer opportunities for trauma.”
The views from the university experts reflect some views of the South African Medical Research Council (SAMRC), which made presentations to the government ahead of the latest alcohol ban, offering alternatives.
While the SAMRC’s modelling showed a massive improvement in bed availability because of the alcohol ban, it recognised that there would be significant push-back from South Africans to such a move.
It recommended a host of alternatives to the ban – including limiting the availability of alcohol, reducing the drunk driving limit and changes to advertising – however, noted that these measures should have been implemented some time ago, for them to have the desired effect.
The group said 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 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,” it said.
However, “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,” it said.
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.
“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,” it said.
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 weeks.