What to expect after lockdown

As we’re still enduring lockdown, one cannot avoid thinking about South Africa’s exit strategy in the next few months. Although the lockdown period has temporarily supressed the transmission of Covid-19 amongst South Africans, it certainly won’t eliminate it. If we just continue our lives as we did before, we will have undergone the lockdown for nothing.

This begs the question: what will we do when the period is lifted? During a regular ministerial briefing on the 16th of April, Co-operative Governance and Traditional Affairs Minister, Dr Nkosazana Dlamini Zuma, gave some indication of what to expect post lockdown.

“When we do stop the lockdown, we can’t do it abruptly. We have to phase it in so that there’s an orderly move towards what would be normality,” said Dlamini Zuma.

With predictions of the pandemic expected to peak in the colder months ahead, and potentially catastrophic personal and national consequences of prolonged economic shut-down, precautionary measures will need to be taken. Alex Welte, Research Professor at the South African (National Government) Department of Science and Innovation at Stellenbosch University, answers some pertinent questions.

Post-lockdown, how do we gauge if the epidemic is getting out of control again, and how do we then respond?

If there is a rapid escalation in cases, or hospitals begin to get overwhelmed, do we enter another lockdown? How many lockdowns can we endure before unemployment and the slowdown in the bare bones basics of the economy becomes even worse than a massive but transient epidemic? How do we conceive, implement, and monitor meaningfully distinguishable levels of social distancing, and how do we step back, cautiously but with some urgency, from the brink of total stagnation?

How do we scale up testing to the level at which it plays a real role in controlling the epidemic?

In South Korea there is continuous mass testing; over 400,000 tests have been conducted compared to about 35,000 in South Africa (our populations are similar sizes). As soon as infected people are identified, they have to go into isolation until they’ve recovered. This has helped keep the epidemic manageable and maintain standards of care for those who experience acute illness – so mortality rates are low. How do we adapt this to our informal settlements, infrastructure and finances? We need rapid, simple, cheap, and reliable tests to become available here, and fast.

What social distancing measures can be maintained for the long term?

Should people who can work from home continue to do so by default? Should restaurants remain closed except for takeout? Can we encourage online grocery shopping? Do airports remain open only for essential travel and goods? What public transport rules will be instituted? How do we even begin to implement social distancing in high-density shack settlements? Or could this epidemic be the impetus to finally address the housing crisis, or, indeed, the land question?

What do we do about schools?

Perhaps a handful of schools can implement sustained distance-learning, but this is impossible for township schools, and even schools in middle-class areas. Perhaps we have to accept that the school year must be cancelled and that a cohort of children will matriculate 12 to 18 months later (or whenever the pandemic has passed). But without schools and feeding schemes, many children will go hungry unless something creative is done. Alternately, if we restart schools soon, can the youth show us how they wish to adapt their environment to take care of their futures?

What steps can be taken to prepare hospitals, both public and private?

Perhaps the main benefit of the lockdown is that it is giving intensive care units an opportunity to prepare for a spike in cases. The impressive crisis-driven adaptations we have seen in other countries may not be replicable here, but it is clear the trenches of this proverbial war are the high care settings of formal healthcare facilities. The pressure Covid-19 puts on health systems is not primarily about people dying. The challenge is that many of those who become really ill can, in principle, benefit hugely from effective care – but they will not get much care if the system is overwhelmed.