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SAs response to COVID-19 worsens the plight of waste reclaimers

- Melanie Samson

The clock is ticking: in the absence of government support, not being able to work means waste reclaimers don't have money to buy food.

Lockdowns to prevent the spread of the deadly coronavirus are dramatically transforming people’s daily lives across the world. One thing that remains unchanged is that we continue to produce massive amounts of waste each day.

South Africa generates 59 million tonnes of general waste a year. As only 10,8% of urban households separate their waste, most of the recyclable items get thrown away. Yet the country has recycling rates comparable to European countries for some materials.

This is thanks in large part to reclaimers who, through what I call their ‘separation outside source’ system, separate people’s recyclables, just outside their homes and at landfills. After salvaging the recyclables, the reclaimers haul them great distances, sort and clean them. They sell the materials to small buyback centres, who sell them to larger buyers. The recyclables are subsequently resold for export or as inputs for production.

South Africa’s 60,000 to 90,000 reclaimers collect an astonishing 80% to 90% of used packaging and paper that are recycled, providing crucial inputs for production and saving municipalities up to R750 million a year (US$41.7 million) in potential landfill costs.

Despite their significant contributions, reclaimers in South Africa (as in most countries) are not paid for the service they provide. Instead, they earn a pittance when they sell what they collect.

South Africa’s measures to flatten the COVID-19 infection curve are making reclaimers’ situation even worse. Since the country went on lockdown at midnight on March 26, 2020, reclaimers have been locked out of landfills and cannot work in the streets. They have also been excluded from all forms of government support.

A history of exclusion

That the measures announced by the government leave reclaimers out should come as no surprise. Current government policies on waste and recycling do not meaningfully include reclaimers. Their central role in the sector is overlooked by an economic model that assumes that a part of the economy can be hived off as “informal” and deemed irrelevant to policy development.

This has enabled municipalities to completely ignore the separation outside source system and implement recycling programmes that dispossess reclaimers. This is not unique to South Africa.

The exclusion of reclaimers continues through the government’s responses to COVID-19. Waste management was declared an essential service, allowing workers in this sector to keep working. Not so reclaimers. This, despite their crucial role in municipal solid waste management systems. Like millions of other workers considered informal, they are not eligible for government financial support programmes.

Many governments are disseminating information on how long the virus remains on different materials so that people can protect themselves when they purchase and use them. But, there are no public service announcements on how to dispose of the same products to minimise risks for reclaimers.

In South Africa, as in countries like Brazil and India, this burden has fallen on reclaimers.

An essential service

According to information gathered by the Global Alliance of Waste Pickers, reclaimers in a number of countries have been affected in similar ways by government responses to COVID-19 that ignore them. Some core demands are emerging. These include permission to continue working; personal protective equipment, soap and washing stations; free rapid testing and health care; a basic income; and food parcels.

In addition, reclaimers in South Africa are demanding inclusion in the R500 million (US$27.8 million) government fund to cushion small businesses from the ravages of the virus. The South African Waste Pickers Association and the African Reclaimers Organisation want a declaration that they are essential service providers, a simple process to obtain permits, and protective equipment.

The reclaimers’ demands are in line with the “Guideline on Waste Picker Integration for South Africa”, which recognises and values reclaimers’ role in the sector. Although it must still be published, the guideline was agreed by all stakeholders. The pandemic creates an opportunity for the government to implement the guideline and support reclaimers.

No time to waste

Whether and how industry and municipalities that rely on reclaimers for profits and savings will assist them is unclear. But the clock is ticking: reclaimers earn their incomes daily and are already struggling. In the absence of government support, not being able to work means they don’t have money to buy food.

It is crucial that the government designate reclaimers as essential service providers without delay, and give them masks, gloves, protective gear, sanitisers and access to health care. They need access to public spaces and buildings to store their materials, as well as trucks to transport them. Reclaimers need public washing stations, food packages, rapid testing and income support needed by millions of other South Africans.

Many livelihoods are at risk. Resources must be made available to fund reclaimers, along with other essential activities, vulnerable workers and the unemployed.

Melanie Samson, Sr Lecturer in Human Geography, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Crowdsourcing: Scale of COVID-19 calls for new approaches to research

- Chris William Callaghan

Crowdsourcing is a promising approach to biomedical research and development (R&D) and could produce solutions to pandemics like this one.

COVID-19 is not the world’s first pandemic. Nor is it the only type of big problem that the world faces. Environmental degradation and drug-resistant diseases are other examples.

What’s special about the new coronavirus is the speed with which it has arisen and multiplied.

The current system of scientific and academic research can’t respond fast enough to problems like these, especially when data is still being generated. But there are potentially ways of overcoming this mismatch.

I propose that crowdsourcing is a promising approach to biomedical research and development (R&D) and could produce solutions to pandemics like this one.

The biomedical research and development industry largely responds to private incentives – even if subsidised by governments. Drugs are more likely to be developed for wealthy markets offering opportunities for chronic medicines that need to be taken for the rest of one’s life. This is because drug companies face the challenge of very large initial investments which they might not be able to recoup if a drug is not profitable. There’s less incentive to do R&D that could have wider social benefits.

A large-scale response to the COVID-19 outbreak is under way and there are already vaccines under development. But there is no indication yet that they will be successful. The current R&D response may simply not be large enough to stop the pandemic quickly enough.

How do we stop COVID-19?

To stop this pandemic, it may be necessary to move activities out of already productive (and profitable) research activities. And this may have to happen on a scale that is proportionate to the scale of the cost of the outbreak. A radical restructuring of the incentives of the biomedical research industry may be necessary to shift this activity away from its profitable uses and into (uncertain) vaccine research.

Academic research suggests how this might be done. Probabilistic innovation theory suggests that problems such as COVID-19 need to be exposed to processes that radically increase their probability of success. This may require novel technologies and methods to greatly increase the chances of solving the problem such as biomedical crowdsourcing, machine learning and big data science.

These have already demonstrated their effectiveness in biomedical research, but not yet at the scale required to stop the pandemic. Another useful example of biomedical crowdsourcing is gamification, a process whereby complex biomedical problems are used as the basis for computer games, with the goal of solving them. The site FoldIt is successfully using protein folding games to solve these kinds of problems.

A useful way of thinking about this approach is in terms of a societal benefit ratio. This is the ratio of the research efforts invested in solving a problem to the consequences of the same problem. In other words, many problems with very high human and economic costs don’t receive enough problem solving resources – the scale of the investments in solving these problems should be appropriate to the scale of the problem, or it might not be solved.

Current R&D efforts aimed at tackling the pandemic may produce a societal benefit ratio that is too small. The COVID-19 pandemic potentially affects around 8 billion people. Estimates of necessary interventions suggest that, if not addressed, the damage to the global economy could be in the trillions of dollars. The problem with current approaches seems to be that they are largely rooted in the profit-driven structure of the biomedical industry. Even with academic collaborators, this restricts the size of the investments in solving the problem.

Existing efforts will surely come up with a solution given enough time. But it might be necessary to consider other scientific approaches that have already demonstrated their success in biomedical research, and try them at a large enough scale.

How crowdsourcing works

Advances in technology have made it possible to crowdsource solutions to biomedical problems. Biomedical crowdsourcing is a problem-solving methodology based on putting problems online as an open call for anyone to solve. Sites like InnoCentive provide platforms for the initiation and administration of scientific crowdsourcing, but a large-scale global project might be administered by the United Nations or the World Health Organisation.

The successes of crowdsourcing in biomedical research are well documented. Sites such as InnoCentive have shown that complex scientific problems can often be solved more cheaply and quickly than they would using in-house R&D departments.

It could be argued that the scale of the crowdsourcing efforts to date has been too small to force activity into uncertain avenues of research. If governments across the world were to pledge a portion of their ongoing economic costs of the pandemic, it might be possible to offer a large biomedical crowdsourcing award, for example in excess of a thousand billion dollars. The scale of this award would better match the scale of the consequences of the pandemic. Such countries would not have to pay a cent if a solution were not found. Those seeking to solve the problem (solvers) bear the cost and risk of these efforts. This makes it necessary to offer a very large award. These costs include opportunity costs, such as the costs of not doing other work in the meantime.

If crowdsourcing were to solve this problem, then what of others that we have failed to solve until now? The current pandemic might offer researchers a unique chance to test this methodology at a large scale. If necessity drives invention, then there is no more important time than this to try new ideas.The Conversation

Chris William Callaghan, Professor, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Personal versus public freedoms South Africa during COVID-19

- Harriet Etheredge

In restricting individuals' movements and interactions during any national disaster, the conflict between public interest and personal autonomy will get messy.

As the COVID-19 pandemic took hold in South Africa two weeks ago, the first glimpse emerged of the lengths to which people would go to avoid isolation. The country also saw what mechanisms law enforcement had at their disposal to impose such measures.

The case that received the greatest coverage involved a mother and daughter who had tested positive for COVID-19 fleeing a health facility with a third family member. The Department of Health applied for an urgent court order to track the family down and compel them into isolation. This was granted. The family was subsequently located and isolated.

Very soon afterwards the government sought to clarify the legal position around the event. It gazetted a new regulation for COVID-19 that makes it a criminal offence to refuse testing, treatment or isolation. If an individual does refuse isolation, they may be held involuntarily for 48 hours.

During this time an urgent warrant must be obtained to extend the isolation period. Any person who contravenes these regulations is subject to fines or imprisonment.

This case is polarising and peppered with prickly ethical issues. Many may be scandalised by the arrogant and irresponsible actions of the family. The opposing contention is that the family was hindered in exercising its autonomy.

In any national health disaster calling individuals to voluntarily restrict their movements and interactions, the tenuous no man’s land between public interest and personal autonomy is bound to become a messy quagmire. On one hand, there is the evasive action of those who feel their autonomy is being restricted. On the other hand are people seeking a larger public good. In this case it’s the quest to “flatten the curve” of the pandemic by reducing infection rates.

Public versus personal interests

Autonomy is a person’s right to self-determination. So, it’s my right to do what I want to, when I want to and in the manner I want to – provided the continued exercise of my autonomy does not infringe on the autonomy of another. Both ethically and legally, this is where autonomy meets its limit.

Through evading isolation, the family may have jeopardised the autonomy of many who are at risk of COVID-19 and are taking measures to avoid it, like social distancing. That’s surely enough to make people feel angry.

There is a great deal of historical precedent in ethics literature for curbing personal autonomy in the interests of the wider public. Some examples are so obvious we take them for granted because they are inherently “wrong”. They include murder, theft and kidnapping.

Other examples are more subtle and include the right to freedom of speech, which is limited at the point where it offends the privacy or dignity of someone else.

Modern health policy leans demonstrably towards public health interests over those of individuals. Hence, we have notifiable diseases like tuberculosis where disclosure is mandatory.

In the case of HIV the Health Professions Council’s guidelines allow healthcare workers to disclose the status of an HIV-infected individual to their sexual partner after sufficient counselling – even if the individual disagrees. Disclosure here is justified because it’s seen to be in the interests of the wider public.

The bent towards public health priorities is also clear in primary care practices like vaccination and fluoridating water.

Lockdowns

In the case of COVID-19 it could argued that the demand on healthcare systems could be greater in developing countries than northern hemisphere countries. This suggests that the decision to impose lockdowns is all the more imperative.

The global south has weak health systems. It also has huge groups of individuals with diseases like HIV and TB. And millions of people live in very close proximity, in informal housing that facilitates the rapid spread of disease.

Because of this (and because in a novel pandemic like COVID-19 where there is very little data – and hence evidence – on which to base health recommendations) the decision to impose a lockdown makes sense. Under these circumstances, it is always advisable to proceed with utmost caution and in the interests of public health.

But a lockdown pits personal choice against collective good. Given the circumstances it appears reasonable to expect people to agree to limiting their freedoms.

Enforcing lockdown and adapting to it

Can authorities trust citizens to take measures like social distancing of their own accord?

The answer seems to be no and, in these cases, it has been necessary to cleave a legal framework compelling people to act in a morally responsible manner.

To ensure that principles like justice and equality across South African society don’t succumb to COVID-19, it will be necessary to clamp down on those who flaunt the law while the rest of the country abides by it.

But such enforcement must be elastic enough to respond to the South African context, and demonstrably address the practical and social challenges that many face.The Conversation

Harriet Etheredge, Bioethicist and Health Communication Specialist, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

SA needs to mitigate the worst of its inequalities in tackling COVID1-19

- Imraan Valodia and David Francis

South Africa won't flatten the COVID-19 pandemic curve unless all citizens have the means to stay at home.

As South Africa entered its 21-day lockdown, the political message was that South Africans were all in it together. However, it is clear that while society has been united politically to fight COVID-19, there are extreme and persistent economic and social inequalities. The lockdown confines everyone to their home for three weeks. But what does this mean in a country riven with inequalities?

The lockdown has illuminated how the spatial, economic and social inequalities which were characteristic features of the apartheid period have persisted in post-apartheid South Africa. Media coverage has shown inequalities in access to transport, shops, COVID-19 testing, and the very different ways the lockdown has been enforced and policed in different communities.

Here, we focus on the economic inequalities which have been highlighted by the lockdown. A time of crisis, such as this, shows the economy for what it really is. It strips it of all the trappings that often obscure the true economic relations. Events like this allow us to see how different parts of a society are structured to deal with distress, disruptions and economic shocks.

In South Africa, it’s a stark picture.

Deeply unequal

Economic data can help us construct a picture of the financial inequalities across South African households. If we divide households in the country into five groups (quintiles), from the poorest 20% to the richest 20%, we see how deep inequality is in the country. According to forthcoming research by our colleague Gabriel Espi at the Southern Centre for Inequality Studies, drawing from the National Income Dynamics Study from 2017, approximately 18 million South Africans live in the poorest 20% of households. Almost half of these poorest households are in rural areas. (While there are some doubts about the reliability of population counts generated by the National Income Dynamics Study, and whether the data underestimate poverty, the household-level insights it provides are very useful.)

On average, these poorest households have about five members and a total monthly household income of R2,600 (or about R567 per person in the household). Only 45% of households have an employed member. Much of this income would have been lost as the shutdown began. Indeed, a recent study by the Southern Africa Labour and Development Research Unit, which specialises in research on poverty and inequality, labour markets, human capital and social policy, found that the poorest 10% of households will most likely lose 45% of their income through the shutdown.

In contrast, 7 million people live in the richest 20% of households, with approximately two people per home (the average size is 1.93 people per household). The average monthly income for these households is almost R38,000 per month (or R21,000 per person). Almost 80% of these households have at least one employed member, and they work far more hours at a far higher wage than those in the poorest 20% of households.

Many of the people in the richest households are able to continue to earn an income by working from home, and many will actually save money due to reduced expenditure on things like eating out, holidays and entertaining.

For others, in lower-paid formal employment, the lockdown has exposed many to the risk that they could lose their jobs. For this group, the Unemployment Insurance Fund provides some temporary relief.

One particular group – informal workers – has no protection whatsoever, and the lockdown effectively removes their ability to earn any income at all.

Analysis of the Labour Force Survey data shows that there are 2.6 million South Africans working in the informal sector as own-account workers or their employees. Approximately a million more people are employed as domestic workers, many of whom do not have employment contracts or any unemployment benefits.

Many of these people would effectively have lost their jobs and their ability to earn an income at midnight on Thursday 26 March. When the lockdown ends, many of these workers, especially women, who often occupy the most precarious positions in the labour market, will find it very difficult to re-establish their work on the street corners, taxi ranks and train stations around the country. These workers, sometimes called “the precariat”, have work, but no protection whatsoever.

During events like a lockdown, or a protracted economic crisis, it is not income, but wealth, which sustains households. Here, the inequalities are unfortunately even more striking.

A forthcoming study by our colleagues Aroop Chatterjee, Léo Czajka and Amory Gethin of the Southern Centre for Inequality Studies and the World Inequality Lab finds that the poorest 50% of South Africans have an average net wealth of negative R16,000. That means their assets are less than their liabilities; they are deeply in debt. The richest 10% of South Africans, by comparison, have an average net wealth of R2.8 million per person (the top 1% have an average net wealth of R17.8 million per person).

While these individuals would have lost a portion of their wealth in the recent stock market crash, they are still substantially better off than most, and their household far better equiped to endure the lockdown.

Access to food

In terms of access to essential supplies, there is also a chasm between rich and poor. As we saw from the long queues in the shopping centres prior to the lockdown, those in the top quintile had sufficient income to go on a buying spree and stock up in anticipation of the lockdown. On the other hand, in the bottom quintile, millions of people had to queue in the supermarkets after the lockdown was in operation, jeopardising their health.

A recent study by the Institute for Land and Agrarian Studies finds that households with different incomes have very different access to food. The poor are at a significant disadvantage during the lockdown, with potentially catastrophic results for nutrition and hunger.

It is clear from these figures that while all households are locked down together, their abilities to manage the situation vary substantially. The resources to survive a three-week lockdown vary hugely between households. For the rich, this period may well mean an increase in savings. But for the poor, it means financial ruin. Most of the low wealth households will be plunged further into debt, as they are forced to liquidate their assets to survive the lockdown. The financial and economic consequences of the lockdown will be nothing short of catastrophic for many – if not most – South Africans.

What’s to be done?

The bold, decisive and evidence-based action by the government in response to the public health crisis the country faces should be applauded. The health response has, so far, been good. There has been rapid action to address some of the economic fallout of the crisis, including extraordinary tax relief, and bringing forward the payment of social grants.

But the current crisis is really worsening enormous existing inequalities, in addition to creating new ones.

Far more needs to be done to counter the economic destruction currently under way. South Africa cannot tackle the problem with marginal economic policy interventions. It needs immediate and drastic action informed by the best available economic evidence which is being offered by researchers across the country. South African society is at risk if it does not address these economic inequalities.

Indeed, the COVID-19 pandemic makes it clear how interrelated the society really is. The country can’t successfully flatten the curve of infection unless all have the ability to stay at home. For many the choice between staying at home and starving, or going out in search of work, is fast approaching.

For many others, spatial apartheid and extremely high levels of poverty make it virtually impossible to conform to the social distancing required to contain the spread of the coronavirus.

South Africa will not be able to tackle the COVID-19 crisis in a unified way if it does not mitigate the worst of its inequalities, and time is running out.The Conversation

Imraan Valodia, Dean of the Faculty of Commerce, Law and Management, and Head of the Southern Centre for Inequality Studies, University of the Witwatersrand and David Francis, Deputy Director at the Southern Centre for Inequality Studies, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Covid-19 lockdown needs to protect inner-city communities

- Siyabonga Mahlangu and Matthew Wilhelm-Solomon

In South Africa, the collision of HIV, TB and Covid-19 could be devastating, and radical measures are needed to address the spread of Covid-19.

The lockdown rules require that residents only leave their homes to seek medical care and “buy food, medicine and other supplies or collect a social grant”.

The army and police have been deployed to enforce the lockdown. 

In South Africa, the collision of HIV, TB and Covid-19 could be devastating, and radical measures are needed to address the spread of Covid-19, particular with South Africa’s overstrained health system. However, if lockdown measures worsen the health conditions of the most vulnerable groups – including those living in inner-city occupations, both South African and foreign nationals – they could be counterproductive.

Police and private security have been moving through the streets of Hillbrow and Yeoville, Johannesburg, firing rubber bullets and beating pedestrians with sjamboks. A Jeppe resident we spoke to reported being fired at with no warnings by police on Monday night. Public order policing rules require that police give two warnings before using any force. 

Police and private security violence is an all too familiar, rather than exceptional, sight for inner-city residents. While constitutional protections in the post-apartheid era provide radical and progressive protections and housing rights, inner-city populations have all too frequently been subject to raids, evictions, and, in the case of undocumented migrants, deportations.

According to 2011 statistics, more than 30,000 households and over 120,000 people were earning below the R3,200 per month necessary to access most decent rental housing in Johannesburg. There are likely to be tens of thousands living in unlawful occupations in high-rises, warehouses and houses, which have not been legally classified as “informal settlements”, but rather labelled “bad buildings” or “hijacked buildings”.

While there are cases of title-deed fraud and illegal rent collection, most of the residents of these buildings, both South Africans and foreign nationals, belong to low-income groups: informal workers and traders, recyclers, the unemployed and precariously employed, contract workers, cleaners, security staff, and beggars, among others. 

The residents of these buildings have long been the targets of persecutory police action. The army and police have often been deployed against inner-city residents, in campaigns like the Zuma-led Operation Fiela in 2015. In 2017 the former Johannesburg mayor, Herman Mashaba, increased police raids on occupations while continuing to deprive their residents of access to basic services. The ICF, in collaboration with the Socio-Economic Rights Institute of South Africa (SERI) are contesting the legality of these raids, on the basis they were conducted without warrants and breached rights to privacy and dignity.  

It is critical that police and army deployment for the Covid-19 lockdown does not result in the persecution of residents of unlawful occupations, along with others; this intervention needs to be gender sensitive and not allow for sexual harassment and xenophobic discrimination. 

Furthermore, while Ramaphosa promised community health teams to low-income areas, which have been sent into townships, no residents in several inner-city occupations that we have spoken to have been visited by these teams. 

President Cyril Ramaphosa and his advisers, aware of the potential impact on low-income groups, stated plans to take measures that include emergency water supplies “using storage tanks, water tankers, boreholes and communal standpipes” in “informal settlements and rural areas”.  However, again this ignores that many inner-residents are living with inadequate access to water. 

The Inner City Federation (ICF), founded in 2015, of which Siyabonga Mahlangu is general secretary, represents over 40 of these buildings. It began campaigning against evictions and for the provision of basic services, including water, to inner-city occupations before the Covid-19 outbreak. For instance, on 28 March, 2018 the ICF handed a memorandum to the mayor’s and president’s offices, demanding access to basic services, which was ignored by both offices. 

Many Johannesburg residents feel that their rights, according to section 27 of South Africa’s Constitution, guaranteeing access to food, water and social security, have been infringed and violated by the City of Johannesburg.

In many inner-city occupations hundreds of people often have to share a single tap or water point, such as a fire hydrant. As water points and shared amenities are mostly communal, physical distancing is extremely difficult. In addition, many residents have to use buckets instead of toilets, or use public toilets. This, at night, is of course particularly dangerous for women and children. Several ICF members we’ve spoken to telephonically contend that they struggle to follow Covid-19 guidelines due to the difficulty in accessing water.

City officials need to ensure that water, soap and (where water is unavailable, and at key points like building entrances) hand sanitiser be provided to low-income groups who cannot afford these items, and that there is safe and free access to public toilets.

In addition, the national and municipal agencies need to work with NGOs on distribution of information, grounded in evidence, that is meaningful to residents living in stressed conditions (for instance, sanitising communal resources facilities, guidance on minimising water use in hand washing, the re-use of water, and water storage). 

The current mayor of Johannesburg, Geoffrey Makhubo, has taken important steps in halting any disconnections of water and electricity, along with several other municipalities; however, it’s important that water is restored to those whose water has been cut. In addition, it’s important that water tanks are also provided, accessible to low-income inner-city residents without reliable water access.

In the inner city there are no street traders working. Yet many inner-city residents rely on informal trade for income and for food  There are also severe concerns about food shortages among those who have lost incomes during the lockdown. Beggars are likely to be among the most vulnerable during lockdown, many of whom are blind and disabled, and will not have savings to survive on. Disability amplifies many of the difficulties of water access and protecting against Covid-19. In addition, children could be particularly susceptible to malnutrition

There needs to be food support for those who cannot go 21 days with no income. Finally, there needs to be a moratorium on forced evictions, as a coalition of social justice groups have called for, and a stop to all deportations which could worsen the spread of Covid-19 through scattering, and worsening the condition, of vulnerable groups.

Finally, there needs to be collaboration to provide food support for those who need it during the lockdown. 

Civil society groups like Tshisimani are calling for nationwide solidarity along with income, water and food security. The challenges facing inner-city communities are not unique, but they should also not be ignored as part of a wider response, and the municipal and national government should actively support inner-city residents and civil society in the response to the pandemic. An effective public health response to Covid-19 requires that all residents in South Africa, no matter their economic condition or nationality, are included in the response. 

It is critical that, along with other precarious populations, inner-city populations regardless of nationality are cared for and not persecuted during the lockdown. 

President Ramaphosa’s team, together with the present executive mayor of Johannesburg, Geoffrey Makhubo, will be held to account and must attend to these concerns as a matter of urgency. The lockdown cannot be used to continue to suppress the rights and lives of inner-city residents, along with those living precariously, throughout South Africa.

Siyabonga Mahlangu is General Secretary of the Inner-City Federation (@InnerCityFed, innercityfederation@gmail.com), a community-based organisation founded in 2015 representing the residents of over 40 inner-city buildings. Matthew Wilhelm-Solomon (@wilhelmsolomon)  is a lecturer in anthropology at the University of the Witwatersrand and an associate researcher on the Migration and Health Project Southern Africa. This article was first published in Maverick Citizen/Daily Maverick. 

Centre for Deaf studies breaks the silence on COVID-19

- Wits University

The Centre for Deaf Studies (CFDS) at Wits is contributing to society by keeping the Deaf community informed about the coronavirus pandemic.

Thee COVID-19 pandemic has spread at an alarming rate over the past few weeks in the country. To date, over 1400 cases of COVID-19 cases have been confirmed in South Africa.

Government, media houses and various institutions have been disseminating important information  and updates with the public around COVID-19 through various platforms.

To ensure that the Deaf community gained access to crucial information on the global pandemic, the CFDS at Wits has been playing an active role through a number of initiatives that filtered information to the Deaf and hard of hearing communities in South Africa.

 

When the President addressed the nation on 15 March, the CFDS ensured there was a full live stream interpreting by a Deaf person through the use of relay interpreting – a practise of translating messages from one language to another through a third language for a targeted audience.

“Deaf to Deaf communication is the best way of getting such crucial information across,” says Professor Claudine Storbeck, Director for CFDS.

In an effort to raise awareness around COVID-19, the Centre also produced “Corona Info for kids”, an educational video for children teaching them about the deadly virus. The aim of the video was to make information accessible for deaf children in a deaf appropriate way that would make an impact, which also included a fun handwashing-alphabet clip.

In recent weeks, since the coronavirus outbreak in South Africa, CFDS has been offering and sharing information through these videos in South African Sign Language (SASL) to ensure the Deaf Community could access information in their first language.

“In any form of crisis or trauma, people communicate best in their 'mother tongue' and therefore we are making sure that information is available in SASL. ‘If you talk to a man in a language he understands, that goes to his head. If you talk to him in his own language, that goes to his heart.’ This quote from Madiba is so appropriate when it comes to including the Deaf community in our planning around this pandemic,” says Storbeck.

While the focus is on the Deaf community, the Centre has added subtitles to the videos to create inclusivity and enable Deaf and hard of hearing people to watch and share these videos with their hearing family and friends. Here is a list of the videos produced by CFDS for the Deaf community:

  1. Coronavirus Information in SASL 
  2. Coronavirus Information for Deaf kids in SASL 
  3. EyeBuzz Kids: Wash Your Hands (A-Z)
  4. Key Highlights: Presidential Address on Coronavirus in SASL 

With a week into the 21-day lockdown to reduce the spread of coronavirus, the Centre has cancelled their contact home-based support for families of deaf infants and young children (HI HOPES) and will be offering support via WhatsApp and videos. A five-week online SASL course will be released next week for hearing people wishing to learn about Deaf culture and how to communicate with the South African Deaf community without leaving their homes. A dedicated WhatsApp hotline (074 029 2764) has also been set up for Deaf children and adults to send their questions on the lockdown via either text or video. The hotline can be accessed via WhatsApp. Enquiries: claudine.storbeck@gmail.com 

COVID-19 UPDATE (20) – WELLNESS UPDATE

- Wits University

The University’s wellness support services are here to help staff, students and the Wits community in dealing with the disruption of our normal lives.

Dear Colleagues and Students,

South Africa is about to complete its first week of the national lockdown. We wish to remind Witsies to continue protecting themselves, their families and the broader community by observing the call to #StayHomeSA in a bid to slow down the number of infections in the country. Sadly, many individuals and families are finding it hard to deal with the disruption to normal life during this period. It is normal and expected during difficult times.

The University’s wellness support services such as the staff counselling line, the Counselling and Careers Development Unit (CCDU) and the Gender Equity Office are available to assist during the lockdown.

Cup of coffee with smiley face

The following services are thus available to Witsies:

Help for students

The CCDU Lockdown Wellness Chronicles offers daily coping strategies that can be used by all. The site has daily prompts to help structure and regain control of life and also to prepare for normalcy. Visit the CCDU website for more information on various mental health and wellness topics.

Students who would like to contact a counsellor for either personal, career or life coaching purposes can email  the CCDU and leave their contact details and one of the team’s professionals will respond. Email info.ccdu@wits.ac.za.

The Wits Student Crisis Line is available to all Wits students for counselling 24/7/365 on 0800 111 331.

The Campus Health and Wellness Centre is available to assist with primary healthcare and mental health enquires:

-          Primary healthcare enquiries – Call 0743077259 or 0824832251

-          Mental health enquiries – Call 0766093924

Help for staff and immediate family members

The Impil’enhle programme launched by the University in September 2019 offers free services for staff and their immediate families to receive counselling for stress, anxiety, relationship and marriage problems, parenting, abuse, trauma as well as legal and financial advice. This independent service offered through Kaelo Lifestyle is provided in all South African languages 24/7 days a week.

Call 0861 635 766 OR dial *134*928 OR Send a ‘Please call Me’ to 072 620 5699 OR email asknelson@kaelo.co.za

COVID-19 Medical Line

Should you suspect that you have COVID-19, please contact the COVID-19 Medical Line during work hours for medical-related advice on prevention, diagnosis and treatment options - call 0861 493 587 and select option 2 for members and then select option 6. Alternatively, contact the National Institute for Communicable Diseases (NICD) on 0800 029 999. Still unsure about how to monitor yourself for symptoms of COVID-19?

Gender Equity Office

During this time of lockdown and looking after ourselves and our communities, we realise that there are some who will be in spaces where they are not safe. The Gender Equity Office is available via email info.geo@wits.ac.za or call (011) 717 9790. Alternatively, call the national gender based violence command centre on 0800 428 428 or send a "Please Call Me" to *120*7867#. It is important to remember that should you require a restraining order, courts continue to operate for this purpose. The GEO is available to guide you through the process and prepare you for what to expect when you apply for the order.

ADDITIONAL RESOURCES

Busting Myths

There are many myths circulating around the transmission and prevention of the coronavirus. Wits Lecturer Neelaveni Padayachee from the Department of Pharmacology explains the myth around drinking alcohol to prevent the virus.

Helping children cope with changes

The impact that Covid-19 might have on children will vary and their responses could be influenced by factors such as gender, social support, inherent resilience and the level of exposure to the virus. Dr Ajwang' Warria, a Senior Lecturer in the Department of Social Work offers guidelines on how to help children during this period. Read the article.

Coronavirus posters in multiple languages

There is a series of educational posters (some translated by Wits students) on coronavirus is available in multiple languages. Download, print or share the following resources in Sepedi, Sesotho, Setswana, siSwati, Tshivenda, Xitsonga, Afrikaans, IsiXhosa, IsiZulu and English.

The Jive Media 'Hay’khona  to COVID-19'-posters were translated by Wits Famelab students.

Remember to practice good hygiene and to maintain physical distancing.

Stay safe

Wits COVID-19 Management Committee

2 April 2020

COVID19 Testing Station opens at Wits

- Wits University

A new COVID-19 Testing Station at Wits, managed by Gift of the Givers, is open to patients who fit NICD criteria and are referred by a doctor.

Wits University and the Gift of the Givers Foundation have opened a COVID-19 Testing Station on the Braamfontein Campus (Enoch Sontonga Road).

Gift of the Givers manages the testing station, while Mullah Laboratories co-ordinates the sites and reports to the National Institute for Communicable Diseases (NICD) and provides results to the referring doctor.

Tests will be conducted in an NICD approved, SANAS accredited laboratory with feedback to the NICD electronically. The turnaround time for results is between 24 and 48 hours.

Who can be tested?

  • Patients must fit the NICD case definition criteria and must have a doctor's referral before testing. This reduces contamination risk and contact time in the best interests of all concerned.
  • HPCSA rules require that the patient has to consult his/her OWN doctor if it's a telephonic consultation or any doctor if it's a face-to-face consultation.

Cost

  • The COVID19 PCR testing costs R750, and payment is due via EFT before testing.

Bookings and operating times

  • Please note: Testing is strictly BY APPOINTMENT ONLY. NO WALK-INS permitted.
  • Bookings: Call the toll-free number on 0800 786 911
  • Operating times:Monday - Friday: 07:45 - 17:00

No fees will be earned by Wits University or Gift of the Givers. The fee simply facilitates a more affordable price for the public.

Gift of the Givers COVID-19 Testing Station at Wits University

Wits School of Molecular and Cell Biology lends a hand with glove donation

- Wits University

The Wits School of Molecular and Cell Biology has donated medical gloves for frontline healthcare workers at Chris Hani Baragwanath Hospital in Soweto.

Healthcare workers treating COVID-19 patients urgently require medical gloves for their own protection and to avoid contamination. However, gloves and other personal protective equipment (PPE) is in short supply.

Protective equipment saves lives

The Director-General of the World Health Organisation (WHO) highlighted in his media briefing on 27 March 2020 that the chronic global shortage of PPE is one of the most urgent threats to our collective ability to save lives.

Prof. Yasien Sayed in the Protein Structure Function Research Unit (PSFRU) in the School of Molecular and Cell Biology coordinated the donation effort. Sayed was alerted to the critical need after Wits Medical School graduate, Dr Naeem Vallee, a first-year intern doctor at the hospital, relayed the shortage via a colleague whose wife is a Wits PhD candidate whom Sayed supervises.

Wits Medical School graduate and first year intern doctor at Bara Naeem Vallee takes delivery of medical gloves against COVID19 donated by the Wits School of Molecular and Cell Biology

Through the collective efforts of Sayed, Dr Pieter De Maayer, Dr Angela Botes and Dr Vanessa Meyer, a total of 56 boxes each containing 50 pairs of gloves were donated.

“At the moment, the Department of Internal Medicine at Chris Hani Baragwanath are full in the swing of preparing to deal with the impending COVID onslaught. Three wards have been specifically isolated to host and rehabilitate and treat the patients that will come back as COVID positive. It’s an extremely tense time. The lack of personal protective equipment is huge challenge we as healthcare practitioners face in dealing with this pandemic,” said Vallee, who took delivery of the donated gloves. Vallee graduated MBBCh from Wits in 2019.

“I’m extremely grateful to Prof. Sayed and his colleagues for recognising that we on the frontline need help, and for his generosity. This is a time where we all need to work together to prevent the spread and flatten the exponential growth curve of the COVID pandemic.” 

Sayed, who personally delivered the boxes to the hospital, says: “The donation of gloves represents a small token of our appreciation of our healthcare workers’ selfless and admirable efforts, and we hope that these gloves will afford them some measure of protection against the virus.”

Prof. Yasien Sayed coordinated medical glove donation efforts against COVID19 from the PSFRU in the Wits School of Molecular and Cell Biology

Fingering coronavirus ‘spike’ protein

The SARS-CoV-2 virus, the novel type of a coronavirus that causes coronavirus disease (COVID-19), has several glycoproteins on its surface. One of these proteins is referred to as the ‘spike’ protein, which is responsible for binding to receptors on the host cell prior to infecting the cell and hijacking the host’s cellular machinery for replication and reproduction of new viral particles.    

The PSFRU investigates the structures, dynamics and energetics of a variety of proteins using a multidisciplinary approach that relies on the principles and methodologies of biochemistry, biophysics, molecular, and structural biology and bioinformatics.

Keeping Witsies safe

Prior to announcement of the lockdown on 26 March 2020, the School had manufactured and dispensed 70% EtOH (ethanol) surface disinfectant freely to Wits staff to minimise contamination by the coronavirus. The disinfectant comprises 95% industrial ethanol (also called alcohol) diluted with distilled water to a ratio of 70%. Alcohol kills germs effectively, as long as alcohol comprises 60% to 95% of the solution. This is a ratio shown to be effective against germs. Alcohol attacks and destroys the ‘envelope protein’ that surrounds some viruses, including coronaviruses. This protein is vital for a virus’s survival and multiplication.

Caiphus Hlatshwayo Assistant Lab Technician in the School of Molecular and Cell Biology pours ethanol to produce sanitiser against COVID10 supplied free to Witsiesgy-pouring-ethanol_600x300

“We use 70% ethanol to sterilize surface areas when we are required to work under sterile conditions in our laboratories, for example, when we do tissue cell culture work. The ethanol is effective in killing a number of germs, including viruses. Cleaning all objects and surfaces that we come into daily contact with is a sensible practice to protect against coronavirus,” says Prof. Marianne Cronjé, Head of the School of Molecular and Cell Biology.

Hay’khona Corona! Spreading the word, not the virus

- Wits University

A poster series to action South Africans on how to care of themselves and others.

Wits University students who participated in the South African leg of FameLab, an international science competition, helped to translate a series of posters with a key messages on how every South African’s actions can save lives.

The Jive Media 'Hay’khona  to COVID-19'-posters were translated by Wits Famelab students.

The multilingual posters were produced by research communication specialists Jive Media Africa, and are published with a Creative Commons license so you are free to copy, print and share them (provided no modifications are made).

“Altruism is a strong motivator” says Jive Media Africa Director Robert Inglis, “People are looking for ways they can help, and sharing relevant, relatable messages is one of those ways.”

Hay’khona is an isiZulu expression signalling strong negative sentiment. Inglis says the posters say:

No, not here! to COVID-19

The posters have been translated into a number of languages from South Africa and other African regions, including IsiZulu, IsiXhosa, Setswana, Sesotho, Sepedi, SiSwati, Tshivenda, Xitsonga, Afrikaans, Yoruba, Luo and French.

https://jivemedia.co.za/science-spaza/haykhona-corona-spreading-the-word-not-the-virus/ 

How to support your children during Covid-19

- Dr Ajwang' Warria, Wits Department of Social Work

Strategies for parents to engage with their children at home during Covid-19 lockdown.

Woman and Child © unsplash

The national lockdown as a result of the coronavirus started in South Africa at 23:59 on Thursday, 26 March. Exposure to uncertainty has heightened anxiety levels and stretched the care and protection mechanisms normally provided at home.

Children, in particular, are vulnerable to the extraordinary circumstances of lockdown, social distancing, and a global pandemic.

 The United Nations Convention on the Rights of the Child (UNCRC) indicates special obligations for the caregivers of children in times similar to these. The best interest principle stresses that children should be assisted and protected at all times and their developmental needs met.

Covid-19 presents parents and caregivers an opportunity to deepen their participation in the lives of their children, mitigate harmful consequences and thereby safeguard their children's futures.

The impact that the coronavirus might have on children will vary and their responses could be influenced by factors such as gender, social support, age, inherent resilience, and level of exposure to the virus. What remains evident is that children tend to rely on parents for their emotional needs. Thus, parents (and any primary caregivers) can play a crucial central role as children’s sources of safety, security, and information.

The family is one of the most important systems of a child’s life. The collective nature of care that happens within the home setting is crucial, as many people, including children, look to their family for support when they face challenges. Social and cultural factors influence the care that people give and receive within these networks of care.

Here are some strategies for parents to engage with their children at home during Covid-19 lockdown. These strategies are drawn from a published study, which investigated strategies used by parents in Kenya to support children during terrorism acts:

  • Engage the child in open conversations using a language that the child can understand. Avoiding discussions may make the child more fearful and anxious. During the lockdown, remember that parents might be the only available support to the child. However, this support could also (be nurtured to) include older siblings, grandparents, teachers, etc. who can be accessed online.
  • As parents/caregivers, manage your own anxieties, which will help your children cope. Your well-being is imperative to your children’s wellbeing and recovery, as children sometimes regulate their own emotions based on the emotional response of their parents/caregivers.
  • Answer your children’s questions. The kinds of questions asked by children range from issues of safety, access to medical care, recovery, death, schooling, friends, teachers, pets, etc. Parents should respond both to their children’s anxieties (emotionally, by providing reassurance) and to the question itself. Children can ask difficult questions, but parents should not shy away from answering. Do not give a child false information – rather provide reassurance and let your child know that you will look up accurate information and share it with them. Children’s questions are essential. Questioning permits children to exercise their right to participation on matters concerning them.
  • Listen! Children need to make sense of things happening around them. The ability of parents/caregivers to actively and intently listen to their child is crucial. Parents/caregivers who are constantly glued to their cell phones for coronavirus updates might miss the opportunity to provide the secure base needed for children to take risks and ask frightening questions.
  • Provide accurate, factual information. Generally, children might not have clear, factual information. It is vital that parents/caregivers help children to understand what is happening, i.e., tell the real story reassuringly and holistically. This also presents an opportunity to rectify any incorrect information or misconceptions your children might have heard about or read.
  • Covid-19- related events have altered the way we do and see things. Thus, it is important to maintain a daily routine. Performing everyday activities as far is possible is vital, as this routine provides the structure that children rely on. By maintaining familiar schedules, based on age, gender and culture, children can establish normalcy, which will reduce their anxieties.
  • Monitor exposure to media. Continuous repetitions of Covid-19 news in any form risks re-traumatising or causing secondary trauma to children. Protect your children from what you think and know would exacerbate their anxieties and that which is unhelpful towards their healing.
  • Help build resilience in your children by facilitating play, nurturing care and celebrating survival with them on an on-going basis. Resilience can go a long way post-Covid-19.
  • Consider and plan for the worst-case-scenario. Parents/caregivers need to think about and work out alternative care arrangements for their children, should the parents/caregivers fall ill or die. Discuss these arrangements with children (reassuringly!) in an age-appropriate manner and with those identified and expected to provide care.
  • Look after yourself. Care for parents/caregivers is also vital. Engage in a relaxing activity and check-in with other parents. Share problem-solving strategies and support each other towards for effective childcare. These safe spaces enable parents/caregivers to talk about their own Covid-19-related (parenting) challenges and pain. Parents/caregivers need to monitor their own mental health and, if they have difficulties caring for their children, seek professional help.

RESOURCES:

UNICEF

Department of Health – Covid-19 webpage

South African Depression and Anxiety Group

National Institute for Communicable Diseases

CCDU Lockdown Wellness Chronicles

COVID-19 UPDATE (19) – TEACHING AND LEARNING (STUDENTS)

- Wits University

Message from the Deputy Vice-Chancellor: Academic regarding the resumption of the academic programme.

Dear Students

I hope that you are all well and that you are taking the necessary precautions to keep safe!

I know that many students are anxious about resuming the academic programme and doing so online.

The Senior Executive Team (SET) met recently and agreed to the following schedule: 

1-14 April 2020

All academics will prepare to take lectures online.

15-19 April 2020

Online orientation begins this week for staff and students. All course outlines, lecture notes, reading lists and additional audio-visual material will be uploaded and tested during this period. 

20 April 2020

The University opens for the second term and delivery of the academic programme begins online.


The almanac is currently being updated (we are consulting with faculties) and will be finalised early next week.

Learning Management Systems

All our Learning Management Systems (LMS) including Wits-e (Sakai) and Moodle will be hosted in the Amazon cloud to ensure that our systems have sufficient infrastructural support and that they are able to cope with large number of users accessing the systems at the same time.

Access to Smart Mobile Devices

We are aware that approximately 10% - 15 % of students may not have access to smart mobile devices (according to the results of the biographical questionnaires conducted over the last four years by Wits’ Business Intelligence Unit), and Faculties and Deans have been asked to develop specific plans in this regard.

Broadcast Options

We are exploring working with the SABC (Radio and Television), DStv and eTV to determine if it is feasible to broadcast key lectures on-air, particularly for those who do not have access to devices or data.

Access to Data and ICT Support

Wits has worked with Telkom, Vodacom and MTN to ensure that students can access selected learning sites without using data. Cell C is due to come on board shortly. All services will be activated within the next ten days. For a complete list of the zero-rated sites, visit: https://www.wits.ac.za/mywits/zero-rated-data-to-students-and-applicants/. Please note that students must have at least R1 worth of data loaded on a SIM card in order to access these sites. If you have any queries or concerns, please contact the ICT Service Delivery team via ithelp@wits.ac.za  or call (011) 717-1717 or log a call via https://witshelp-ism.saasiteu.com/.

Faculty Support

You will receive a more detailed letter from the Dean of your respective Faculty later this week, followed by additional information from your School/Department and/or course coordinators. Please feel free to share your views on potential online/digital learning solutions with your respective faculties. 

Additional Support

There is no doubt that we will offer additional support for students when we resume contact teaching. This could include additional lectures, boot camps, comprehensive laboratory sessions and additional tutorial support as appropriate.

Conclusion

We live through extraordinary times and have to develop extraordinary ways of teaching and learning. Our solutions may not be perfect but I would like to assure you that our academics and professional staff are working hard every day to ensure that we deliver a quality teaching and learning experience under the current circumstances. I know that you too will try your best to succeed. I have no doubt that we can overcome the many barriers that we will face and that together we can succeed.

Keep safe!

Professor Ruksana Osman

Deputy Vice-Chancellor: Academic

1 April 2020

COVID-19 UPDATE (19) – TEACHING AND LEARNING (STAFF)

- Wits University

Message from the Deputy Vice-Chancellor: Academic on the resumption of the academic programme.

Dear Colleagues

I hope that you are all well and that you are taking the necessary precautions to keep safe!

I write to you in my capacity as the Deputy Vice-Chancellor: Academic to share the thinking of the Senior Executive Team (SET) on the resumption of the academic programme and also to solicit your ideas and advice on best practices in your area as we move into an online teaching mode. Please read carefully through the attached Emergency Plan for Teaching.

The SET met yesterday and agreed to the following schedule: 

1-14 April 2020

All faculties will prepare to take the academic programme online.

I know that many faculties are already off the starting blocks.

15-19 April 2020

This period will serve as the online orientation period for staff and students. All course outlines, lecture notes, reading lists and additional audio-visual material should be uploaded and tested during this period. 

20 April 2020

The University opens for the second term and delivery of the academic programme begins online. 


Please note that the almanac is currently being updated (we are consulting with faculties) and will be finalised early next week.

I know that many academics are enthusiastic about taking the academic programme online while others are anxious about doing so. This is new for many people and I would like to assure you that we have established both central- and faculty-based teams to assist you through the process. I would like to acknowledge the great coordination that is taking place between colleagues in CLTD, ICT and the Library to ensure that staff and students are fully supported and assisted as we transition to online teaching. The Emergency Plan for Teaching (attached) provides a step-by-step guide on how to begin this journey.

We have also ensured that all our Learning Management Systems (LMS) including Wits-e (Sakai) and Moodle will be hosted in the Amazon cloud to ensure that our systems have sufficient infrastructural support and are able to cope with the large numbers of users accessing the systems.

We are  mindful that approximately 10% - 15% of our students may not have access to smart mobile devices (according to the results of biographical questionnaires conducted over the last four years by our Business Intelligence Unit), and Deans have been asked to develop plans to take this reality into account.

There is no doubt that we will have to consider additional support for students when we are able to resume contact teaching. This could take a variety of formats including additional lectures, boot camps, comprehensive laboratory sessions  and tutorial support as required.

Conclusion

These solutions have been necessitated by the pandemic and have had to be devised quickly. We know that they are not perfect, and we are acutely aware that there is unevenness across disciplines, schools and faculties in the adoption of online teaching. In many cases, this is dictated by the particular demands of the programmes offered. However, we have to do all that we can to provide our students with a quality teaching experience so that we do not lose the academic year.

I am confident that we have some of the best academics in the sector, and coupled with our determination, resilience and ability to adapt to change, we will without a doubt succeed in these endeavours.

I envisage that there may well be some barriers along the way, but I also believe that we are well positioned to find solutions to the challenges that we may face.

Please feel free to write to me at Ruksana.Osman@wits.ac.za to share any suggestions or best practices that could be useful during this time.

Keep Safe!

Professor Ruksana Osman

Deputy Vice-Chancellor: Academic

1 April 2020

'You can do more,' economists tell SA government

- Wits University

50+ economists and others from Wits are part of a group of more than 78 who wrote an open letter urging President Cyril Ramaphosa for more significant action.

OPEN LETTER TO PRESIDENT CYRIL RAMAPHOSA AND THE CABINET FROM SOUTH AFRICAN ECONOMISTS, BUSINESS ANALYSTS AND ECONOMIC JUSTICE ADVOCATES:

Dear President Cyril Ramaphosa,

We commend you and your government for the bold and decisive public health measures that you have taken in response to the crisis precipitated by the COVID-19 pandemic. We welcome measures to stem the spread of the virus. 

We are writing to you to suggest other measures that are urgently required to support and stabilise the economy and assist those hardest hit by the crisis. As you have noted, these public-health interventions will have significant adverse economic effects, compounding the persistence of inequalities in living conditions, wealth, income, and access to health and other services.

It is widely predicted that the virus will trigger a global recession, due to collapsing demand and the supply shocks this crisis will entail. It is estimated that South Africa’s GDP could contract by between 1.8 and 7%, with devastating impacts on jobs and livelihoods. This looming crisis requires large-scale economic interventions. For example, the United Kingdom, France and the United States have injected resources totalling 18.9%, 13.6% and 10.7% of GDP into their economies respectively. To date, the measures announced by the South African government, although welcome, do not match the scale of the challenge.  

In the face of this looming crisis we believe more significant action is required. These interventions must protect the most vulnerable.

This response is different from previous attempts to resuscitate ailing economies. We must both acknowledge that physical distancing and a lockdown will slow economic activity, and that extraordinary measures are needed to cushion the resultant hardship and avoid long-term social and economic harm.

There is a significant risk that millions in poverty will fall into destitution; millions more, currently in work, will be driven into poverty and become unable to meet their basic needs; and thousands of businesses will be forced to close due to falling demand as a result of the lockdown, falling incomes and a contraction of economic activity. The self-employed, atypically employed, informal workers, and small businesses, are particularly vulnerable, but none will be exempt from its effects. Traditional social support networks will be disrupted. The long-term impact on business capacity, and physical, financial, and human capital, could be devastating to our already ailing economy. In any already deeply unequal society, we know that the hardship will fall hardest on black people, and especially black women and children.

Economic interventions must therefore aim to:

  1. support households and communities,
  2. protect workers,
  3. sustain businesses,
  4. strengthen public health interventions;
  5. and strengthen the economy.

While we appreciate efforts already undertaken in each of these areas, we are concerned that they are not comprehensive enough, and are not being implemented sufficiently rapidly or on a large enough scale to prevent real hardship for millions of South Africans. While we recognise that the stringent social isolation measures are unavoidable, we need to commit as a society to ensuring they do not cause unnecessary hardship to our people, and especially to the working poor and other vulnerable groups. 

The following measures indicate the kinds of opportunities that are available:

Rural children walking too school

Support households and communities:

  1. Income transfers to lower-income and affected households, in the form of a special COVID-19 grant, a top-up to existing grants, and/or a universal basic income grant. Creativity is needed to speed up delivery, including income transfers via digital payment mechanisms. We appreciate the practical difficulties involved.
  2. Targeted, temporary and compulsory payment holidays from municipal taxes, rent and mortgages, and other debts owed, and a ban on evictions from houses, including on farms.
  3. Undertake measures to relieve women of the burden of care, in and outside the home, for example, by the provision of childcare for essential workers and additional income support.
  4. Ensure food security and food sovereignty through a coordinated and safe roll-out of food packages in food-stressed neighbourhoods, working with community groups to build collective action and solidarity. Children require special attention.

Small business and entrepreneurs

Protect workers:

  1. Guarantee wage payments so that monthly wages of all workers are secured for the full duration of the lockdown. The expansion in UIF payments is both welcome and critical. , but this should be a fallback, not a default.
  2. Rigorous implementation of leave requirements so that workers are not forced to use annual leave during the furlough period, and ensuring temporary workers as sufficiently accommodated.
  3. Extend unemployment benefits to casual and informal-economy workers, including the provision of temporary unemployment payouts for lost income during periods of lockdown.
  4. Ensure additional health and safety provisions are in place for essential workers and for when workers return to work.

Entrepreneur. Business. Market. Sugar. Selling.

Sustain businesses:

  1. Significantly expand access to low-rate emergency loans, including through low-cost liquidity provision by the South African Reserve Bank. The current amount of funds available, and the voluntary nature of the “solidarity fund”, fall well short of the expected need. Moreover, there is some evidence that the solidarity fund has diverted donors from other charities that play a vital role in supporting the most vulnerable.
  2. Targeted, temporary and compulsory payment holidays from municipal taxes, rent and mortgages, and other debts owed.
  3. Other forms of targeted and temporary tax relief if low-cost loans and payment holidays are insufficient.
  4. Increase the additional resources that are being directed to the health system, including for testing, treatment, medicines, community health care, and COVID-19 scientific research.

Generic_Rural area_© Flickr/Isabel Sommerfeld

Strengthen public health interventions:

  1. Strengthen the requirement for resources to be pooled between private and public healthcare providers, particularly for free testing and treatment of COVID affected patients.
  2. Rapidly scale up government’s attempts at the local production of critically needed health products, medicine and equipment.
  3. Scale up efforts to ensure greater access to water and sanitation, through the provision of water access points, safe ablution facilities, and removing restrictions on homes with water metres. The provision of soap and/or sanitiser is important.
  4. Ensure free mobile data and public internet access, to keep the public informed and curb the spread of fake news.

Economy and infrastructure

Strengthen the economy:

  1. Monetary policy measures to guard against capital flight and manage the exchange rate, ensure access to affordable credit, and ensure sustainable government bond rates. A “helicopter drop” of funds to households - for example, R1000 for each individual for a period of four months - could complement the grants discussed above. 
  2. Reviewing the current Medium-Term Expenditure Framework which requires considerable budget cuts, including in wages and healthcare.

We appreciate the Temporary Employment Relief Scheme, which aims to prevent retrenchments while maintaining standards. In the past, however, ensuring rapid and effective scaling up of the scheme has proven difficult. It is crucial that implementation be prioritised in the current crisis.

These measures will require additional government financing. We appreciate the effort to mobilise funds outside the fiscus - such as the Industrial Development Corporation (IDC), Public Investment Corporation (PIC), Unemployment Insurance Fund (UIF). However, the scale of interventions required will necessitate additional fiscal and monetary expansion by the Treasury and SARB respectively, as has been the case worldwide. A concrete plan for responsibly managing this must be tabled, a number of signatories are working on proposals in this regard. In addition, we support your call for global transfers and action on the international level. 

Commitment, implementation and responsiveness remain a major challenge. While swift action has been taken on health responses, economic interventions have been subject to delay, confusion and incoherence. We need to accept that as with health policy, some risks will need to be taken in this unprecedented situation. 

While the Presidency must direct interventions, as far as possible the economic interventions should seek to empower communities, promote their mobilisation, and build social solidarity, as has been noted by a wide number of civil society organisations.

The Presidency must reassure the most vulnerable people and businesses that they will be protected.

This moment calls for all South Africans to contribute. We are willing to support in advancing these shared objectives. We would welcome the opportunity to put these proposals before yourself and the appropriate forums and provide additional technical support as needed.

Yours sincerely,

[List of Wits University authors(*):]

Professor Vishnu Padayachee - Distinguished Professor and Derek Schrier and Cecily Cameron Chair in Development Economics, School of Economics and Finance, University of the Witwatersrand

Dr Gilad Isaacs - Co-Director, Institute for Economic Justice and School of Economics and Finance, University of the Witwatersrand

Lumkile Mondi - Senior Lecturer, School of Economics and Finance, University of the Witwatersrand

Professor Imraan Valodia - Dean of Faculty of Commerce, Law and Management, University of the Witwatersrand 

Professor David Everatt - Head of School, Wits School of Governance, University of the Witwatersrand

Professor Uma Kollamparambil - Head of School, School of Economics and Finance, University of the Witwatersrand

Professor Pundy Pillay - Professor of Economics, School of Governance, University of the Witwatersrand

Dr Laura Rossouw - Senior Lecturer, School of Economics and Finance, University of the Witwatersrand

Professor Mills Soko - Professor of International Business and Strategy, Wits Business School, University of the Witwatersrand

Professor Ben Fine - Visiting Professor of Economics, University of the Witwatersrand, and Emeritus SOAS

Dr Mthokozisi Mlilo - Senior Lecturer, School of Economics and Finance, University of Witwatersrand

Dr John Khumalo - Senior Lecturer, Wits School of Governance, University of the Witwatersrand 

Halfdan Lynge-Mangueira - Senior Lecturer, Wits School of Governance, University of the Witwatersrand

Dr Nicolas Pons-Vignon - Senior Lecturer, School of Economics and Finance, University of the Witwatersrand

Cheryl-Lyn Selman - School of Economics and Finance, University of the Witwatersrand

Sibulele Nkunzi - Lecturer, School of Economics and Finance, University of the Witwatersrand

David Francis - Deputy Director, Southern Centre for Inequality Studies, University of the Witwatersrand

Thabo Dikobe - Lecturer, Wits Business School

Ayanda Magida - Researcher, Wits Business School

Professor Rod Crompton - Adjunct Professor, Wits Business School, University of the Witwatersrand

Rubina Jogee - Lecturer, School of Economics and Finance, University of the Witwatersrand

Mark Everett - Executive Manager CLEAR-AA, University of the Witwatersrand

Aroop Chatterjee - Southern Centre for Inequality Studies, University of Witwatersrand

Avril Joffe - Head of Department, Cultural Police and Management, University of the Witwatersrand

Tlhalefang Moeletsi - Researcher, School of Economics and Business Science, University of the Witwatersrand

Professor Stephanie Allais - Associate Professor and Director of the Centre for Researching Education and Labour, School of Education, University of the Witwatersrand

Professor Tshepo Madlingozi - Director of the Centre for Applied Legal Studies (CALS),  University of the Witwatersrand

Professor Jackie Dugard - Associate Professor, School of Law, University of the Witwatersrand 

Professor Firoz Cachalia - Adjunct Professor, School of Law, University of the Witwatersrand

Professor Tracy-Lynn Humby - Professor, School of Law, University of the Witwatersrand

Sonia Newton - Senior Programme Manager, Wits Business School, University of the Witwatersrand

Kemantha Govender - Communications Manager, School of Governance, University of the Witwatersrand

Professor Jonathan Klaaren - Professor, Wits Institute for Social and Economic Research (WiSER), University of the Witwatersrand

Professor Vishwas Satgar - Associate Professor, Department of International Relations, University of the Witwatersrand

Sibusisiwe Ndlovu - Exams Marking Officer, Wits School of Business, University of the Witwatersrand

Professor Ian Goldman - Professor, Centre for Learning on Evaluation and Results, University of the Witwatersrand

Professor Emeritus Edward Webster - Professor Emeritus, Department of Sociology, University of Witwatersrand

Zubeida Bagus - Business Manager, Faculty of Commerce Law and Management, University of the Witwatersrand

Sky Konrad, Finance Officer - CLEAR-AA, FCLM, University of the Witwatersrand

Professor Anthoni van Nieuwkerk - Peace and Security Studies, Wits School of Governance, University of the Witwatersrand

Professor Jill Bradbury, Associate Professor, Department of Psychology, University of the Witwatersrand 

Professor Michelle Williams, Professor, Department of Sociology, University of the Witwatersrand

Professor Salim Akoojee, Associate Professor and Senior Researcher, REAL at University of Witwatersrand and School of Education at University of Nottingham

(*) The list continues to grow as the letter reaches more people.

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What will happen to Africa after the coronavirus?

- Bob Wekesa

It would help if everybody comprehend that the world will not be the same after the dust settles on the pandemic.

Already, tonnes of writings have surfaced on the geopolitical implications of the coronavirus. Most analysts rightly concur that the world changed in those hard to pinpoint moments when the outbreak went globally viral. 

It is now virtually cliché to refer to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that causes the Coronavirus Disease 2019 (Covid-19) or simply coronavirus as a global phenomenon. The World Health Organization (WHO) designated it a pandemic on March 11 – meaning a contagious disease that spreads around the world – after the fact. In other words, the novel coronavirus was global before it was declared pandemic. 

What are the implications for Africa? It would help if the whole kit and caboodle of African governments, academics, businesses and civil society comprehended the fact that the world will not be same after the dust settles on the pandemic.    

The words of Italian communist leader and scholar Antonio Gramsci uttered in 1929 ring true today: “The old world is dying and the new world struggles to be born”. 

With lockdowns, curfews, conspiracies and moral panics, the whole world has not only dramatically changed but continues to do so before our eyes.

The suddenness and fluidity of the pandemic means that political, economic and financial projection and risk assessments for 2020 and the 2020s decade have to be re-analysed given the upended global optics. It is for this reason that rating agency Moody’s downgrading of the South African on March 27 is not only preposterous but also based on a world quite different from the one we knew just the other day. 

Economic downturns in places like South Africa caused in part by poor governance and in places like Nigeria due partly to oil price wars between Russia and Saudi Arabia will have to be revised afresh. 

Parallels have been drawn between the current crisis and past crises of all kinds. Because the pandemic is both a health and economic problem, the global financial meltdown of 2007/08 has particularly shown an unnerving similarity.

How the big powers in the global balance of power manage the crisis on their shores and abroad will be a major barometer for the new world that we are uncertainly entering. 

During the 2007/08 crisis, talk of the decline of the West and the rise of what would be referred to as emerging economies was rife. It is perhaps time enough to revisit the works of analysts such as Dambisa Moyo (Dead Aid, 2010, How the West Lost 2011) and Fareed Zakaria (The Post-American World, 2008) to mention but two authors. 

More importantly, the global power play revolving around the coronavirus-enforced dynamics will signal the geopolitical shifts that African countries would need to consider. One point among others is that the period immediately after the global financial meltdown over a decade, saw relations between African nations and emerging powers surging with China as the de facto leader. What happens now that both China and the West have been hammered by the virus?

The new normal post-Covid-19 might mean that African nations reliant on aid from the global north and some emerging economies find themselves on their own as hitherto wealthy nations – badly hit Spain, Italy and China come to mind – struggle to reconstruct their battered economies.    

Six years ago when the Ebola virus ravaged Liberia, Guinea and Sierra Leone; the US, China and the EU stepped into the breach. Today African countries are virtually on their own as these countries battle the pandemic at home with limited wiggle room to extend a helping hand abroad. 

The little we have seen in assistance is the $500 000 support by the USAID to South Africa, the African nation with the highest number of infections on the continent. China, where the virus is commonly believed to have started has been more agile in donating testing kits across the continent. At this point however, the assistance falls short of traditional American and Chinese responses to disasters of the Covid-19 magnitude on the continent.

The foregoing indicates that African countries that entertain the optimism of the world bouncing back to the pre-pandemic times would better get used to the fact the world is already moving in an entirely new direction. 

Even though the WHO has been censured for slow action when the virus first surfaced in central China, it would appear that this UN entity is the one that has done the most in providing testing equipment and providing public health information the continent. Should African leaders therefore lobby for a bigger role for this cash-starved entity – and indeed the UN system in general – in the post-pandemic period?

The pandemic is a live demonstration and consequence of globalization while at the same time revealing and accelerating its fault lines. 

Save for selected pockets such as South Africa’s fledgling tech industry, Kenya’s nascent innovation hubs and Nigeria’s tech-savvy Nollywood industry, many of the leaps in globalization eluded the African continent. For instance, appreciable use of the internet – globalization’s enabler – started gaining traction only in the mid-2000s long after it had become a way of life elsewhere. 

Ironically, Africa’s late insertion into the heart of the globalization may have been a blessing in disguise, shielding the region from would be up early uptick in coronavirus cases. 

As a demonstration and consequence of globalization, coronavirus has smashed the records in terms of reaching all the corners of the world at supersonic speed. The dense worldwide web of aerial, marine and terrestrial transport systems played a definitive role in the jumping of the virus from China to the rest of the world. These infrastructures that facilitate globalization ensured that the virus could be in one location in one hour and materialise in another location in a couple of hours. 

An observation to make from the transportation dimensions of globalization is that Africa’s weak insertion into the networks meant that the first cases across the board came much later compared to the rest of the world. And, interestingly, the so-called imported cases emanated from Europe, not China! 

As a threat to the essence of globalization, it is now evident that coronavirus will accelerate the dynamics in the global political economy that were already in play. Although primarily a health crisis, its magnitude is such that markets have quickly followed suit into pandemic mode. 

Turbulence has been primarily seen in the slamming of the breaks on international travel and the closure of borders. In some form of reverse anti-globalism, African countries have been the ones to close their airports to arrivals from the developed world, foregoing the benefits of tourism in the process. It is there a possibility that these actions that have been subject of jokes on social media might lead into new migration and border management regimes between African countries and the rest of the world? 

The upshot is that professionals paid to observe the geopolitical terrain will be busy at home in the coming days.

Dr Bob Wekesa is the research, partnership and communications coordinator at the African Centre for the Study of the United States at Wits University. This article was first published in IOL.

Would a Longitude Prize speed production of a Covid-19 vaccine?

- Chris Callaghan

To stop economic destruction, we need to refocus vast resources from other productive activity – a truly grand prize might do the trick.

The human and economic costs of the current coronavirus outbreak seem to be increasing exponentially as the search for a vaccine goes on. Great efforts in that regard are being made by academics and companies alike, and success seems inevitable given enough time. However, the exponentially increasing human and economic costs of the pandemic raise the question of whether progress could be accelerated.

An instructive case is Ebola. While the 2014-16 outbreak in West Africa was ultimately ended by academics working together with the pharmaceutical industry to develop a vaccine, the initial response to the discovery of the disease in 1976 was very slow. Insufficient attention had been paid to the problem, particularly by a pharmaceutical industry focused on more lucrative markets than Africa.

The economic incentives for the industry to pull out all the stops over the new coronavirus seem much clearer given that any company that finds a vaccine will have a captive market of billions of people, including in the world’s wealthiest nations. But that economic return would potentially be quite short-term if the virus mutates again or disappears, as Sars did. Medicines for chronic diseases tend to be prioritised because these are the most profitable.

Yet while companies look to their balance sheets and scratch their heads, finance ministers and corporate leaders look at theirs and tear their hair out. To stop the pandemic before economies are destroyed beyond all medium-term remedy, it may be necessary for them to induce a radical, rapid refocus of vast amounts of resources from activities where they are already productively, profitably employed on to a new goal – finding a treatment or vaccine – with an uncertain pay-off.

Crowdsourcing has historically cracked scientific problems considered at the time not just to be time-consuming to solve but actually unsolvable. In 1714, for example, the British government’s Longitude Prize was used to successfully crowdsource a solution to a problem bedevilling maritime navigation. The effectiveness of crowdsourcing in biomedical research is also well documented. Sites such as InnoCentive demonstrate that the technique is often more effective, quicker and cheaper than in-house research and development.

What if it were possible to do something similar for Covid-19? One option would be for the World Health Organisation or the United Nations to ask countries across the world to pledge and guarantee some significant proportion of their anticipated future costs of the epidemic (one, two, or three years ahead): a figure that would amount to many billions of pounds. Although the R&D costs (as with almost all biomedical crowdsourcing projects) would be borne by the solvers, and although individual countries would pay nothing if a solution was not found, the sheer size of the award might incentivise academic, industrial and government scientists to collaborate at an unprecedented scale.

Given that any solutions would still have to undergo safety testing and clinical trials, biomedical crowdsourcing might be able to “crash” the timelines of the invention portion of the biomedical research process – the most uncertain part of the timeline. Differences in the capabilities of different stakeholders would provide opportunities to develop synergies and economies of scale. Such synergies might increase the chances of success, but policymakers might also need to act in a way that complements the effects of such a large incentive, to mitigate unanticipated outcomes.

While academics are probably less likely to respond to financial incentives, the sums on offer might at least broaden the range of people pursuing solutions beyond the obvious suspects in biomedicine. For example, it might catalyse the application to biomedical science of novel applications in machine learning, big data and artificial intelligence. Proteomics, for example, is a field that is concerned with the biomedical opportunities offered by almost infinite combinations of protein strings.

The academic publishing and grant funding mechanisms might also be used to focus broader academic attention on addressing the pandemic.

History suggests other benefits of such huge R&D efforts. The industrialisation that occurred in countries locked in to solving the singular problem of the Second World War seems to have created a 30-year period of post-war global growth. If a biomedical crowdsourcing effort were undertaken on a large enough scale, the resources brought into the field might provide the capacity to solve many other health-related problems that have hitherto been unsolvable, to the ultimate benefit of humankind

You might object that the UK’s revival of the Longitude Prize in 2014 to incentivise the search for new antibiotics has not yet led to the desired outcome. But this might be because the scale of the incentive – £10 million – is not large enough to shift activity out of already productive uses.

Just as lockdowns are large-scale efforts to match the scale of the coronavirus outbreak, a collaboration between governments to pledge a massive award would also be a response that is proportionate to the problem that they all face.

Chris Callaghan is a Professor in the School of Economics and Business Sciences and at Wits University, and Director of the Knowledge and Information Economics/Human Resources Research Agency (KIEHRA). This article was first published in Times Higher Education.

Bold programmes are needed to mitigate the economic crisis

- Imraan Valodia

The Covid-19 crisis is first and foremost a health and humanitarian crisis is likely to have lasting impacts on how we live.

It is also likely to have a lasting impact, in the long term, on how we conduct our economic lives. In the short term, we need to urgently consider how we manage the economic impacts in a way that does the least long-term harm.

The economic fallout from Covid-19 is unique for at least five reasons. First, unless you have lived through the Great Depression in the 1930s, the extent of the economic decline takes us into uncharted territory.

Second, and more complex, is the fact that we are unable to deal with the crisis employing the normal set of tools we traditionally use in an economic crisis. When an economic crisis occurs, and the level of aggregate demand in the economy falls, we find ways – typically through increasing government expenditure or loosening monetary policy – to boost the level of aggregate demand. In other words, policymakers act to counteract the factors leading to a fall in demand. The uniqueness of the current situation is that we are, from a health perspective, actively trying to suppress the level of aggregate demand. 

In order to manage the spread of Covid-19, governments are being forced to ask the population to stay at home, closing schools and universities, and restricting spending in restaurants and bars. In other words, our policy response is further reducing the level of demand. Furthermore, our health policy actions are also impacting on the supply side of the economy. Asking workers to stay at home impacts negatively on firms’ ability to supply goods to the market. 

As the level and rate of infections increases, we can expect that not only will we have to deal with increasing costs of healthcare service provision, but the economic dimensions of the crisis will deepen. Both the demand and supply side of the economy will have to be further constrained to manage the infections. In short, this is no time for traditional economic policy tools – we need a bold and different response.

Third, in designing a response to the economic challenges, it is worth noting that the economic fallout has very little to do with purely economic factors. However, unless we act to address the economic fallout, vast swathes of our economic system will be significantly undermined, if not destroyed. 

Moreover, we cannot succeed in our health policy objectives to reduce infection rates and “flatten the curve”, if we ignore the realities of our economic life. How does one ask an informal worker not to operate her food stall at a busy intersection without providing relief to ensure that she can feed her family?

Fourth, we don’t know how long the crisis will last and what its final impact will be, but this crisis is a temporary phenomenon, which will end. From an economic perspective, it would be prudent for policies to assist to ride out the storm rather than pick up the pieces at the end. We should be implementing emergency measures to ensure that economic agents – firms, workers and households – are able to maintain as much of their economic infrastructure as possible. 

Policies should be aiming to ensure that, as far as is possible, firms do not close down, workers do not lose their jobs and households are able to maintain their current economic standards. The economic costs of retaining firm capacity, jobs and economic life are likely to be much lower than the costs of re-establishing these after the crisis has run its course. Moreover, we cannot ignore the risks to peoples’ health and economic wellbeing.

In South Africa, the economic problems that we have faced for the last few years have already significantly undermined our productive capacity and that of households across the board, but especially so the lowest-income households, who have fewer resources than in previous years. The economic impacts of the Covid-19 infections will have to be absorbed by an already stressed economy.

Fifth, the pace at which the infections are spreading and will continue to spread, notwithstanding the social distancing measures, is exponential. The economic impacts are also being felt at a pace that we have not experienced before. Thus, governments need to act urgently. The Cabinet has acted decisively on the strategy to flatten the curve. We now need urgent action on the economic front.

The following is a set of programmes that could feasibly be implemented on an urgent basis:

  1. The most urgent need is to adequately resource the health system, both public and private, to manage the immediate response to a rise in the level of infections. At least two areas of the health system will be severely challenged – our abilities to test and our abilities to manage the emergency response in hospitals. While healthcare professionals can design the response, they will require substantial additional resources. Based on the experiences of other countries who are further along the path than we are, the health department should be able to estimate, under different scenarios, the economic resources that will be required in the coming weeks. From a fiscal policy perspective, the government should urgently investigate the efficacy of a special appropriation bill to make the necessary resources available to the health system. If need be, the National Treasury will need to revise our fiscal policy and adjust the budget deficit. The economic and social costs of not acting now will be more significant than the economic costs of a temporary adjustment of our fiscal targets. The evidence from South Korea indicates that this health system response is a critical factor in reducing the infection rates and managing the crisis.

  2. Given the challenges in aggregate demand and the complexities with supply chains, firms, both large and small, will have a significant fall in revenue, but not in costs (which may well increase). This will temporarily place pressure on firms’ and households’ liquidity and balance sheets. Unless we have measures to tide firms and households over this temporary “financial shock”, many will be forced to lay off workers and cease operations (for firms), or plunge into severe stress (for households). Here, collaborative strategies with development finance institutions and the commercial banking sector are likely to have significant ameliorative impacts – policies such as temporary mortgage holidays will give firms and households the breathing space to manage the challenge. Interventions of this sort are needed for more systemic temporary relief. Mortgage holidays for owners of a property will allow them to, in turn, allow temporary rent holidays to tenants. In short, we need to investigate temporary financial instruments to manage the pressure on the liquidity of firms and households.

  3. Government has already announced measures to use the R180-billion surplus in the Unemployment Insurance Fund (UIF) to assist firms and workers. While these measures are to be welcomed, a short-term holiday on UIF contributions is unlikely to have a major impact. On a more positive note, using the Training Layoff scheme, which suspends the employment relationship and pays the worker 75% of the wage, will have a positive impact. Even this, however, may well be insufficient. It is interesting to note that even right-wing governments like the UK are providing guarantees to cover 80% of the salary of workers that may be temporarily laid off work.

  4. Our most vulnerable group of South Africans are poor pensioners. This group has the highest level of risk and the least ability to themselves manage the challenge. South Africa is in the very fortunate position of having direct access to this group via the old-age pension and grants system. Policy interventions like one (or more) additional payments to this group (a 13th cheque) may go a long way to increasing their ability to manage the shock.

  5. One particularly vulnerable group is workers in the informal economy. South Africa has approximately 3-million informal workers. This group is especially vulnerable because their daily work activity – selling small batches of tomatoes, preparing meals, collecting waste, etc. – is the only way by which they and their families are able to survive. Many of these workers are itinerant, and operate in areas like taxi ranks, where large numbers of people congregate. Unfortunately, we do not have an easy mechanism to provide support to this group, but unless we find a mechanism to do so, the repercussions will be serious, on both health and economic considerations. I am not, under normal circumstances, a supporter of a universal income grant, but in these extraordinary times, the government will have to provide income support to this group. A short-term, emergency universal grant to all South Africans for a fixed period of time, to be recovered later through the tax system, may well be a necessary and effective measure. A measure such as this, linked to an ID number to be cashed through the banking system or even at retail outlets, may well be feasible to implement, even for those without bank accounts.

  6. The government should be careful not to focus exclusively on the poorest among our citizens. The economic impacts of Covid-19 will be felt by the middle classes too (in South Africa, the middle classes do not have particularly high incomes). Policies such as interest-free credit card purchases of food and medical supplies for a period of six months would go a long way toward protecting middle-income groups.

  7. From a health response perspective, we are likely to face severe shortages of vital medical equipment and drugs – gloves, ventilators, drugs such as prednisone, etc. Special procurement arrangements with manufacturers, similar to those entered into for antiretrovirals, will not only boost economic output, but also build the capacity of the healthcare system to manage the upcoming challenge.

  8. Our scientific capabilities to better understand the medical and social dimensions of the Covid-19 challenge will likely have a significant impact on our ability to manage the challenge. South Africa has excellent capacity in its universities and science councils to assist with the global effort to manage the crisis. Two interventions may be useful: first, to appoint a high-level scientific committee to advise (like many South Africans I am concerned about the plethora of advisory bodies, but this is a crisis and we should have the best minds advising); and to make available a competitive research grant fund for short-term research interventions to assist in managing the crisis.

  9. Government has acted speedily to address the challenges of price gouging of critical products like food and medical supplies. In general, price controls are not a good idea because it creates further opportunity for hoarding and “black markets”. However, there may be a good case for the government to work with the private sector to establish price controls in a few very specific medical items. If the pandemic spreads as it is expected to, South Africa will need a significant capacity to test for the virus. We should urgently be developing local capacity to produce testing kits. Also, the price of a testing kit, whether in the public or private sector, should be set at a price that will be affordable. Currently, a Covid-19 test in the private sector costs between R1,000 and R1,200 – this is clearly unaffordable. If we are to make Covid-19 testing kits available to all, this price will have to be reduced.

  10. Our economic policymakers need to be working in concert with each other. While respecting the independence of the South African Reserve Bank, we need a fiscal and monetary policy to be fully coordinated. Furthermore, it is important that our policies, both on health and economics, are aligned with countries in the region. While it is important to close borders to reduce the spread of infections, South Africa’s health and economic systems, however inadequate, are much better resourced than our neighbouring countries. We should be working collaboratively to manage the health challenges and coordinate our economic measures.

In summary, these are extraordinary times. The impact of Covid-19 will have to be absorbed by an already fragile economy. Millions of South Africans live well below any benchmark of a reasonable economic life and, unfortunately, this is precisely the group that will be most affected by the economic fallout from Covid-19. The 100-basis points reduction in the repo rate by the South African Reserve Bank provides some relief. However, this is hopelessly inadequate for the task at hand. What we need is an urgent economic policy action. Unless we address the economic challenges, our health policy efforts to flatten the curve will be compromised and the risks of economic inaction are significantly higher than decisive action now.

Professor Imraan Valodia is the Dean of the Faculty of Commerce, Law and Management at Wits University. This article was first published in the Business Maverick.

Covid-19, #ClimateEmergency and Lockdown

- Vishwas Satgar

The coronavirus is an opportunity to end the war with nature.It’s a moment to be humble and realise our finitude in a wondrous and infinite natural order.

Covid-19 has pushed an already weak and crisis-ridden global economy over the edge. Massive value has been erased from crashing stock market prices. Many commentators are talking about the return of economic conditions similar to the great financial crash of 2007-2009. The most powerful countries in the world from China to the US have ground to a halt. 

This pathogen, possibly from delicate creatures like a pangolin or a bat, has engendered the worst global pandemic since the Spanish flu (1918-1920), which killed 100-million people. Death rates are going up globally. Right-wing nationalists in Europe and the USA have been confused as this virus has jumped racist border regimes, and infected all populations. Citizens are no longer concerned about their racist messages, but rather about how to survive. 

Governments all across the world are seized with the challenge of protecting their populations, at least that is what it seems like given the people-centred rhetoric. The geo-politics of Covid-19, engulfing the entire globalised world in its rapid spread, is also a shot across the bow of carbon capitalism. Elite consumption of exotic animals, at high prices, in Wuhan, China unleashed the swift and lethal revenge of nature. 

This does not mean that this is a “Chinese virus” as the racist Donald Trump has suggested. We are all susceptible and are trying to live through the fear, paralysis and risks brought by this pandemic. Overnight, jobs have disappeared, paycheques have shrunk, loved ones are in critical health situations fighting for their lives and hunger is knocking on the door of many. Healthcare systems, weakened and commodified through decades of marketisation, have or will be overwhelmed.

Yet the very same elites that caused the problem are not carrying the burden of the consequences of their actions. For climate justice politics, these injustices are not new. Elite use and consumption of fossil fuels is linked directly to extreme weather shocks such as heatwaves, droughts, floods and cyclones, for instance, which impact those most vulnerable the hardest. Yet there is no consequence for those responsible and the fossil fuel industry, carbon-addicted states, and the wealthy carbon-based consumers continue as though climate science does not exist.

‘Black Swan’ event, or worsening systemic crisis

In the business world, Covid-19 tends to be reduced to a “black swan event”. A sudden or unforeseen happening, with great consequence and rationalised after the fact. The idea was initially popularised by Nassim Nicholas Taleb’s five volumes on uncertainty including the famous Black Swan, which has been described as one of the most famous books since World War II. While in his work, the concept has a richer philosophical grounding, it has become part of  everyday risk management discourse. Business risk analyses missed the likelihood of a Covid-19 pandemic and it certainly was not a concern. Its occurrence, however, cannot be explained as a black swan event. 

From an ecological Marxist perspective, it has to do with the contradictory relationship between natural and social relations, has a historical genealogy within how eco-cidal capitalism works and can be causally attributed. Simply, for Covid 19, this means it’s a dangerous problem that is engendered by capitalism’s persistent domination of nature. 

It spread from a “wet market” involving organised crime syndicates, linked to shadowy global poaching, and smuggling networks that steal wild creatures from their habitats and place them on elite menus. Avaricious Chinese capitalism, with its appetite for resources and capturing markets, like the West, understands nature as a site of extracting value; nature must serve the juggernaut of accumulation.

South Africans are now familiar with the appetites and reach of this capitalism due to the annihilation of our rhino population merely for their horns. Wet markets also exist in other parts of South and East Asia, and have not been restricted, leaving open the possibilities of new waves of pandemics. 

For many years, epidemiologists and environmentalists have been concerned about the public health consequences of such markets, given that animal to human transmission of deadly viruses is a known fact and has been implicated in avian flu (from birds), MERS (from camels) and ebola (monkeys), for instance. These animals are also traumatised and kept in unsafe conditions. 

In Brazil, Jair Bolsonaro has unleashed land grabs in the Amazon – one of the most bio-diverse habitats on planet Earth. Industrial farming, mining, logging and wild animal poaching are ending the natural protective barriers between human society and ecosystems, heightening the risks of pathogens spreading, but in this case also contributing to climate change, given the role the Amazon plays in a planetary ecosystem to sequester carbon. 

Climate scientists have already warned humanity that further warming of the Arctic, for instance, will not only release deadly greenhouse gases such as methane, but also pathogens that have been frozen into ice sheets. Like Covid-19, the worsening climate crisis and its global shocks, are not black swan events, but dangerous systemic crisis tendencies produced by a hard-wired logic based on the duality of capitalism versus nature. Science has provided us with understandings and warnings, and yet the global capitalist system persists in driving us towards harm and destruction. 

Carbon capitalism and imposed collective suicide

A world led by those who place profit above human and non-human life, is placing us all in jeopardy. We are not given a choice as the eco-cidal logic of global capitalism destroys the conditions that sustain life. Our planetary commons – biosphere, oceans, forests, land and water sources – are all being commodified and destroyed to make a few wealthy. 

On a planetary scale, we are living through an imposed collective suicide. As neoliberalism becomes authoritarian and mutates into the second coming of fascism to defend the wealth of the few, it is revealing a simple fact: It’s not learning lessons about the harm it is inflicting. Instead, it wants to defend at all costs a life-destroying system. 

Karl Polanyi in the social science classic, the Great Transformation (1944), drew attention to such elite behaviour when the ship is sinking. In the late 19th century, based on marketisation through the gold standard, the world was driven into World War 1. Lessons were not learned and the world was again locked into gold standard marketisation in the 1920s, and this gave rise also to fascism and World War 2. 

This time, we are all dealing with the failure of capitalism’s conquest of nature through treating it as capital through financialisation. The science on biodiversity loss, climate and water, for instance, are all unequivocal that we are breaching limits and surpassing boundaries that endanger everything. At the same time, the raw and infinite power of nature is gathering pace. The present generation of young people understand the dangers of this very well. One of my former students, an extremely intelligent and sensitive young person, placed this public post on his  Facebook page in the midst of the Covid-19 outbreak:

Tonight, for the first time in a long time, I cried. I felt everything inside of me: the depth and immensity of my pain, my sorrow, my grief, my lament, my worry, my confusion, my longing, my despair – I felt it all and wept, wept for the sadness I’ve kept hidden so long, wept for the loved ones I miss so dearly, wept for the suffering and uncertainty of the world, wept for reasons I don’t even understand. 

Many of us weep for the collective suicide we are living through. This is not about victimhood, but about understanding the depth of crisis and the urgency to overcome this universal challenge of our extinction. It is a conscious knowing rooted in deep wells of pain, anxiety and existential suffering growing in prevalence among the young because of the collective suicide being imposed by financialised carbon capitalism. 

Greta Thunberg and many of the young climate activists in South Africa such as Raeesah Noor Mohamed, Nosintu Mcimeli, William Shoki, Awande Buthelezi, Jane Cherry and Courtney Morgan, to name a few,  understand this. They carry their pain, their understanding of injustice as they protest. 

But is the present resistance enough? The cry of 1 degree Celsius movements – Sunrise Movement, Extinction Rebellion, #FridaysForFuture and the Climate Justice Charter process in South Africa – are all coming up against power structures and ruling classes not willing to break with the imposed collective suicide of financialised eco-cidal carbon capitalism. Yet in the context of Covid-19, not only are global populations shocked, but it has rocked, assailed and unhinged the very same power structure standing in the way of addressing the climate crisis. Covid-19 is forcing, even reluctantly, ruling classes to try to act with concern for life.

Lockdown and the ANC’s epidemiological neoliberalism

Covid-19 has thrown us into a state of exception. From a climate justice perspective, this is a dress rehearsal for a world that breaches 2 and 3 degrees Celsius in which climate shocks on a global scale imperil life-supporting socio-ecological systems such as food, water and  health systems through unbearable temperatures. Waking up then is too late. 

This is the underlying premise of climate justice activism, given that climate science is telling us what is arriving with business as usual or low mitigation trajectories. With the Covid-19 crisis, our governments seem to be suddenly realising markets and corporations are not more important than human life. Is this the case?

The disaster capitalism of Covid-19, as Naomi Klein reminds us, brings forth profit-making opportunities even from the suffering of the people. Trump is leading the way. His first crucial move was to build up fossil fuel reserves thus keeping oil prices bolstered, then he unleashed the privatised healthcare system and is now keeping pharmaceutical companies “free” to manipulate the prices of essential medical equipment instead of repurposing production through the Defense Production Act. However, this is not the end of the story and struggles inside US society will certainly determine if Trump’s epidemiological neoliberalism will triumph or not.

In South Africa, we have been witness to a sea change from kleptocratic state and neoliberal austerity policies (including cutting billions of rands from health spending), announced by Minister of Finance Tito Mboweni, to cross-subsidise corrupted and failing parastatals, to the war on Covid-19. 

The country is going into this government-declared war with a dualistic healthcare system, with the vast majority dependent on a public healthcare system gutted by corruption, mismanagement and austerity. This healthcare system, with these specific features, is what is going to be overwhelmed not just by Covid-19, but by over two decades of ANC misrule. The lockdown of South Africa has to be understood in this context. 

Put more sharply, the warped rationalities of commodified healthcare for a few and failing healthcare for the many is clearly the frontline the government is trying to avoid in the country’s Covid-19 response. For most South Africans, in a state of shock and panic, this lockdown crash-landing of the economy on the wretched lives of a precarious working class and poor seems like the best response. 

Of course, this shock therapy has been administered repeatedly since neoliberal strictures informed the first democratic budget in 1994 and the macro-economic shift of 1996, kleptocratic neoliberalism of the Jacob Zuma project and now the new epidemiological neoliberalism of the ANC. In this context, the so-called China success story of shutting down Wuhan peppers government-speak. 

But the other epidemiological success story of South Korea is not referenced. South Korea did not lock down its economy, but put the emphasis on: (1) intervening fast through test kits produced (100,000 a day), on a mass scale domestically; (2) test early, often and safely (it has conducted over 300,000 tests), such that detection happens quickly; (3) contact tracing, isolation and surveillance, which has used smart apps, mass messaging and has prevented an overload on the healthcare system; and (4) enlist the public’s help. While not perfect and easily replicable, it’s nonetheless an important alternative to lockdown.

South Africa’s lockdown has not been preceded by mass testing despite the two-month lead time the South African government had since the outbreak in China. Even as the country goes into lockdown, the costs of tests are prohibitive, there has been no clear communication about international partnerships to get testing going on a mass scale, there is no clear messaging on testing details and grassroots civil society has not been mobilised, despite its enthusiasm to rise to the challenge. 

Instead, the lockdown has shifted the focus to managing economic chaos, mitigation measures and privatised charity through a “solidarity fund”. Deep anxiety, fear and insecurity is running through society. South Africa is going into the lockdown as one of the most unequal countries in the world. 

The crisis of socio-ecological reproduction is deep as expressed through high levels of structural unemployment, intra-African income inequality, hunger and water inequalities (54% of South African households do not have access to clean water through a tap in their homes). 

Lockdown means South Africa’s precarious working class and poor are now responsible for solving the Covid-19 problem because they carry the burden. Lockdown is meant to save their lives while worsening their already wretched life worlds. Hence the ANC government is off the hook with this cunning move of epidemiological neoliberalism while taking Covid-19 disaster capitalism to a new level. 

Ending the war with nature 

Covid-19 is an expression of contradictory natural relations. On the one hand, it is devouring the most vulnerable in our society and, on the other hand, it is prompting humanity to slow down collective climate suicide. Carbon emission data is certainly going to register deep drops since the onset of Covid-19, with airlines, shipping, cars and other carbon-emitting technologies brought to a halt. 

Covid-19 has achieved what almost three decades of UN multilateral negotiations have failed to achieve. If governments can take the Covid-19 emergency seriously, they can take the climate crisis seriously. The UN climate meeting in Glasgow this year has to open with lessons learned from Covid-19 to address the global climate emergency. In this context, South Africa will have to tell its story to the global public. However, there is a lot the South African government should consider as this pandemic unfolds, including its war-on-Covid-19 approach.

South Africa’s government declared Covid-19 a disaster in terms of the Disaster Management Act. It has unleashed an important coordination capacity in the state, preventative regulations, is disseminating information, has imposed a 21-day lockdown and introduced economic mitigation measures. The command structure is led by the president. The Disaster Management Act was not kicked into gear during the worst drought in South Africa’s history (2014-till now), which ravaged numerous communities, collapsed part of the globalised food system and pushed up food prices. Many communities still have acute water needs and are being challenged to maintain basic hygiene. 

As Covid-19 transmission spreads, water-stressed communities are going to be hotspots as these are poor communities and very likely to also have many with compromised immune systems. If the drought was handled properly by the ANC government, water issues would not have been a problem now. 

Moreover, if the ANC government did not get caught up in the tides of populism around the land question and listened to the South African Food Sovereignty Campaign, including taking seriously their Peoples Food Sovereignty Act handed over to Parliament, we would be sitting in the midst of Covid 19 with more communities, villages, towns and cities having localised agro-ecological food sovereignty pathways to cope with the current situation. Instead, we are living the drama of a war-centred crisis management approach.

The war approach to Covid-19 is limited in three respects and holds out dangers for how leadership is practiced now and what capacities we build in this defining moment. First, war works with a simple logic. There’s an enemy, militarise (build war-making capabilities), mobilise your society in the effort and deploy this to destroy the enemy. It is a reductionist way of thinking; it is not a systems view of the world.

Covid-19 is manifesting in our midst together with other systemic crises, such as economic crises and climate crises. Financialised capitalism has produced an unstable global economy and grotesque inequalities. It has not worked. The climate crisis is worsening with a lack of will to phase out fossil fuels and decarbonise. 

We are facing a 1.5 degree celsius increase in planetary temperature most likely in the next five years, accompanied by intensifying climate shocks. These crises are interconnected, cascade into each other and push our socio-ecological orders towards collapse. A war mentality does not appreciate the interconnectedness of all of this. 

Put differently, even if Covid-19 is addressed with war-like precision and the epidemiological curve flattens globally and in South Africa, we are not returning to a new normal. We are returning to a world in permanent crisis; a new abnormal. Hence, how we address Covid-19 and reconstruction after it, must lock in democratic systemic reforms that cushion us from more crises. 

South Africa will need an eco-justice stimulus package to tackle the impacts of Covid-19, the economic crisis and worsening climate crisis. South Africa’s climate justice charter is a crucial point of departure in this regard.

Second, a war approach to Covid-19 is based on dangerous philosophical foundations. It continues the anthropocentric conquest of nature, central to capitalist thinking. Killing Covid-19 in this frame is about us being the dominant species. We demonstrate to the forces of nature our superiority. This is really a conceit which fails to understand that nature has been and will always be more powerful than us. 

Moreover, we are extremely dependent on nature as a species to ensure our reproduction. With Covid-19, we are really trying to mitigate the revenge blow from nature. It’s a moment to be humble and realise our finitude in a wondrous and infinite natural order. We are just one little part of a vast and delicate web of life. Ending Covid-19 should be about ending the war with nature. This includes ending wet markets for exotic animals, ending globalised industrial agriculture and rapidly phasing out fossil fuels.  

Third, the war on Covid-19 keeps us bound up in an ethical knot and derives from deeply oppressive ways of thinking. Violence whether colonial, imperial, patriarchal, racist or eco-cidal is not what the world needs. Modern industrial scale violence that is calculated, instrumental in its reason and deadly is breeding a fast violence from nature. A violence we cannot match. Everyday violence of poverty and structural inequality has to be addressed as we come out of this pandemic moment. 

Complex and holistic systems thinking, grounded in an ethics of care rather than war has to prevail. Put differently, if Covid 19 helps jettison the Thatcherite neoliberal subject – competitive, greedy and possessive individual – for a more humane state of being and solidarity-based society, it would have produced our strongest defense against a crisis-ridden world. It would have also affirmed an ethics of care for our natural relations that nurture us, feed us and enable us to have life.

Dr. Vishwas Satgar is an Associate Professor of International Relations, Wits. He edits the Democratic Marxism series, is the principal investigator for Emancipatory Futures Studies and has been an activist for four decades. He is the co-founder of the South African Food Sovereignty Campaign and the Climate Justice Charter process. This article was first published in the Daily Maverick.

Foreign migrants must be included in Covid-19 response

- Jo Vearey and Sally Gandar

Why South Africa needs to actively engage all foreign migrants in its response to Covid-19.

It is a well-established fact that for infectious disease control measures to stand any chance of success, they need to reach everyone. This is no different in the case of Covid-19 in South Africa, yet our response to controlling the spread of the virus, and protecting those most vulnerable to infection, continues to exclude marginalised foreign migrants. 

Our response to more privileged international tourists and visitors, and those in South Africa for the purposes of work and study, has, however, been far more proactive. Covid-19, as with any other communicable disease, knows no borders and its spread within South and southern Africa is inevitable. We need to slow down the spread of infection so that our region’s already over-burdened and struggling health systems have a chance to respond.

International travel restrictions

On Sunday 15 March 2020, President Cyril Ramaphosa announced the National State of Disaster in terms of the Disaster Management Act, outlining a number of drastic steps to try and curb the spread of Covid-19. On Wednesday 18 March 2020, some of these actions came into effect, one being a range of inward travel restrictions implemented by the South African Department of Home Affairs (DHA).

These restrictions – designed to reduce the spread of Covid-19 by supporting its containment – are applicable to inbound travel from countries that DHA has defined as “high-risk” – those where there is ongoing, the community-level transmission of Covid-19 as per the daily situation reports published by the World Health Organisation (WHO).

Under the International Health Regulations (IHR), the decision to implement any restrictions on inbound travel is a sovereign one, meaning that any given country can choose which countries to include – or not – within their respective travel restrictions. Travel restrictions are, themselves, matters of “health diplomacy” and states must balance the need for an effective public health response to the control of infectious disease with the negative impacts of restricting travel, which can include detrimental effects on the movement of goods and disruptions to social structures. 

While there is evidence to suggest that travel restrictions can be effective at the start of an infectious disease outbreak by delaying the spread of disease and – importantly – allowing for the implementation of national preparedness plans, once community-level infections become more established the positive impact of travel restrictions lessens. An example of the negative consequences of travel bans includes a report from the Minister of Health, Dr Zweli Mkhize, who indicated on Thursday evening (20 March) that Covid-19 test kits on their way to South Africa had not yet arrived due to the cancellation of international flights.

The current travel restrictions are applicable to air, land and seaports of entry, and interventions implemented include closing 35 of South Africa’s 53 land borders, reducing the number of seaports where crew and passengers can disembark from ships, and restricting entry to individuals travelling from or through countries deemed “high risk” by the DHA. 

In fact, the DHA has now prohibited entry of all foreign travellers coming from, or via, high-risk countries, regardless of pre-existing visa or visa waiver agreements. Visa waiver agreements with medium-risk countries are also suspended. This applies to persons holding passports who would usually be exempt from requiring a visa to enter South Africa, or who would usually obtain a visa upon arrival.

A selective right to remain

Citizens of countries the DHA has deemed high or medium risk – which corresponds to many European countries and the US – who hold a valid visa, and who wish to remain in South Africa, can extend their visas, as per Immigration Directive 7 of 2020, dated 17 March 2020. Such persons “will be allowed to re-apply for such visa” subject to certain requirements, and visas valid to 31 July 2020 may be issued. If these foreign nationals do not meet all the requirements, they may be able to apply for a waiver subject to further requirements. 

In addition, the directive allows for people from these high-risk countries whose visa has expired since 1 December 2019, to “re-apply for such visa”; they will be exempt from the usual conditions associated with “over-staying” on an expired visa. How the bureaucratic processes regarding these applications will be managed remains to be seen but it is going to place further pressures on an already struggling DHA.

While these efforts by the DHA are welcomed as part of a national and international solidarity in response to Covid-19, we have serious concerns about who we are leaving behind and the resultant risk for the health of all who live in South and southern Africa. 

Key here is to ask what these special measures – particularly in relation to visa extensions and “the right to remain” – mean for foreign migrants currently in South Africa who have travelled from neighbouring countries that are not (yet) considered high-risk. Presently, citizens of European countries and the US currently in South Africa are protected by the new Immigration Directive, but it is silent on foreign nationals from the region whose visas may have expired. This group of migrants are likely to be afraid to test or report to others that they are unwell for fear of arrest, detention and deportation, with particularly worrying implications for contact-tracing.

Solidarity or securitisation?

In Monday’s media conference, the Minister of Home Affairs, Dr Aaron Motsoaledi, spoke of the importance of “international solidarity”, acknowledging that South Africa has more cases of Covid-19 than neighbouring countries and, as a result, has a responsibility to protect countries elsewhere in the SADC region. 

The minister also indicated that the choice of the 35 ports of entry that will be closed, was motivated by the aim to “stop the virus from moving through our borders”. Motsoaledi stated that they would be “putting up a lot of higher walls in this war” (presumably against Covid-19) and this was clearly no metaphor as we now see a R37.2-million wall being built along the border between South Africa and Zimbabwe. To date, Zimbabwe has not reported any cases. 

On Thursday evening, during a Q&A session about Covid-19 with the South African Medical Association, the minister of health stated that South Africans must recognise that neighbouring countries do not pose any risk to South Africa. Rather, it is our infection rates that pose a risk to them.

Regardless of the seemingly contradictory positions of the two medical doctors currently steering our response to Covid-19, R37.2-million is being spent on a border wall. Is this the most appropriate use of taxpayers’ money? How many test kits could be purchased for the same amount? Intensive care beds? Respirators? Personal Protective Equipment (PPE) for frontline healthcare workers?

Each Covid-19 test done by the National Institute for Communicable Diseases (NICD) costs the state R300. That means that the amount spent on the fence would fund 124,000 testing kits. The private pathology labs are charging between R900 and R1,400 for the test. The amount spent on the fence would thus fund between 41,333 and 39,333 testing kits at private laboratory rates. 

Similarly, if one looks at wages, the living wage calculator indicates that a living wage in South Africa is R6,570/month. The amount being spent on the fence would equate to assisting 5,662 persons with a living wage for one month to try and ameliorate the impacts that the Covid-19 pandemic may have. A further comparator that we can use is the SASSA Older Persons Grant, which many people across South Africa rely on to survive. This grant amounts to just over R1,780 per month. The R37.2-million to be spent on a fence, would provide for the equivalent of 20,898 old age pension grants, or if made available to persons for a three-month period to try and ameliorate the impacts of Covid-19 on the economy, it would assist over 7,000 people for that period. These may seem like small numbers when we think of the numbers of the South African population that will be impacted by Covid-19, not necessarily by being infected but by losing their income, but one thing is certain, building walls – or a fence – will help no one.

It is not the time to implement such securitisation measures (many of us would argue that there is never such a time); the spread of Covid-19 will not be stopped by a border fence. The effects of such a response are likely to cause further harm to all in South Africa and the region by forcing individuals – particularly those currently holding an irregular status – to cross the border through other means, resulting in migrants being further distanced from any public health intervention. 

Urgent measures are required to ensure we include all foreign migrants – not only tourists and international travellers from high- and medium-risk countries – in our response to Covid-19. There needs to be assurance that, regardless of their current documentation status, no foreign migrant will face any sanctions when engaging with state authorities, including when seeking healthcare or being included in contact tracing. Without this, our efforts to reduce the spread of Covid-19 will fail.

Jo Vearey is with the African Centre for Migration and Society (ACMS), Wits University. Sally Gandar is with the Scalabrini Centre of Cape Town. This article was first published in the Daily Maverick.

Hypocrisy in the time of Covid-19

- Jo Vearey

The sanctimony of moving from blaming foreign migrants to rendering them invisible in a critical public health moment will have implications for our response.

Before Covid-19, the South African field of migration, health research and advocacy meant investing energy in countering prevailing, unfounded negative public and political discourse that incorrectly blames foreign nationals for the failures of the South African public health system. 

This dangerous, xenophobic and racist rhetoric positions certain migrants who have travelled across the country’s borders as “contagious” and as importers of infectious disease. This scapegoating, in addition to the various structural challenges faced by foreign migrants (including difficulties in accessing the documentation required to be in the country legally), has resulted in a plethora of negative outcomes that affect everyone in South Africa. One such result, of particular importance in the time of Covid-19, is the challenges that foreign nationals reliant on the public healthcare system face when trying to access the services to which they are legally entitled; we need to think carefully about the implications of this for an effective national, and regional, response to Covid-19. 

Numerous evidence-informed calls have been made for ensuring that migrant and mobile populations are included in the development of responses aiming to achieve universal health coverage in South Africa, the Southern African Development Community (SADC), and globally. Such calls are about far more than the right to good health; they are about implementing a public health approach that will address the political and social determinants of poor health, including those that result in poor access to healthcare. In turn, such a public health approach aims to support the goal of improving health for all. 

The fear, however, is that South Africa and SADC may now experience the public health consequences of xenophobia, racism and blame.

 

 South Africa is currently making difficult decisions about how best to “flatten the curve”, determining the most appropriate interventions to slow down the spread of Covid-19 and protect the most vulnerable in our society.  Yet there is a notable absence of visible engagement with the very population who have, until now, been unfairly placed at the forefront of many South African debates relating to a struggling public healthcare system and a high prevalence of communicable diseases, notably HIV and TB. 

This hypocrisy – of moving from blaming foreign migrants to now rendering them invisible in a critical public health moment – will have implications for our response to Covid-19. It is essential that we effectively include foreign migrant populations in our programming. A failure to do so risks devastating impacts not only for foreign migrants, but for all in the South and southern African population as a whole. 

Don’t get me wrong: I think that the National Institute for Communicable Disease (NICD) is doing a stellar job in a difficult time. But this is about more than the role of the NICD alone. We need to follow the advice of Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation (WHO) and enact a “Whole of Government, Whole of Society” approach

And this includes the Department of Home Affairs thinking carefully about its role and responsibility in the time of Covid-19; for example, what are the public health implications of DHA’s approach to border management and requirements for asylum seekers to renew their permits every 3-6 months?  

With Dr Aaron Motsaledi in place as the minister of home affairs – a former minister of health and medical doctor – this should be an obvious way to go, but recent history has told us otherwise and it is now time to turn the tables. We need SADC member states to be bold and develop regional responses. Now is not the time – we don’t have the time – for diplomacy. Political differences in what a regional health approach should look like need to be set aside in order to ensure we have cross-border Covid-19 responses in place. 

A public health approach is not only relevant in the time of an epidemic, it is based on principles of justice, equity and respect.  Now, more than ever, we need to enact these values. We need to target interventions to those who have been left behind. Evidence generated over the past few decades, which has been regularly communicated and shared with key decision-makers, service providers, and the wider public, clearly indicates that there are populations in South and southern Africa who have been left behind in our public health planning. This includes certain groups of foreign migrants, sex workers and others working in the sex industry, and members of the LGBTQI+ community.  

In addition, we know that while there have been gains made – mostly attributed to the actions of civil society and public health advocates – in the provision of health interventions to residents of informal settlements and hostels, as well as to those who are incarcerated in prisons and within the Lindela detention centre, we know that these populations remain left behind in our preventative and curative health responses. 

HIV and TB are concentrated in these spaces, the result of persistent structural and political determinants of poor health, placing these populations at an increased risk of the worst health outcomes associated with Covid-19. People reliant on overcrowded public transport and housing solutions can do little to effectively practice social distancing or self-isolation. It is especially ironic that – among other groups – the very population who, until now, have been considered responsible for poor health in South and southern Africa are being left-behind: foreign migrants.

Whether the apparent lack of consideration of foreign migrants is a result of their continued exclusion in public health planning, or due to the initial cases of Covid-19 identified in South Africa being imported from outside of the African continent, is irrelevant. Perhaps the tables have turned and recognition of the ways in which international tourist travel can be associated with the spread of infectious diseases has been brought to light, challenging and perhaps even silencing, at least for now, the pervasive blaming of foreign migrants for the health challenges faced in South Africa.

Jo Vearey is an Associate Professor and Director of the African Centre for Migration & Society (ACMS) at the University of the Witwatersrand.  She is also Vice-Chair of the Migration Health and Development Research Initiative (MHADRI). This article was first published in the Daily Maverick.

Wits Covid-19 Update (18)

- Wits University

The role of essential staff during the national lockdown.

MESSAGE FROM THE SENIOR EXECUTIVE TEAM

Dear Colleagues

Please note the University’s position on the role of essential staff during the national lockdown period:

1. Staff that are not essential services staff and are able to work from home during the lockdown period are required to work;

2. Staff that are not essential services staff and are not able to work from home but would ordinarily be required to work are not expected to come to campus and work; and

3. Staff that are essential services staff are required to work on a rotational basis where appropriate.  

In terms of Section B(1) of Annexure B of the amended Regulations issued in terms of the Disaster Management Act, 2002 on 25 March 2020 (“the Regulations”) the following categories of staff are considered essential services staff:

a. Medical Services;

b. Animal Care Services;

c. Financial Services necessary to maintain the functions of the payments environment;

d. Laboratory Services;

e. Cleaning, Sanitation and Waste Removal Services;

f. Security Services; 

g. Critical Maintenance Services; and 

h. Staff assisting with accommodation for essential services staff.

The relevant line managers, who have been appropriately authorised, will be in contact with employees who form part of essential services with a plan on how operations will be expected to continue during the lockdown period. Essential services employees will be issued with a formal letter and permit from the University which authorises them to leave their places of residence to attend to work. 

The University will ensure that the proper precautions are taken in the workplace to mitigate against the risks identified in the context of COVID-19. 

The Senior Executive Team is finalising a protocol around leave and other arrangements. This will be shared with organised labour and staff in due course. 

Once again we thank all staff for their contribution to the University and society during these exceptionally difficult times.

SENIOR EXECUTIVE TEAM

26 MARCH 2020 (16:00)

Wits COVID Update 17: Staff Appreciation and Reopening

- Wits University

Prof. Adam Habib addresses staff on living through the COVID19 pandemic and expresses his appreciation to staff for their contribution during this period.

The target date for Wits to reopen is 20 April 2020, in line with the rest of the higher education sector, but this is dependent on how the pandemic evolves. The mode in which the second block is likely to be online and staff are thus advised to prepare to take teaching online with the support of Wits ICT, the Centre for Learning, Teaching and Development, and Faculty Teaching and Learning units. Students will also require additional support when contact teaching resumes in the form of additional lectures, tutorials and boot camps, as appropriate.

The video addresses issues related to the digital divide, access to smart mobile devices and data, and the University’s agreements with ICT providers to zero-rate sites. Wits has reached out to broadcasting houses to determine if they can provide a solution to reach 10% of Wits’ students who do not have access to smart mobile devices. Faculties should also explore other practical ways in which this can be achieved.

Read the latest updates at www.wits.ac.za

Wits COVID Update 17 (Students): Wits to reopen on 20 April

- Wits University

Prof. Habib speaks on living through the COVID-19 pandemic, and the Senior Executive Team’s (SET) decision to go into early recess and to evacuate residences.

The target date for Wits to reopen is 20 April 2020, in line with other universities in the higher education sector, but this is dependent on how the pandemic evolves. The mode in which the second block will open is likely to be online and students are thus advised to prepare to go online. Professor Habib addresses issues related to the digital divide, access to smart mobile devices and data, and the University’s agreements with ICT providers to zero-rate sites. Wits has reached out to broadcasting houses to determine if they can provide a solution to reach the 10% of Wits’ students who do not have access to smart mobile devices. This figure is based on the results of a comprehensive biographical questionnaire conducted annually by Wits. Faculties are also exploring a range of other possibilities to ensure that all students are appropriately supported.

Read the latest Wits updates at www.wits.ac.za

Wits heroes confront COVID-19

- Wits University

Amongst the best in their fields, Wits experts are at the frontlines and behind-the-scenes against COVID-19, the respiratory disease caused by the coronavirus.

Eminent academics at Wits University in disciplines including epidemiology, medicine, public health, biomedical engineering, governance, and others, are the unsung heroes leading the charge against COVID-19.

The pandemic galvanized President Cyril Ramaphosa on Sunday, 15 March 2020, to invoke a state of disaster in South Africa, and then a national lockdown effective midnight, Thursday, 26 March 2020.

There is hope against this viral pandemic, however.

In concert with the National Institute of Communicable Diseases (NICD), the Department of Health, and the South African government, an army of heroic scientists at Wits are helping to understand, predict, and contain COVID-19, manage the public health and socio-economic impact, and develop treatment and care regimens.

The Wits heroes mentioned here represent just a fraction of the University’s community of academic, professional, and support staff who all are working tirelessly and contributing in multiple ways to mitigate this state of disaster.

We salute you all.

Understanding the enemy

  • Professor of Epidemiology in the Wits School of Public Health, Cheryl Cohen is a medical doctor and co-head of the Centre for Respiratory Disease and Meningitis at the NICD. Through her work she aims to generate evidence to guide policy for the control of respiratory diseases. In 2009, she led the establishment of a national surveillance programme in South Africa for severe acute respiratory infections. She is at the forefront of COVID-19 case-finding, diagnosis, management and public health response. In this video, Cohen explains how the NICD Help Lines can assist the public and healthcare workers respectively.
  • Adriano Duse is Professor and Head of Department of Clinical Microbiology and Infectious Diseases at Wits. On 12 March 2020, Duse delivered a public lecture entitled, Myths and Facts about SARS-CoV-2: The COVID-19 Outbreak 2019-2010 – What you can do to reduce infection risk, hosted by the Wits Students’ Pathology Society. In January 2020, Duse delivered a radio Masterclass on Superbugs. Listen to the podcast.
  • Kerrigan McCarthy is a clinical microbiologist and Head of the Division of Public Health, Surveillance and Response at the NICD. Here her responsibilities include oversight of the Outbreak Response Unit, Notifiable Medical Conditions and GERMS-SA surveillance. McCarthy lectures in the Wits School of Public Health.
  • Amongst the virus hunters interrogating the epidemiology [patterns and causes of disease] of Covid-19 is microbiologist Lynn Morris, a Research Professor in the School of Pathology at Wits and the Interim Executive Director of the NICD. Morris is internationally recognised for her work in understanding how the antibody response to HIV develops. A National Research Foundation A-rated scientist, she is amongst the most highly cited researchers in the world. Morris has a lifetime’s experience fighting viruses. She explains why COVID-19 presents one of the greatest challenges yet for South Africa and the world.

Professor Lynn Morris received the Harry Oppenheimer Fellowship Award in June 2017

Understanding each other 

  • A Distinguished Professor of Medical Anthropology and Public Health, Lenore Manderson is internationally renown for her work in anthropology, social history and public health. She has played a leading role in training and research in inequality, social exclusion and marginality, the social determinants of infectious and chronic disease, gender and sexuality, immigration and ethnicity, in Australian, Asian and African settings.

The advent of COVID-19 prompted the Institute of Plumbing South Africa (IOPSA) to contact Wits for an expert to deliver a Q&A webinar for their members. Given the requirement of taps and plumbing for hand-washing, hygiene and sanitation against the virus, coupled with social distancing, quarantining and isolation protocols, plumbers were understandably concerned. Manderson participated in a 1.5-hour long Q&A session for IOPSA. Watch the PIRB Breakfast Tech Talk – Virus Q&A webinar

Lenore Manderson is a Distinguished Professor of Medical Anthropology and Public Health is the Wits School of Public Health

  • Associate Professor Jo Vearey is the Director of the African Centre for Migration & Society at Wits and Director of the African Research Universities Alliance (ARUA) Centre of Excellence on Migration & Mobility. Given that the coronavirus spread originally via travelling, Vearey cautions against “hypocrisy in a time of Covid-19” and advocates that foreign migrants be included in the Covid-19 response. “The sanctimony of moving from blaming foreign migrants to now rendering them invisible in a critical public health moment will have implications for our response to Covid-19,” says Vearey.

In this podcast, Vearey discusses how South Africa’s impending winter, an historical HIV-AIDS pandemic, and xenophobic attitudes combine to generate surprising and unexpected responses to Covid-19.

Towards treatment

  • Professor of Vaccinology and paediatrician, Shabir Madhi is Director of the Medical Research Council Respiratory and Meningeal Pathogens Research Unit (RMPRU) at Wits. Madhi holds the NRF/SARChI Chair in Vaccine Preventable Diseases. His research has focused on the epidemiology and clinical development of lifesaving vaccines against pneumonia and diarrhoeal disease and has informed the WHO recommendations on the use of the lifesaving pneumococcal conjugate vaccine, rotavirus vaccine, and influenza vaccination of pregnant women.

    Madhi is the immediate past Director of the NICD and former President of the World Society of Infectious Diseases. He has consulted to the WHO in the fields of vaccinology and pneumonia and to the Bill and Melinda Gates Foundation on pneumonia.

    Watch Madhi explain how coronovirus enters the body. Read why pregnant women are not more prone to contracting COVID-19. 

Professor Shabir Madhi

  • On the treatment front, Professor Helen Rees is Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI). She chairs the World Health Organization’s (WHO) African Regional Immunization Technical Advisory Group and she is Co-Chair of WHO’s Ebola Vaccine Working Group. South Africa is one of 10 countries involved in an urgent global trial, "Solidarity", announced by the WHO to identify the most effective treatment for coronavirus. Listen to Rees discuss South Africa's role in this global study. 

Professor Helen Rees

  • Renowned HIV expert, Professor Francois Venter is Director of Ezintsha and Deputy Executive Director of Wits RHI. With an active interest in public sector access to HIV services, medical ethics and human rights, Venter is attuned to the impact of COVID-19 on those with comorbidities such as HIV and TB. He is an advisor to the South African government, to the Southern African HIV Clinicians Society and to the WHO. Venter speaks from quarantine about the changing landscape of COVID-19 and the fundamental role that behaviour change plays in reducing infection. 

HIV expert Prof. Francois Venter is Director of Ezintsha and Deputy Director of Wits RHI

Caring for the sick

Professor Feroza Motara is Academic Head of Emergency Medicine in the School of Clinical Medicine at Wits and at Charlotte Maxeke Johannesburg Academic Hospital - where the first COVID-19 patient in Gauteng was treated. Motara has since December 2019, when news of the virus broke, been preparing her team and the hospital to care for the ill. Read Motara’s comments about how healthcare workers on the frontline of the pandemic are coping. “We’re in the profession because there is that dedication and commitment. You still have to go to work and do what you need to do,” she says.

Big Data battle lines 

  • Predicting and anticipating the trajectory of the virus to mitigate casualties and inform policy requires number-crunching, modelling, and analysis of Big Data. An interdisciplinary team of researchers at Wits this week launched the most comprehensive data dashboard to date on the COVID-19 virus in South Africa. Wits School of Physics Professor Bruce Mellado-Garcier, who initiated the project, says: “We are experts in analysing and interpreting big data, and we believe that it is important that someone put this data together and present a bigger picture of the impact of the virus on the country.”

Prof. Bruce Mellado in the School of Physics initiated the Covid-19 data dashboard project

  • Similarly, the Gauteng City-Region Observatory (GCRO) has developed an interactive map showing the province’s vulnerability to Covid-19. Dr Julia De Kadt, et al, devised this Map of the Month. The GCRO is a partnership between Wits University, the University of Johannesburg, and the Gauteng Provincial Government. Its mandate is building strategic intelligence through improved data, information, analysis and reflective evaluation, for better planning, management and co-operative government. 

Expert commentary advancing policy 

  • Professor Karen Hofman is Director of the SAMRC/Wits Centre for Health Economics and Decision Science (PRICELESS SA), a research-to-policy unit that provides evidence, methodologies and tools for effective decision-making in health. PRICELESS SA analyses how scarce resources can be used effectively, efficiently, and equitably to achieve better health outcomes. Some PRICELESS SA research has shown how fiscal, regulatory and legislative levers can improve health via social determinants.

Hofman, with Susan Goldstein, Deputy Director of PRICELESS SA, wrote one of the earliest articles advocating hand-washing, which has since become COVID-19 protocol.

  • Economist Prof. Imraan Valodia, Dean of the Faculty of Commerce, Law and Management at Wits, is currently coordinating an international study, in 10 cities, of the informal economy. His research interests include employment, the informal economy, gender, and industrialisation. He is a part-time member of the Competition Tribunal and a Commissioner on the Employment Conditions Commission and Chair of the National Minimum Wage Advisory Panel. 

“The COVID-19 crisis is first and foremost a health and humanitarian crisis that we are all living through, which is likely to have lasting impacts on how we live. It is also likely to have a lasting impact, in the long term, on how we conduct our economic lives”, says Valodia. Read his analysis of the risks on economic inaction of COVID-19. 

Professor Imraan Valodia

  • In the School of Governance, Adjunct Professor Alex Van Den Heever holds the Chair in Social Security Systems Administration and Management studies, which seeks to develop the field of social security postgraduate teaching and research in Africa and South Africa. Van Den Heever has worked in the areas of health economics and finance, public finance and social security. His research interests span healthcare management, healthcare quality, healthcare delivery, cost and economic analysis, health equity, health inequality and disparities, and preventive medicine. Read Van Den Heever’s analysis of the health and economic ramifications of COVID-19. 

Innovating against infection 

  • In the Faculty of Science, Head of the School of Molecular and Cell Biology, Prof. Marianne Cronje and her team took the initiative to synthesise virus-killing surface disinfectant and provided limited quantities of this disinfectant freely to University workers ahead of lockdown. The production plant has now been shifted to PIMD, while the school retains scientific oversight. 

In the school’s Protein Structure Function Research Unit, Prof. Yasien Sayed coordinated the donation of 56 boxes of protective gloves to healthcare workers at the Chris Hani Baragwanath Hospital, after a Wits medical intern mentioned the shortage. Gloves and other PPE (personal protective equipment), such as masks, are critical to preventing infection.

  • Michael Lucas, a PhD candidate in the School of Mechanical Engineering has developed a revolutionary infection control solution. WATCH Lucas explain how his self-sanitising surface coating will help to address nosocomial [hospital-acquired] infections, as well as mitigate contamination of food processing plants and public transport surfaces. The Antimicrobial Coating Technology is now in its fifth year of development, with implications of preventing infection beyond COVID-19.
  • Adjunct Professor in Biomedical Engineering David M. Rubin leads the Biomedical Engineering Research Group in the School of Electrical and Information Engineering at Wits. Rubin and biomedical engineer and lecturer, Adam Pantanowitz are working on a model to show the effect of intermittent quarantines.  It is currently very limited, but may have some benefit in terms of maintaining essential services and some continuity of economic activity.  “At this stage, we’re only demonstrating the concept on standard viral epidemic models rather than a specific COVID-19 model,” cautions Rubin.

Adam Pantanowitz, Wits biomedical engineer. ©Lauren Mulligan | www.wits.ac.za/curiosity/

Official government regulations for #21DaysLockdownSA

- Government Communications Department

Government has released the early directives following President Cyril Ramaphosa’s address on Monday night.

The Department of Government Communications and Information System issued the following information on Tuesday, 24 March 2020, about the National Lockdown due to COVID-19:

A 21-day national lockdown has been declared:

 The lockdown will begin on the evening of Thursday 26 March 2020 at 23:59.
 The lockdown will remain in force for 21 days.
 All South Africans will have to stay at home until midnight on Thursday 16 April 2020.
 The categories of people exempted from this lockdown are as follows:

• Health workers in the public and private sector,
• Emergency personnel,
• Security services – such as the police, traffic officers, military medical personnel, soldiers and,
• Other persons necessary for our response to the pandemic.

 It will also include those involved in the production, distribution and supply of food and basic goods, essential banking services, the maintenance of power, water and telecommunications services, laboratory services, and the provision of medical and hygiene products.

Will I be able to leave my house?

 There is no need for panic, as lockdown does not mean a shutdown.
 People will still be allowed to get to shops and access essential goods and services but in small numbers.
 It is up to all of us to minimise our movement.
 Only undertake essential trips outside your home such as to get food, seek medical care or access supplies.
 When leaving your home try and go out alone, plan your trip and get in and out of your destination as quickly as possible.
 Practice hygiene when you go out, wash your hands when leaving home, do so again at your destination and before you depart for home.

What about homeless people and those who cannot self-quarantine?

 Temporary shelters that meet the necessary hygiene standards will be identified for homeless people.
 Sites are also being identified for quarantine and self-isolation for people who cannot self-isolate at home.

We are all in this together

 All sectors and citizens are working well together to fight the Coronavirus and we must continue to do so.
 Aggressive containment measures are essential to ensure that the virus does not spread any further.
 Please continue to exercise caution and avoid unnecessary travel.
 We call on everyone to cooperate with government and other sectors to implement the measures.

What services will remain open?

 Most shops and businesses will be closed.
 The police, metro police, military and emergency services will continue to operate.
 Health care services such as hospitals, clinics, doctors, pharmacies and laboratories will remain open.
 Banks and essential financial and payment services, including the JSE will remain open.
 Supermarkets will remain open so that citizens can continue to care for themselves and their families.
 Petrol stations will remain open.
 Companies that are essential to the production and transportation of food, basic goods and medical supplies will remain open.

We are expanding efforts to contain the virus

 This nationwide lockdown will be accompanied by a public health management programme which will significantly increase screening, testing, contact tracing and medical management.
 Community health teams will focus on expanding screening and testing where people live, focusing first on high density and high-risk areas.
 South African citizens and residents arriving from high-risk countries will automatically be placed under quarantine for 14 days.
 Non-South Africans arriving on flights from high-risk countries will be turned back.
 International flights to Lanseria Airport will be temporarily suspended.
 International travellers who arrived in South Africa after 9 March 2020 from high-risk countries will be confined to their hotels until they have completed a 14-day period of quarantine.

https://www.solidarityfund.co.za/

A number of economic interventions are being put in place

 We have set up a Solidarity Fund, which South African businesses, organisations and individuals, and members of the international community, can contribute to.
 The Fund will focus efforts to combat the spread of the virus, help us to track the spread, care for those who are ill and support those whose lives are disrupted.
 The Fund has a website – www.solidarityfund.co.za – and contributions can be deposited via the fund.
 The Fund will be administered by a reputable team of people, drawn from financial institutions, accounting firms and government.
 To get things moving, government is providing seed capital of R150 million and the private sector has already pledged to support this fund with financial contributions.
 We will be spending money to save lives and to support the economy.
 We must applaud the commitment made in this time of crisis by the Rupert and Oppenheimer families of R1 billion each to assist small businesses and their employees affected by the coronavirus pandemic.

We are assisting businesses

 We will be assisting businesses in the informal sector such as spaza shops.
 Registration is now open, on www.smmesa.gov.za, for small and medium-sized businesses that require help during the coronavirus crisis.
 The department of Small Business Development has a debt-relief fund for small businesses.
 Small businesses affected by the outbreak of the coronavirus will be required to produce proof of negative impact as a result of COVID-19.
 We will further be assisting small businesses to avert job losses through the Small Enterprise Development Agency (SEDA).
 Government has urged malls and retailers to consider rent and payment holidays to tenants negatively affected by the lockdown.

There is no need to stockpile food

 Government calls on everyone in the country to avoid panic buying.
 We are aware that many South Africans are worried about the impact of the coronavirus on essential supplies and food in the country.
 As government, we are doing everything we can to ensure that we have enough food and all essentials we need.
 Government has had discussions with manufacturers and distributors of basic necessities, who have indicated that there will be a continuous supply of these goods.
 Let us be considerate and responsible to ensure that we have enough for everyone especially the most vulnerable in our society.

Our social safety net remains in place

 All grants will continue to be paid.
 To alleviate congestion at payment points, old age pensions and disability grants will be available for collection from 30 and 31 March 2020, while other categories of grants will be available for collection from 01 April 2020.
 All channels for access will remain open, including ATMs, retail point of sale devices, Post Offices and cash pay points.

Let us stand and face this together

 The actions we are taking will challenge us as a nation.
 But we are convinced that the cost of not acting now would be far greater.
 In the days, weeks and months ahead our resolve, our resourcefulness and our unity as a nation will be tested as never before.
 Let us all play our part and ensure that we emerge stronger and more united.

You are not alone!

 It is important that you stay connected via the phone, social media or email.
 Maintain your networks and speak to friends or family regularly.
 Keep doing enjoyable and relaxing activities such as reading, pc, board or card games, social networking or watching television.
 Stay informed by getting the facts, not rumours or fake news.
 Engage children in your care in creative ways; create fun learning activities, play games and try to keep their daily routine going.
 Stay active by doing simple exercises within your home or garden.
 Or create an exercise plan specifically to suit your environment.

 

Coronavirus: how big, how bad, and what to look out for

- Shabir Madhi

Cases of illness from the new coronavirus (SARS-CoV-2) disease, known as COVID-19, have been confirmed in more than 100 countries.

Coronaviruses are a family of viruses that cause illnesses that can range from a common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The Conversation Africa’s Ina Skosana spoke to Shabir Madhi about the situation.


What percentage of people who get the virus are dying from it? Is this high compared with other infectious diseases?

There’s no straightforward answer to this question because the epidemic is still at an early stage. It all depends on what the denominator is, which influences the case fatality risk. And we’re still working with unknowns.

The current estimate is that between 1% and 3% of people diagnosed with COVID-19 die. The problem with this estimate is that the starting point is when individuals have become ill, rather than when they were infected. The actual number of people who are infected might be much higher than the actual number of cases that are presenting for medical care.

The implications of this are huge. For example, if the number of people who have been infected but haven’t gone on to develop the disease is high it would mean that the case fatality risk would go down.

The numbers in Iran point to further difficulties with calculating the fatality rate. Initial reports from Iran indicated a case fatality of 10%. This seems very unlikely. This indicates that a large number of cases were going undetected and possibly that mainly very severe cases were being investigated. When investigating very severe cases the case fatality risk is going to be higher.

A 1% fatality risk is moderate and is in the ballpark of other viruses such as respiratory syncytial virus associated with hospitalisation in children. It is, however, lower than the case fatality risk was for the coronavirus strains that caused the SARS epidemic in 2002 – which was 10% – and for MERS in 2013, which was about 35%.

Nevertheless, based on current knowledge, the case fatality risk for COVID-19 is higher than observed for seasonal influenza virus, which has a fatality risk of about 0.1%. Annually, seasonal influenza virus is estimated to cause up to 290,000 deaths globally. Currently, the global number of deaths due to COVID-19 is approximately 4,100.

Is the reaction overblown?

No. It’s warranted. This is because we don’t know how this epidemic is going to pan out. So even if the case fatality risk is very low, if a high percentage of a population becomes infected that low fatality risk could result in a large number of deaths. For example, if an epidemic involves 100 people with a case fatality risk of 10%, 10 people will die. But if an epidemic infects a million people with a case fatality risk of 1%, there will be 10,000 people dying.

The case fatality risk needs to be interpreted in the context of the number of individuals who are going to become infected to be able to understand the total impact of the epidemic. And right now we don’t know what percentage of the different populations will become infected.

Who is most vulnerable to dying from infection?

Current experience – which is largely driven by what has come out of China and more recently from Iran and Italy – is that people over the age of 50 seem to be more susceptible, particularly if they have underlying medical conditions or co-morbid conditions. These include cardiac problems (case fatality risk 10%), diabetes and lung disease (case fatality risk of 7%). People over the age of 70 have a case fatality risk of 14%.

The big unknown for Africa, particularly countries like South Africa, is what the impact will be on populations with a high prevalence of HIV and TB.

The epidemic has only broken out in countries with very low HIV prevalence, so we don’t know to what extent individuals living with HIV might have an increased susceptibility to severe disease. This is true of TB too. Because TB affects people’s lungs it means that people with the disease have a low tolerance threshold for an additional assault.

In the context of HIV, we have shown that even in the era of antiretroviral treatment, individuals with HIV still have a 10-fold greater susceptibility to severe influenza illness than the general population, and a higher case fatality risk. We expect there may be differences in susceptibility and outcomes for COVID-19 cases in settings such as South Africa.

What are the symptoms that should get me worried?

The symptoms are very non-specific and very similar to other viral infections like the influenza virus. Unfortunately there isn’t a particular trigger that’s different to any of the other viruses.

But people can be mindful of a few things. For example, their travel history to a place where the virus is circulating. Or whether the person has come into contact with someone who has visited one of the places where the virus has been shown to be circulating.

Of course this isn’t definitive.

The classical signs and symptoms one can look out for include a fever, cough, headache and myalgia (muscle pain). Again these are very non-descript.

What treatment is available?

Currently there’s no specific antiviral treatment to cure SARS-CoV-2 infection. Besides supportive care, no therapeutic agent has been proven to be effective in treating or improving the outcome of COVID-19 cases. There are clinical trials under way and others are being planned to evaluate different antiviral agents and other possible therapeutic options. The biggest concerns are about a more severe disease, where patients may end up with pulmonary damage which requires supportive care including supplemental oxygen and then might have to be put on to ventilator. Current estimates are that 15% of COVID-19 cases result in severe disease.

Most low- to middle-income settings have fragile health care systems that lack resilience against external shocks such as the demands posed by unexpected epidemics. These countries may lack the capacity to scale up curative services over a relatively short period of time. Such a scale-up of curative services was undertaken in Wuhan to complement existing curative services.

But a quick-fix solution to address an increase in demand for curative health-care services is unlikely in most African countries should SARS-CoV-2 start circulating widely on the continent. This is a culmination of the systematic lack of investment in health care in most countries. It’s not something that can be rapidly fixed in the middle of a pandemic.The Conversation

Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Wits PhD student develops novel infection control solution

- Wits University

New self-sanitising surface coating will help to address infection control in hospitals, food processing plants and public transport surfaces.

The Antimicrobial Coating Technology by PhD student Michael Lucas, now in its fifth year of development, is a novel solution to address the problem of nosocomial infections. These infections, acquired during hospital stays, are a significant and persistent issue faced by hospitals across the world.

“Infection control is an ongoing challenge in hospitals. Surface contamination and subsequent microbial transmission are known contributors to this. My design for a self sanitizing surface coating serves to address this growing problem, and the results are very promising. These antimicrobial coatings can be applied to high contact surfaces where there is a risk of contamination, including medical facilities, food processing plants and public transport surfaces,” says Lucas. 

Wits PhD Student, Michael Lucas

Metal coated plastics are an emerging field of research and development with a wide range of applications. The distinguishing features of Lucas' research include the novelty of multi-step and multi-process additive manufacturing through the use of cold spray and polymer 3D printing. These manufacturing techniques offer design freedom and manufacturing versatility. This means that manufactured parts can be retrofitted into existing hospital surfaces.

The coatings are made up of various metals with known antimicrobial properties, including combinations of copper, silver and zinc. The uniqueness of Lucas' innovative way of depositing the coatings is a competitive advantage that Wits University is protecting through a patent.

“Research is a process of exploration and it's this aspect that appeals most to me. I enjoy problem solving and seeing the application of research,” says Lucas, who won the prestigious Prix Hubert Tuor Innovation Award for his technology last year.

The most promising particle-embedded cold spray polymer metallised coatings were found to be effective self-sanitising surface coatings. Under simulated touch-contact conditions copper coatings on various polymer substrates, for example, repeatedly achieved complete microbial elimination within only a 15 minute contact period. These tests were conducted under laboratory conditions against a variety of dangerous pathogens that are found in hospital high contact surfaces including a multi-drug resistant Staph strain. Thus, the potential of these coatings for the mitigation of surface contact transmission of infections was confirmed.

Preliminary pilot studies validated this, using coated security access cards and a custom coated smartphone cover exposed to various healthcare associated environments within the University of Witwatersrand’s Medical School and adjacent Charlotte Maxeke Academic Hospital.“The next steps include verifying the safety of the coatings for the intended application and to assess the coatings’ efficacy in real world hospital high contact surface environments. This would be the start of taking the technology to market,” says Michael, adding that he sees an opportunity to turn his technology into a viable startup business.

The development of the technology is ongoing, having started during Lucas' undergraduate research project and continuing into his doctoral studies. Together with the now late Professor Ionel Botef from the Schoo l of Mechanical, Industrial and Aeronautical Engineering, Lucas has worked on further developments with Professor Sandy van Vuuren in the Wits Pharmacy and Pharmacology department. Financial assistance has been provided by the DST-NRF Centre of Excellence in Strong Materials (CoE-SM) and SITA Information Networking Computing UK.

The development of the technology is ongoing, having started during Lucas' undergraduate research project and continuing into his doctoral studies. Together with the now late Professor Ionel Botef from the Schoo l of Mechanical, Industrial and Aeronautical Engineering, Lucas has worked on further developments with Professor Sandy van Vuuren in the Wits Pharmacy and Pharmacology department. Financial assistance has been provided by the DST-NRF Centre of Excellence in Strong Materials (CoE-SM) and SITA Information Networking Computing UK. 

Lucas graduated with a Bachelor of Science in Engineering (Mechanical Engineering) from Wits in 2016. Before graduating, he was asked to present his undergrad research into biomaterials via cold spray and 3D printed polymers at the 2015 Mechanical, Industrial and Aeronautical Engineering (MIA) annual valediction. He was subsequently awarded the best presentation in the Mechanical Engineering programme by the South African Institution of Mechanical Engineers (SAIMechE). Due to the novelty and sophistication of the development, his master's in Engineering was upgraded to a PhD research study under the title: Antimicrobial surface coatings via cold spray and 3D printing technologies, which he is currently completing at Wits University.

Wits acts to manage Covid-19 exposure

- Wits University

Wits acts swiftly to manage student who came in contact with COVID-19 carrier.

The Wits COVID-19 management committee would like to advise the Wits community that a medical student has been quarantined after it was found that the student came into contact with a person who had been identified with COVID-19.

The student is being monitored closely and has not displayed any symptoms of COVID-19. The student has been screened and the test results are expected later today. However, as a precautionary measure the Faculty has cancelled the clinical activities scheduled for the student’s class today. All other activities continue as scheduled.

Further information will be made available when it becomes available.

Wits COVID-19 Management Committee

13 March 2020

Student tests positive for Covid-19 and Wits reaches out to affected class

- Wits University

Wits University has just been informed that the medical student who has been quarantined since last Wednesday has tested positive for the coronavirus (COVID-19)

The student was asymptomatic and attended classes last Monday and Tuesday, without knowledge that the student had contracted the virus.

 

In light of this, the University has made the following immediate decisions:

 

  • The cancellation of all contact classes for the Graduate Entry Medical Programme 1 - MBBCh 3 classes. The academic programme will continue online.
  • All students in the affected student’s class have been instructed to go into self-quarantine for 14 days with immediate effect.
  • The Faculty is personally reaching out to each of the 350 students who could be affected. They will receive the full support of the Faculty, including the requisite monitoring and testing.
  • The Dean of Students, Mr Jerome September will coordinate arrangements for students who live in residences, and who require self-isolation. All students who require assistance should contact Thembelihle Dlamini on 0728390223. Those who require counselling can call the 24 hour Wits student support number on 0800 111 331.  

The Department of Health’s WhatsApp number is 0600123456 and provides additional information about COVID19. The NICD website (www.nicd.ac.za) is a credible source of information on COVID-19.

The Wits Senior Executive Team is meeting this afternoon to decide on the way forward for the Faculty and all other University activities. An update will follow this evening. In the interim, we appeal to the Wits community to remain calm. Please be assured that we are managing this issue and making decisions based on the best medical advice available.

 

This is an anxiety causing time for the University community and the country as a whole. However, if we all take a pragmatic approach to this pandemic it is very likely that the country will get through this crisis. Importantly, it is everybody’s responsibility to protect themselves so that we also protect all other South Africans and most importantly the most vulnerable in our society.

 

We will get through this difficult period together.

 

SENIOR EXECUTIVE TEAM

WITS UNIVERSITY

15 MARCH 2015 (13:30)

All contact teaching postponed for Monday, staff to continue with work

- Wits University

Wits announces measures to curb the spread of COVID-19.

The Senior Executive Team of the University of the Witwatersrand met on Sunday, 15 March 2020, and made the following decisions:

  1. All contact teaching and University activities involving face to face interaction are postponed, including tests, for Monday, 16 March 2020. All students are requested to remain at home or to confine themselves to their rooms in residence. Students are encouraged to follow the social distancing policy and to limit interaction where this is possible.
  2. Special arrangements are being made for students who usually eat in dining halls.
  3. Employees are expected to come to work in order to ensure that operations continue. Employees are requested to maintain social distance, and where possible meetings and group work should be conducted telephonically, online, or via video conferencing. We continue to follow the NICD’s protocols in this regard.
  4. All graduations will be postponed until further notice. New arrangements will be communicated in due course.
  5. A temporary moratorium has been placed on all travel, both outbound and inbound, and applies to both local and international travel. This also means that people who have travelled into South Africa, should not be allowed to enter the University.

Remember to also make use of the NICD’s Coronavirus Emergency 24-hour hotline number and to visit the NICD’s website at www.nicd.ac.za if required. For those who are tested at independent laboratories, remember that these are preliminary results. All positive results must be verified by the NICD.

We will keep the Wits community informed as to plans from Tuesday onwards after consultation with the Department of Health and the Department of Higher Education and Training. In the interim, student queries should be directed to the Dean of Students via Jerome.September@wits.ac.za whilst employees with queries should email their line manager, Head of School or respective Senior Executive Team member.

Thank you

SENIOR EXECUTIVE TEAM

15 MARCH 2020 (20:00)

Wits announces early recess

- Wits University

Wits University will be in recess from Tuesday, 17 March 2020, four days earlier than scheduled.

Following meetings with the NICD, experts in infectious diseases and designated government departments, it has been determined that the University is currently in a low-risk moment and that taking the appropriate decisions now may enable the moderation of staff and student exposure to COVID-19.

As a result, the Senior Executive Team has made the following decisions:

  1. The mid-term break will be brought forward and the University will be in recess from Tuesday, 17 March 2020, four days earlier than scheduled. This means that all academic activities for this week will be rescheduled.
  2. Wits will reopen on 30 March 2020 as per the almanac, but this date and the form of the academic programme may change, depending on national and global developments around the containment of the health pandemic. 
  3. After consulting with key health experts, the executive has taken the difficult decision to request all students to vacate their residences within the next 72 hours. We are deeply cognisant that students may have some concerns and challenges around this decision but we believe that we are acting in the best interests of students and the broader public. Minimising exposure in the institution extends beyond face to face contact within the academic programme but also in our residences, especially at this relatively early stage of the pandemic. The Dean of Student Affairs and his team will steward this process and will be available to attend to any challenges that students (including international students) may experience.  
  4. The University will continue to operate on essential and skeleton staff during this period. Over the next 72 hours, managers and executives will consult with staff in their departments to put in place arrangements for essential services to continue up until 30 March 2020. All executives, managers and essential staff will be required to ensure the continuity of operations during this time.
  5. In addition, academic staff may work from home but are allowed to come onto the Wits campuses as appropriate or if required, to ensure the long-term continuity of the academic programme.
  6. Non-essential professional and administrative staff may remain at home unless they are required to report for duty. Matters related to leave and working conditions during this period will be addressed by our Finance, Human Resources and Legal Divisions in consultation with unions and other stakeholders.

[WATCH] Wits Vice-Chancellor Professor Adam Habib announces early recess

As stated yesterday, all graduation ceremonies will be postponed until further notice and more information will be sent to graduands in due course.

South Africa, and the higher education sector has never before confronted a pandemic on this scale. If we are to get through this period with the minimum impact on society, the Wits community and the academic programme, it will require an unprecedented solidarity from all stakeholders. This in principle means that we all need to reflect on how we can contribute to our institution, our country and the collective good of our communities during this time of crisis.

We are in a crucial moment in the life of this pandemic and it is important that we work as a collective for the benefit of our society. We urge all members of the Wits community to heed the words of President Cyril Ramaphosa: “This epidemic will pass. But it is up to us to determine how long it will last, how damaging it will be, and how long it will take for our economy and our country to recover. It is true that we are facing a grave emergency. But if we act together, if we act now, and if we act decisively, we will overcome it.” 

Thank you

SENIOR EXECUTIVE TEAM

16 MARCH 2020 (20:00)

Who should test for COVID-19

- Wits University

Answers to common questions asked by the Wits community.

Dear Colleagues and Students

We have been inundated with requests from students and staff who are concerned about their health and who are requesting to be tested for COVID-19. Here are some answers to the common questions.

  1. Who should be tested for COVID-19?
  2. Persons who may have the following symptoms:
  3. Fever + a cough OR
  4. Fever + shortness of breath

AND

who may have returned from a high-risk country in the last 14 days

AND

who may have been in close face-to-face contact (within 2 metres) in a closed environment for an extended period of time with a confirmed or probable COVID-19 positive person.

[WATCH]  World Health Organization explains who is at risk

Persons who have been in the same enclosed vicinity of a confirmed or probable COVID-19 positive person for an extended period of time should self-quarantine isolate for a period of 14 days. If symptoms develop during this period, they should call ahead and visit a healthcare professional, and follow their advice. These persons may require testing at this time.  

People who may walk through the same corridor as someone who has tested positive for COVID-19 or a large classroom are at low risk and should monitor their health carefully. They do not require testing. 

  1.   How is COVID-19 diagnosed?
  2.   Where can I get tested?

COVID-19 is diagnosed by a laboratory test known as the polymerase chain reaction (PCR) molecular test on a respiratory tract sample (e.g. sample from nose, throat or chest).

If you have no symptoms, self-monitor. If symptoms develop, go into self-isolation and then call ahead and visit your healthcare professional, and take their advice. They will refer you to a laboratory to be tested if required.

  1.   Where are the high risk countries?
  2.   Do all Wits students need to be tested?
  3.   Do students need to be tested before leaving residences?
  4.   Is it not better to stay in residence?
  5.   Where can I get more credible information?
  6.   If I need counselling, where can I get help?

A.    The list of high-risk countries changes daily. View the latest map here: https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd

A.    No. Only those students who meet the criteria above. All students who may have been at risk have already been identified and placed into self-quarantine. This group is being monitored and is receiving the support of the Faculty of Health Sciences and the Office of the Dean of Students Affairs.

A.    No. Students do not need to be tested before leaving residences. 

No. Experts in infectious diseases have advised that the University is currently in a low-risk moment and that taking the appropriate decisions now may enable the moderation of staff and student exposure to COVID-19 as we are still in the early stages of the pandemic. We believe that we are acting in the best interests of students and the broader public by bringing the mid-term break forward.

A.    Try these credible sources:

National Institute for Communicable Diseases – http://www.nicd.ac.za/diseases-a-z-index/covid-19/frequently-asked-questions/

World Health Organization - https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

Department of Health WhatsApp Line: 0600 123 456

Wits University – www.wits.ac.za/covid19

A.    Students, call the ICAS hotline on 0800 111 331

Staff, call the AskNelson Hotline on 0861 635 766 or dial *134*928# or send a ‘please call me’ to 072 620 5699 or email asknelson@kaelo.co.za

SENIOR EXECUTIVE TEAM

17 MARCH 2020 (15:00)

Wits COVID-19 Update 13: Students urged to go home

- Wits University

Message from the Wits Dean of Student Affairs.

Dear Students

We are living through a difficult time and we are doing all that we can to ensure the safety of our students, based on the advice that we are receiving from experts.

We would like to thank those students who have vacated their residences, in line with the call made by the University and the directive of the President, the World Health Organization and other experts. 

Following this morning’s court order, which implored all students to follow the directives referred to above, the majority of students have now left our residences. We urge those who remain to vacate as soon as possible. Many have arranged to leave overnight and those with special challenges are being assessed on a case by case basis. Those who have requested assistance (including international students) from my Office will be advised in the next few hours as to the nature of the assistance that the University can provide.  

In light of the steady rise in the number of people infected with COVID-19, the University urges all remaining students to leave immediately. This is in the best interests of the student body, the University community and the general public. Please note that all catering, cleaning, ICT and other services will be suspended as from tomorrow morning.

We have received many queries from students who are concerned about the submission deadlines for their academic work. The SET has agreed that these deadlines will be extended into April and that new deadlines will be communicated in due course.

We wish all students a safe journey home.

Mr Jerome September

Dean: Student Affairs

Wits COVID-19 Update (15): Wits prepares to go online

- Wits University

Wits from the Senior Executive Team of Wits University.

Dear Colleagues and Students

This is an uncertain time for all of us – staff, students, members of the Wits community, and society. The sands are shifting daily and many of us are feeling anxious about what happens next – to our health and safety, livelihood, to our education, to our research, to our freedoms and to life as we know it.

Whilst we practice physical distance and social solidarity, this disruption also provides us with an opportunity to reimagine how we live, how we work and how we learn. It also allows us to exercise control over the aspects that we can change – and in this instance, how we can learn and work remotely.   

Given the potential of a lockdown and uncertainty around movement in the months ahead, after a deliberative meeting (via Microsoft Teams) this morning, we agreed that:

  • all faculties must prepare to take the academic programme online within the next two weeks (with the full support of the Centre for Learning, Teaching and Development and the Wits ICT teams),
  • all Deans (with the input of Heads of Schools and academics) will maintain a spreadsheet that will determine how programmes can be transitioned to a remote format,
  • students will have to prepare to work online, and
  • the precise date on which the University will reopen and the format in which the academic programme will commence, is still to be determined.

Some of the issues that were discussed are reflected below, including:

  • the digital divide and how to mitigate against deepening this divide,
  • a database analysis indicates that only about 25 out of Wits’ 38 000 students do not have a mobile phone,
  • access to smart mobile devices (a quick survey has determined that about 90% of first year students have access to a smart mobile device) and Deans and faculty will look for practical solutions for the remaining students,
  • access to data (the University has secured zero rated sites from MTN, Telkom and Vodacom, which means that staff and students can access these sites at no cost), and
  • the anxiety of some staff members who are used to contact teaching and who have not been exposed to online learning systems or software (it was agreed that CLTD and Wits ICT would talk academics through these aspects).

We are still deliberating on a number of issues including the minimum requirements for online and distance learning and teaching (infrastructure, data, content modification) and the potential for introducing alternative assessments where applicable. A plan which details the form in which online teaching will take place will be shared in the coming days, in consultation with staff in the faculties.

Please send all your questions, suggestions and concerns to vco.news@wits.ac.za.

In the meanwhile, please keep calm, keep safe, and look out for our latest updates at www.wits.ac.za/covid19. We can overcome this global challenge together.

Thank you

SENIOR EXECUTIVE TEAM

23 MARCH 2020 (18:00)

Wits researchers launch most comprehensive COVID-19 dashboard in South Africa

- Wits University

The dashboard is aimed at informing government, scientists, the media and general public with quick, easy-to-understand information on the current situation.

An interdisciplinary team of researchers at Wits University has launched the most comprehensive data dashboard on the COVID-19 virus in South Africa to date. 

Covid-19 Dash board

The dashboard, that shows the latest statistics on how the virus is affecting the population of South Africa, is updated on a daily basis, using official statistics from both local sources, such as the National Institute for Communicable Diseases (NICD) and international sources such as the World Health Organisation (WHO). The statistics on aspects such as the cumulative confirmed cases in South Africa, the daily confirmed cases, relative increases of infections are presented in colourful, easy-to-interpret visualisations. Other statistics include infections by gender, province, age and transmission routes.

“We are experts in analysing and interpreting big data, and we believe that it is important that someone put this data together and present a bigger picture of the impact of the virus on the country,” says Professor Bruce Mellado from the Wits School of Physics, who initiated the project. The team working on the project includes computer and data analysts, engineers and physicists.

The dashboard is aimed at informing government, scientists, the media and the general public with quick, easy-to-understand information on the current situation. It is updated every day approximately an hour after the release of the official COVID-19 update from the NICD. As more data becomes available, more features will be added to the dashboard.

Mellado is in talks with several government departments to get them to recognise as well as to add to the database, in order to make it a powerful tool in the fight against the virus.

“Our team believes in the power of knowledge to solve complex issues, and we hope that our strong ties and cooperation between the scientific community, the executive and the public can help overcome challenges such as the COVID-19 pandemic,” says Mellado.

Link to the dashboard: https://www.covid19sa.org/

Wits engineers make face shields to protect healthcare workers

- Wits University

A team of innovative Witsies is using their design and engineering skills to create face shields in aid of the fight against COVID-19.

An amazing sense of social solidarity and patriotism has pervaded South Africa recently with many people offering their knowledge and skills to aid the country in its fight against the coronavirus.

The escalating spread of the virus has increased the demand for personal protective equipment (PPE) and medical supplies as more people test positive for COVID-19 daily. Healthcare facilities in the country are seeing a shortage in these supplies for their staff.

On Friday, 27 March 2020, Netcare 911, one of the healthcare facilities currently experiencing a massive shortage of protective gear, called on the 3D printing community to assist with printing head rings for face shields for use by medical staff treating patients with COVID-19.

Teams at Wits from the Digital Incubator at the Tshimologong Precinct, the School of Mechanical, Industrial and Aeronautical Engineering (MIA) along with the Transnet Centre of Systems Engineering (TCSE) and the Transnet Matlafatšo Centre (TMC) heeded the call and used their engineering prowess to assist with a solution to the problem.

Wits face shields. Model: Tshwarela Kolokoto

Recognising that each head ring for the face shields would take approximately 90 minutes to produce and with limited 3D printing capacity, a team – made up of Guy Richards, Letlotlo Phohole, Moses Mogotlane, Palesa Riba and Randall Paton, ,decided on a laser cut solution that would save time.

“Netcare was going to provide the actual shield and clips to put it together. We were not happy with the limitation and wanted to use what is readily available to us, cheap to make, and light-weight. Most of all, we wanted to produce a complete product. We also anticipated long printing times with a 3D printer and possible filament shortages given the national drive for face shields and masks,” said Letlotlo Phohole, Acting Director of TCSE and TMC.

After numerous attempts on Monday, 30 March to cut the shield from downloaded files from GitHub and Thingiverse – a software development platform where over 40 million developers collaborate online to host and review code, manage projects, and build software – the Wits team re-designed the original designs, applying rapid prototyping processes, which they then cut using their laser cutter.

The face shields, which are made from polyvinyl chloride (PVC) sheeting, are a flat pack consisting of two pieces that can be rapidly assembled. “The School had stock of the PVC sheeting from another earlier project. The shields are therefore being provided at no cost to the hospitals”, says Paton.

 Adhering to best safety practices is crucial in the production of these face shields.

“We ensure that after production they [face shields] are washed, rinsed, and dried to remove any potentially harmful residue from the laser cutting. This is done in a production line fashion and is now the tightest bottleneck in the project, given that we only have one working laser cutter,” added Paton.

With an average production time of  3 minutes (including setup time) to cut a set of pieces for each face shield, the team anticipates making 200 to 500 shields a day to help meet the growing demand of protective gear for medical staff.

“We have developed a system that lets us feed the rolled plastic directly into the cutting bed and draw more through when done so speed is climbing,” said Paton. The team has reduced the cutting time to 90 second per shield but the washing and drying still add to that time.

Four days since the call from Netcare 911, by Tuesday, 31 March, the Wits team had produced 140 face shields and distributed 120 to the Wits Donald Gordon Medical Centre and another 20 to the Wits Protection Services staff. An additional 300 face shields have been produced to date, of which 200 will be donated to Charlotte Maxeke Johannesburg Academic Hospital and 100 to Rahima Moosa Mother and Child Hospital. The Wits engineers hope to distribute face shields to Helen Joseph and Chris Hani Baragwanath hospitals, which are also Wits teaching hospitals.

Head of MIA, Professor Robert Reid hailed the team for their extraordinary contribution to society saying that they are upholding one of the five core values of the School, botho (humanity).

“A core value of our School is botho. We strive to nurture and develop the community of which we are part. During this time of national crisis, it is imperative that we use our skills and facilities in any way that will serve our community. I am therefore delighted that we are able to help keep safe the healthcare workers on the frontline in their fight against this awful pandemic.”

Paton said the nationwide response to the call had inspired him.

“I think that many South Africans, as a nation of ‘make-a-plan’, are frustrated by not being able to help in a tangible way during the lockdown and this has channelled that energy somewhere. This has been as inspiring to be a part of as watching everyone trying to help Netcare with 3D printing for the face shields. These are extraordinary people in extraordinary times.”

The Faculty of Engineering and the Built Environment plans to develop other medical equipment, including respirators, devices to prevent people from touching their faces, and medical masks (with filters made out of vacuum cleaner bags and make-up cotton pads designed by students of their own volition). These cross-disciplinary projects will involve people from different faculties at Wits and other stakeholder groups.

Over R100 000 has been raised for this initiative from 68 donors. If you would like to make a tax-deductible donation towards this cause or other initiatives at Wits University against COVID-19, please follow https://wits.devman.co.za/devman/covid-19/giving/ and donate directly to the Wits Covid-19 Discretionary Fund or donate to the Wits Foundation. Bank details:

Wits University Foundation
Standard Bank of South Africa Ltd
Current Account number: 002900076
Branch code: 00 48 05

Swift code: SB-ZAZ-AJJ

For non-monetary donations for this initiative, email randall.paton@wits.ac.za 

 

Wits COVID-19 dashboard goes continental

- Wits University

New features added as inter disciplinary and inter-institutional collaboration data on the pandemic grows.

Wits University’s COVID-19 South Africa Dashboard has grown with new data features, including snapshot views of how the pandemic is spreading in Africa, as well as statistics showing world trends, being added. (As featured in this article in TIME Magazine.)

The dashboard, launched on 22 March, by Professor Bruce Mellado from the Wits School of Physics and Senior Scientist at iThemba LABS, has gained momentum with a number of volunteers from different disciplines working 24/7 to develop and maintain the dashboard. Wits university is working in collaboration with iThemba LABS of the National Research Foundation.  

Covid-19 Dash board

The visualisation of large quantities of data on the pandemic is a critical step in the analysis of that data. It provides an essential input for analysts to develop the first intuition with which to devise models. The relevance of the visualisation that the dashboard provides is therefore significant.

“The design, development and updating of the dashboard requires a large collaborative effort,” says Professor Barry Dwolatzky, Director of Wits University’s Joburg Centre for Software Engineering (JCSE). “I am assisting in the coordination of the project. Under Bruce Mellado’s leadership a team of highly dedicated and motivated student volunteers, drawn from a variety of disciplines, is working to develop and maintain the dashboard. Although all of us are locked down and working from home, a strong team spirit has developed. I find it interesting that few of us have actually met." 

The dashboard is maintained daily and updated within minutes of Government’s announcements on the latest statistics. It provides historical data of relevant parameters, provincial and other breakdowns and it has undergone a number of upgrades since its release.

“Many of the upgrades have been requested by scientists and journalists from all over the country to improve the presentation of the South African data. Currently the site averages about 10 thousand views a day,” says Mellado.

One of the upgrades performed on the dashboard is the addition of a dashboard for the African continent that includes a detailed account of total cases, mortality and recoveries for all African counties. This addition has triggered a collaboration with the Botswana International University of Science and Technology (BIUST) to develop the first COVID-19 dashboard for Botswana, using data from the National Emergency Operation Centre of Botswana.

“This adds a new and important dimension to our existing collaborations with Wits and iThemba LABS,” says Professor Gregory Hillhouse, Head of the Department of Physics and Astronomy at BIUST.

“It is gratifying to see that one of our MSc students who has been trained at iThemba LABS, Mr Otsile Tikologo, is actively involved with this project.”

Another upgrade illustrates the global analysis of the spread in the conditions of containment (or “lockdown”) using epidemiological models. A number of countries have been selected for which containment measures have led to significant reduction in the rate of spread.

Data analysis and statistical treatment of this feature are performed using a frequentist framework. For this purpose the data processing framework ROOT developed by the European Laboratory CERN is used. Results are presented in terms of lower and upper curves for the cumulative number of positive cases as a function of time. These are estimated on the basis of a 68% confidence level. Predictions are updated on a daily basis. 

“Understanding the impact of containment measures on the spread of the virus is essential to managing this crisis. Global data provide an invaluable insight into the dynamics of this complex problem,” says Mellado.

Links

There is a dire need to boost SA’s stimulus package

- William Gumede

Countries such as the US, Germany, India and Brazil have launched help for all sectors of their economies — South Africa needs to follow.

To prevent Covid-19 from destroying their economies many dynamic countries have introduced large emergency economic stimulus packages that comprise significant proportions of their countries' GDPs. These combine monetary and fiscal measures, prioritising injecting cash into the wider economy, rescuing vulnerable businesses, supporting self-employed individuals and providing support to the unemployed.

Many countries rightly see the Covid-19 peril as similar to a war situation, which demands extraordinary measures not usually used in peace-time. Some countries are funding their stimuluses packages through debt, setting aside existing fiscal and monetary restrictions or using reserves kept for emergencies.

Singapore unleashed a stimulus package of almost $55bn, or 11% of the country’s GDP, to prevent it from plunging into recession because of Covid-19. It widened the country’s budget deficit to 7.9% from a previous target of 2.1%, and drew as much as $17bnfrom reserves. The Singapore Monetary Authority  manages monetary policy through tuning the exchange rate, letting the local currency fall or rise against the currencies of its main trading partners, rather than adjusting interest rates. As part of the stimulus package the authority eased the exchange rate in the most aggressive way since the 2008/2009 global financial crisis, by adopting a zero percent annual appreciation rate.

The Singapore stimulus included scrapping property taxes for hotels, restaurants and shops; wage support for businesses, particularly in most vulnerable sectors such as aviation, food services and tourism. It also provided direct cash to the self-employed, including freelancers, lower-income workers and the unemployed. It provided funding to civil society and community organisations and charities involved in community help. Grocery vouchers were given to the needy. Housing loan payments were deferred for up to six months.

South Korea released an economic stimulus package of $13.7bn, just under 1% of the country’s GDP. Part of this will be financed by a combination of reprioritising fiscal resources, debt and treasury bonds to be issued later this year. The Bank of Korea slashed interest rates by 50 basis points. The bulk of the emergency stimulus is aimed at strengthening the public health system, SMMEs and subsidising the wages of struggling companies. It relaxed loans for all exporters. Those who have lost their jobs will be retrained. The government provided childcare subsidies over the lockdown and made cash payments of $816 to each family except the richest 30%. SMMEs are exempt from certain taxes and utility bills over the lockdown period.

Brazil has unleashed a $29bn stimulus package, about 5% of GDP. The stimulus is based on reprioritising existing fiscal resources. The government has refashioned current monetary, fiscal and budget policies to tackle the Covid-19 emergency. It deferred company taxes and allowed employees to make withdrawals from their Employee Indemnity Guarantee Fund, to which all employees have to contribute 8% of their salary. Companies have been allowed to postpone their contributions to the fund for up to three months. The government also lifted import tariffs on medical products and gave tax exemptions to locally produced medical products. 

Private banks agreed to extend the maturity dates for personal, household and SMME loans by two months. Banks were asked to renegotiate easier terms of existing loans of struggling companies without charging extra. The Brazil central bank cut interest rates by 50 basis points and repurchased dollar-denominated sovereign bonds to stabilise financial markets. It eased the capital requirements for banks, to make funds available for them to lend during the crisis. The government lifted its fiscal target to free up financial resources. Those who are self-employed, in informal employment or unemployment will get a basic income grant of $125 a month for three months.

India unveiled a $22bn stimulus package or 1% of GDP, and an additional $2bn to support the public health system. The Reserve Bank of India cut interest rates by 75 basis points to 4.4%. It also cut the case reserve ration, the amount lenders must hold in reserve, by 100 basis points to increase liquidity in the economy. It put a three-month moratorium on loan repayments by banks and informal lenders. The government will deliver 5kg of grains and 1kg of lentil rations monthly to 800-million people, among a range of other direct assistance measures to the poor by civil society organisations, and targeted relief by banks.

Germany has rolled out a €750bn economic stimulus package, about 5% of GDP, financed by new borrowing. It will take on new debt for the first time since 2013, representing 10% of GDP. The stimulus will fund unlimited loans to large companies, pay 60% of salaries of companies going into short-time and provide financial support to the self-employed. Up to €100bn will be used to take direct equity stakes in failing companies to prevent collapses or foreign takeovers.

The US has unveiled a $2-trillion coronavirus rescue package, 11% of GDP, for struggling companies and employees. This includes loans, equity stakes in struggling companies and direct payments to companies and individuals. Mid-size companies with between500 and 10,000 employees can access loans with interest rates no higher than 2%, and those with 500 or fewer can access loans from banks to cover more than two months of operational costs and payrolls, with the government covering repayments for the first eight weeks. Struggling airline companies, which are deemed critical to national security, will get $60bn in loans and grants to help with operational costs and pay employees. The government is paying $1,200 to all families earning less than $99,000 a year.

Given these examples, SA's response so far seems inadequate. It should reduce the reserve requirements for financial institutions to allow them to lend at easier terms to struggling firms. The Reserve Bank could and should cut interest rates further. Personal and corporate taxes should be deferred. The Unemployment Insurance Fund should be used to finance those who have lost their jobs because of Covid-19. Government’s contingency reserve of R5bn should be mobilised for targeted intervention in the crisis. And alleviating the economic crisis is also a credible reason for funds of the Public Investment Corporation to be used.

A basic income grant to the poor, unemployed and homeless could prove crucial to helping them through the coronavirus crisis. Food vouchers should be considered to allow the poor to buy food at retailers. The other option is to distribute food parcels to those in need. However, it will be difficult to reach everyone, even if the food is distributed by the army or civil society organisations. Well-off individuals can pitch in with food parcels or vouchers and contribute towards rolling out a basic income grant. Ultimately, government, the private sector and civil society will have to work more closely together than ever before, whether in the health sector, sharing expertise or supporting the vulnerable.

William Gumede is Associate Professor at the Wits School of GovernanceThis article first appeared in Business Day, 8 April 2020.

South Africa needs to end the lockdown: here’s a blueprint for its replacement

- Shabir Madhi, Alex van den Heever, David Francis, Imraan Valodia, Martin Veller and Michael Sachs.

Academics call on government to develop a comprehensive health and economic strategy if it is to prevent long term socio-economic damage caused by pandemic.

The public debate on strategies to tackle COVID-19 often unhelpfully positions health and economic considerations in a diametric fashion – as trade-offs. In fact, economic policy has health consequences. And health policy has economic consequences. The two need to be seen as parts of a coherent whole.

In the case of South Africa, the country currently faces three interrelated problems. These are the public health threat from the COVID-19 pandemic, the economic and health effects of the lockdown, and a range of intractable economic problems not directly due to the current pandemic. These include high unemployment, low economic growth and falling per capita income.

Any potentially viable response to COVID-19 needs to address all three aspects in concert. This is particularly important as the country plans for the next stage of its response after the lockdown. Focusing only on the health challenges and not paying attention to the economic issues will result in significantly higher economic costs, and will also undermine the health imperatives.

Our view is that a protracted lockdown won’t necessarily have the effect of ridding the country of the virus, but it will result in unacceptably high health and economic consequences.

The cost

The initial lockdown was prudent and is likely to have lowered the risk of community spread of SARS-CoV-2.

But the true number of COVID-19 (the disease caused by SARS-CoV-2) cases is difficult to quantify. A limited number of tests have been done, and community-wide screening for suspected infectious cases has been delayed.

The available evidence on the COVID-19 pandemic suggests that any initial containment of the disease through a lockdown will be short-lived. Also, it’s likely to result in a rebound of cases in the absence of aggressive community-wide screening for SARS-CoV-2 infectious cases, isolation of the identified cases and quarantine of their close contacts for at least 14 days.

On top of this, South Africa may find itself permanently harmed by the simultaneous destruction of both the demand and supply sides of the economy under an extended generalised lockdown.

This will have other unintended long term health and economic consequences. For example, an extended lockdown could result in the undermining of other health services, such as the immunisation of children.

The economic effects of a lockdown, too, are severe.

Early forecasts suggest significant economic disruption from the current lockdown, which is costing the economy an estimated R13 billion per day. Preliminary projections by the South African Reserve Bank indicate that South Africa could lose 370,000 jobs in 2020. Projections by private banking analysts (based on the initial 21-day lockdown) suggest a GDP contraction of 7% during 2020, leading to a fiscal deficit of 12% of GDP (forecast at 6.8% in the 2020 budget) and a debt-to-GDP ratio in excess of 81% in 2021. This means that the country’s already limited public finances will be further constrained.

Towards a post-lockdown strategy

Globally, attention is turning from initial containment through generalised lockdowns to short- and medium-term risk-based public health and economic strategies. We present some considerations for a health and economic policy beyond the lockdown in South Africa.

In this we proceed from the following assumptions:

  • The SARS-CoV-2 will not be eliminated in South Africa until either a vaccine is introduced (yet to be developed), or sufficient natural immunity in the population is achieved. It is therefore necessary to put in place and maintain a sustainable mitigation strategy for COVID-19 for the remainder of 2020, or until a vaccine is available (an optimistic timeline for this is 18-24 months).

  • A generalised lockdown is not a viable long-term prevention strategy for COVID-19 due to its deleterious effects, including the resultant long-term impact on society, public health and the economy.

  • Removal of the lockdown without appropriate health and economic measures will result in an excess mortality from COVID-19, resulting in further economic hardship.

South Africa’s health and economic strategy beyond the current lockdown must be designed to ensure good health care and be economically sustainable. We argue that the country needs to transition to a risk-based strategy which offers effective health protection and allows for the resumption of some economic activity.

This approach has been advocated by researchers in both Germany and the Indian state of Kerala.

Accordingly, the following objectives should be central to any policy.

  • First, mitigate the rapid spread of the virus, while allowing for natural immunity in the population to increase gradually.

  • Second, strengthen health care systems to ensure optimal treatment for as many patients as possible, both those with COVID-19 and those with other serious illnesses.

  • Third, protect individuals at high risk for severe COVID-19 disease; and

  • Fourth, make economic activities possible with measures in place to manage the health risks associated with these activities.

Economic and health strategies

At the highest level, there are three broad intervention strategies available to South Africa (summarised in the table below), adapted from a recent article by leading Australian health academics James Trauer, Ben Marais and Emma McBryde. We believe that option three is the only practicable one for South Africa. And the details of its implementation matter.

Table 1: Typology of interventions and risks

Adapted from (Trauer et al., 2020)

A health strategy based on an extended generalised lockdown is economically unsustainable. It is also damaging to public health. Instead, we need a unified health and economic strategy that allows for some economic activity while inhibiting the uncontrolled spread of the virus. This requires a number of health and economic measures to be implemented in a coordinated manner.

First, to reduce the rate of infections, the country must have ready the capability of mass virus testing and efficient contact tracing before the end of April 2020. This must be accompanied by a comprehensive approach to social distancing. Relying solely on screening of symptomatic individuals will not effectively reduce the rate of infection because high viral loads of SARS-CoV-2 in the upper airway occur in pre-symptomatic and possibly asymptomatic people.

To be successful, the scale of testing needs to be at least equivalent to that in South Korea (17,322 tests per day in South Africa, eventually testing 1 in 150 people). At best, it must be equivalent to that carried out in Germany (36,399 tests per day in South Africa).

Test turnaround times must result in identification of infected individuals within 12 to a maximum of 24 hours. This must be 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. There would perhaps be 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.

Secondly, 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 outlined above, a risk-based economic strategy is required that balances economic and health imperatives.

Decisions on differential opening of the economy should be made in line with the criteria proposed in a recent paper by German researchers. This includes, for example, 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. Of course, these decisions will have to be based on a careful assessment of factors such as household structure and composition in South Africa, and public transport.

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 dynamic fashion, responding to the latest evidence.

This article has been amended to reflect updated estimates of the daily cost of the lockdown.

Cas Coovadia, member of the University of the Witwatersrand Council, also contributed to the discussions that led to the writing of this articleThe Conversation.

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, and Michael Sachs, Adjunct Professor, Economics, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 UPDATE 21 – POSTGRADUATE STUDENTS

- Wits University

Message from Professor Zeblon Vilakazi, Vice-Principal and Deputy Vice-Chancellor: Research and Postgraduate Affairs.

Dear Postgraduate Students

I hope that you are all well and keeping safe. This is a difficult time for all and I hope that you remain in high spirits.

You should have received an email earlier this week pertaining to the commencement of the academic programme, which is scheduled to resume online on 20 April 2020. As postgraduate students, and particularly those conducting research at the Master’s and Doctoral levels, your course of action is slightly different. Due to the diversity of research being conducted and the great breadth and scope of the disciplines being explored, it is impossible to address postgraduates as a homogenous cohort.

I would therefore like to advise you to work directly with your supervisor during the lockdown period and beyond, in order to ensure that your research continues from wherever you may be geographically located. A number of online resources have been made available to you during this period to make it easier for you to work from where you are.

Should you have any problems or issues, please raise them with your supervisor or with your relevant Faculty Dean.

Regards

Professor Zeblon Vilakazi

Vice-Principal and Deputy Vice-Chancellor: Research and Postgraduate Affairs

3 April 2020

Resources for postgraduate Students

Access to Data and ICT Support

Wits has worked with Telkom, Vodacom and MTN to ensure that students can access selected learning sites without using data. Cell C is due to come on board shortly and all services will be activated within the next ten days. For a complete list of the zero-rated sites, visit: https://www.wits.ac.za/mywits/zero-rated-data-to-students-and-applicants/. Please note that you must have at least R1 worth of data loaded on a SIM card in order to access these sites. If you have any queries or concerns, please contact the ICT Service Delivery team via ithelp@wits.ac.za  or call 011 7171717 or log a call via https://witshelp-ism.saasiteu.com/.

Learning Management Systems

All our Learning Management Systems (LMS) including Wits-e (Sakai) and Moodle will be hosted in the Amazon cloud to ensure that our systems have sufficient infrastructural support and are able to cope with a large number of users accessing the systems.

Access to Smart Mobile Devices

We are also aware that approximately 10% - 15 % of students may not have access to smart mobile devices (according to the results of the biographical questionnaires conducted over the last four years by our Business Intelligence Unit), and Faculties and Deans have been asked to develop a plan in this regard.

Access to Digital Library Resources

There are several resources available to students, including:

For Research and Writing Assistance, visit:

For more information, contact Denise.Nicholson@wits.ac.za 

Access to the Wits University Press eBook collection

In this time of unprecedented crisis, when universities are developing online teaching systems and academics are working from home, Wits University Press is joining a large number of international university presses and academic publishers in providing free access to content for students and researchers.

Links to JSTOR: https://about.jstor.org/covid19/?utm_source=jstor&utm_medium=display&utm_campaign=dsp_jstor_home_right_covid19_03_2020

Link to Proquest:

https://www.proquest.com/products-services/ebooks/ebooks-main.html#whatsnewSection

The Wits University Press books at JSTOR are here: https://www.jstor.org/publisher/witsup

For more information and all updates, visit www.wits.ac.za/covid-19

Wits switches to remote online teaching and learning from 20 April 2020

- Wits University

Wits institutes an emergency remote teaching and learning programme as one measure to help minimise the time lost in the academic project.

Dear Colleagues and Students

We are living through an unprecedented era which has tremendous implications for humanity and for us as the Wits community. We know that through our collective efforts we can stave off the coronavirus, and that through physical distancing, testing and quarantining, we can flatten the curve and eventually overcome the disease. But what we do not know, is exactly how long this will take and the exact nature of the resources that will be required.

In Sesotho: Read the Sesotho translation or listen to the audio below.

In IsiZulu: Read the IsiZulu translation or listen to the audio below.

Our collective challenges

As the Wits community, we are thus left with some difficult options – wait out the pandemic (and potentially lose the 2020 academic year) or switch to emergency remote teaching and learning alongside a range of other contingency and continuity plans. After consultation with our various constituencies, we have opted for the latter.

We are cognisant of the tremendous effort that has been expended by academics and professional and administrative staff in recent weeks, who have tirelessly prepared online material, who have learnt to switch between pedagogies, and who now have a better understanding of our learning management systems.

At the same time, we are acutely aware of the anxiety and uncertainty that this mode of learning presents for both our colleagues and students. The world as we know it is in flux, and it will take our collective courage, dexterity and commitment to fend off the effects of this pandemic and to adapt to new ways of teaching and learning.

We are aware that the playing field is uneven and that whilst many in society and our community enjoy greater levels of privilege, the consequences of the pandemic have illuminated and amplified the existing inequalities in our society – with the poor, marginal, precarious and under-resourced disproportionally experiencing its fallout. We understand that our emergency remote teaching and learning plan has to take into consideration the different learning environments of our students and their access to learning resources, appropriate devices and data.

Our success is dependent on how we respond as a community – our Senior Executive Team members have to be agile enough to ensure that requisite plans and resources are in place to switch to the emergency remote teaching and learning programme. Our Deans, Heads of Schools, academics and professional and administrative staff have shown that they are able to adapt to a changing environment and are now going beyond the call of duty to ensure student success. Our students will have to exercise their own agency and will have to make an extraordinary effort to adapt to remote online learning with the requisite support from faculties, particularly over the next few months. We acknowledge the importance of the University to provide support but it is also important for our students to develop their own agency to overcome the challenges that confront us today.

Wits re-opens online on 20 April 2020

The next few days (15-19 April 2020) will be used to transition to the online environment with the University officially opening for the second block on 20 April 2020. The almanac has been revised but is dependent on how the crisis unfolds in the months ahead. To be clear, the University is not transitioning to a permanent online modality for all courses, nor are we becoming a correspondence institution. We are instituting an emergency remote teaching and learning programme as one measure that will help us to minimise the time lost in the academic project.

We are clear that the emergency remote teaching programme will not serve as a comprehensive solution to our current challenges. There are specific disciplines that may be patient-based, laboratory-based, studio-based or involve creative practices that cannot be undertaken online. In these instances, we will have to explore high intensity immersion classes when we resume contact teaching, resequencing the academic year to allow for theory to be taught online upfront followed by the practical and laboratory-based components later in the year, and perhaps even recalibrate the almanac.

Access to devices, data and learning resources

Multiple surveys across the institution have revealed that between 10% and 15% of students do not have access to appropriate computing devices, adequate access to data or conducive learning environments. To this end, we are putting in place the following measures to ensure that the majority of students are able to learn remotely:

Wits has established a Mobile Computing Bank (MCB) which will enable qualifying students who do not have access to appropriate mobile learning devices to loan basic devices from the MCB. These basic computing devices will be suitable for educational purposes and will be pre-loaded with the required learning resources before being delivered via the South African Post Office to students who absolutely need them. The cost of the device will be added to students’ fee accounts and will be reversed if the device is returned in good order at the end of the 2020 academic year. The students most in need will be prioritised when devices are allocated.

The University has finalised an agreement with four telecommunications service providers: Telkom, MTN, Vodacom and Cell C to zero-rate Wits’ library and learning management sites from 15 April 2020. The full list of zero-rated sites is available via this link:https://www.wits.ac.za/mywits/zero-rated-data-to-students-and-applicants/ 

We are working through Universities South Africa to reach agreement with telecommunications service providers to ensure that other products and sites like Microsoft Teams, Zoom and other learning sites are either zero-rated or reverse billed to the University. These sites may have to be accessed via the Wits VPN. Negotiations are underway and we will keep the University informed of these matters in the coming days.

In cases where students do not have access to any device or data, other options are being explored, including the possibility of using the South African Post Office to deliver paper-based material to our students. Additional support will be made available for students when contact teaching resumes, and particularly for students who will have had difficulty in transitioning to online learning. It may be necessary for face-to-face lectures to be extended through the September and December vacation breaks and for some cohorts, to extend the academic programme into 2021.

Students who have queries related to the academic programme should contact their respective schools. Students who do not have access to adequate mobile computing devices and cannot secure them elsewhere, should contact the following Faculty representatives:

Commerce, Law and Management: Tshepiso.Maleswena@wits.ac.za

Engineering and the Built Environment: FacultyRegistrar.EBE@wits.ac.za

Health Sciences: Henda.VanDerWalt@wits.ac.za or Morne.Greyling@wits.ac.za

Humanities: help.humanities@wits.ac.za

Science: SSSC.Science@wits.ac.za

Postgraduate research

As per the communique sent to all postgraduate students on the 6th of April 2020, those students pursuing their Masters or PhD degrees should engage directly with their supervisors to ensure that their research continues. A list of the library sites that have been zero-rated has already been shared with all postgraduate students. In cases where patient-based, studio-based or laboratory-based work is required, these matters should be discussed with the supervisor, Head of School and/or Dean of the respective Faculty. 

Conclusion

The next few weeks are going to be challenging for us as a country and as a University. We have no choice but to stand strong in order to overcome this common invisible enemy. We should galvanise our resources to achieve one common goal – to see our students succeed and complete the academic year, despite the inequalities that pervade our society. In so doing, we will develop the high level skills to rebuild our country and produce the problem-posers and problem-solvers needed to tackle the complex problems that confront our society.

We will emerge from this crisis – stronger and more resilient than ever. This is a complex challenge that will require multiple responses from all of us. Let us use this time to find each other and to work together towards a common goal for our students, our staff and our common humanity.

Keep healthy and stay safe.

SENIOR EXECUTIVE TEAM

14 APRIL 2020

Process to apply for mobile computing devices

- Wits University

This communique outlines the process through which students who require assistance with a loan device can apply.

MESSAGE FROM THE DEAN OF STUDENT AFFAIRS 

Dear Students

This communication follows the email that you received yesterday and will specifically outline the process through which students who require assistance with a loan device can apply.

COVID-19 is challenging us all to do things differently and to adjust to a “new normal”. We do this from very different circumstances. The University acknowledges these disparities and is doing all it can to ensure that our students are supported during this difficult time. As previously indicated, the remote online teaching and learning programme will start on 20 April 2020.

Whilst we have addressed the majority of the issues related to data access, we understand that some students still do not have access to devices appropriate for online and remote learning. We have thus secured a limited number of devices suitable for educational purposes that will be made available to students in need. Applications will be considered on a case by cases basis, and will take the needs of each applicant into account. These limited number of devices will be delivered to students in need.

Please note these are basic devices, will be on loan to students and will be charged to fee accounts. The charges will be reversed if the device is returned in good working order at the end of the academic year. Whilst we acknowledge that it may be difficult for some students to do so, we want to encourage those students who are able to, to continue their own efforts in securing an appropriate device.

Who may apply for a loan device?

  • Students registered for a full-time degree in 2020;
  • NSFAS funded and “missing middle” students with a family income of less than R600 000 annually. Bursary/scholarship funded students who have not received devices from their funders. (Please note that all information supplied will be verified); and
  • Students who do not have their own device, or who do not have access to a device.

Due to the challenges with delivery, regrettably only students residing within the borders of South Africa are eligible for this assistance.

Devices will be allocated in the following order of priority: final year undergraduate students, first year students, other undergraduate students and then postgraduate students.

Conditions

Devices will be made available on a case by case basis, and decisions are made on the basis of the information available and/or provided. In addition:

  • All devices must be returned by the end of the 2020 academic year. Where devices are not returned, students will be charged for the full cost of the device;
  • Where a device is damaged and/or lost, a student will be liable for the full repair and/or replacement cost of the device; and
  • Wits takes no responsibility for maintenance or the insurance of the device.

Application process

Students in need may approach their respective faculties for assistance, provide all the information required and note the conditions for assistance. Recommendations for assistance may also be made to faculties through student leaders (the SRC, school councils and class representatives) and the Division of Student Affairs, provided that all the relevant information is supplied. Incomplete applications will not be considered.

As the academic programme starts on 20 April 2020, those needing assistance are urged to apply through their faculties as soon as possible.

Students must make sure that they provide the following information:

  • A brief motivation (including proof of income, if possible);
  • Name and Surname,
  • Student Number,
  • Identity Document Number,
  • Year of Study,
  • Physical delivery address details (including province) on the application for assistance, including providing their up to date contact mobile numbers; and
  • Name and contact details of a next-of-kin, parent, or guardian (the University may contact the next of kin / parent/ guardian to verify information provided).

Applications are made through Faculties, via the details listed below:

Commerce, Law and Management: tshepiso.maleswena@wits.ac.za

Engineering and the Built Environment: FacultyRegistrar.EBE@wits.ac.za  

Health Sciences: Henda.VanDerWalt@wits.ac.za or Morne.Greyling@wits.ac.za

Humanities: help.humanities@wits.ac.za

Science: SSSC.Science@wits.ac.za

We hope that these loan devices will go a long way in supporting students in need. Online and remote learning will require some adjustment to your way of learning. It won’t be easy. Some mistakes will be made and lessons will be learnt. We will do our best to support you towards your academic success and the realisation of your dreams.

Stay safe!

Jerome September

Dean: Student Affairs

COVID-19 Update 23: Wits opens online on Monday, 20 April 2020

- Wits University

Wits will commence with emergency remote online teaching and learning from Monday, 20 April 2020.

Dear Students

We hope that you are all in good health.

As you know, Wits will commence with emergency remote online teaching and learning from Monday, 20 April 2020. Whilst many students are looking forward to starting the second teaching block, we understand that many of you may feel uncertain and anxious about learning online. We would like to reassure you that we are on hand to support you as we embark on this different learning journey together.

A phased approach to online learning

The academic programme will be introduced in phases over the next few weeks, so that you have time to adjust to the new learning environment. All lectures will be available on our learning management systems and can be downloaded at any time. If you are still waiting for your mobile computing device to be delivered or your data to be connected, do not despair – you can access your lectures and other resources from Sakai or Moodle as soon as you are connected. Whilst we will be resolute in our efforts to recover the lost elements of the 2020 academic year, we remain committed to you, our students who are an integral part of the Wits community.

Tests and assignments

No assignments or tests will fall due or be scheduled until the 4th of May 2020. These measures will ensure that students are not academically disadvantaged in any way.

Mobile Computing Devices dispatched

We are cognisant of the digital and related learning inequalities in our society and we are doing our best to ensure that we address your needs. Hundreds of mobile computing devices have been pre-loaded with the requisite software and have already been dispatched. Staff are working through this weekend to ensure that the remaining devices are pre-loaded and dispatched, so that they reach students on Monday or during the course of next week.

Zero-rated sites

Wits has negotiated with telecommunications service providers to have learning and library sites zero-rated so that you can access them at no cost to users. You may require R1 of data to be loaded before you access these sites: https://www.wits.ac.za/mywits/zero-rated-data-to-students-and-applicants/. (P.S. Zero-rating means that you are not charged when you access these sites.)

Access to data

The University has signed a contract with MTN to provide 30 gigabytes of data (10GB Anytime and 20GB Night Express) at no cost to you (Wits students) for one month, to kick-start your online learning journey. It is imperative for your mobile number to be updated on the student self-service portal if you wish to make use of this service, as these numbers will be provided to MTN.

Help is a click away

Please direct academic enquiries to your respective faculty as follows:

Commerce, Law and Management:

Undergraduate: Danie.Deklerk@wits.ac.za

Postgraduate: Deeksha.Bhana@wits.ac.za

Engineering and the Built Environment: Anne.Fitchett@wits.ac.za

Humanities:

Undergraduate: Heila.Jordaan@wits.ac.za

Postgraduate: Hugo.Canham@wits.ac.za

Health Sciences: Henda.VanDerWalt@wits.ac.za or Morne.Greyling@wits.ac.za

Science: SSSC.Science@wits.ac.za

ICT Helpdesk: Send an email to ithelp@wits.ac.za or log a query via https://witshelp-ism.saasiteu.com or visit www.wits.ac.za/mywits for details.

Let’s walk this journey together

Our academics and professional, administrative and support staff have worked tirelessly over the past few weeks to prepare to go online. We have galvanised our resources to support you over the next few months and your success is our priority. We accept that this is a new learning experience and that there may be some challenges, but we are on hand to solve them together. Please feel free to share suggestions on how we can improve emergency remote online teaching and learning over the next days, weeks and months.

Look after yourself and keep healthy and safe.

SENIOR EXECUTIVE TEAM

17 APRIL 2020

COVID-19 Update 24: How to access your data

- Wits University

Dear Students

ACCESS TO DATA – MTN and VODACOM

Yesterday we informed you that the University had signed a contract with MTN to provide 30 gigabytes of data (10GB Anytime and 20GB Night Express) at no cost to you (Wits students) for one month, to kick-start your online learning journey.

We are pleased to let you know that Vodacom came on board this morning with an equivalent offer and will provide details on this in the course of the next 48 hours.

MTN is  in the process of verifying information and will be activating the data before Monday morning. Please access the attached information for  MTN users to see how to check balances.

If you are using an alternative service provider you may wish to purchase a sim card and then get yourself on to either the MTN or Vodacom network. Please bear in mind that you would then need to update your cell number on the self-service portal. Your new number will only be relayed to MTN and Vodacom on Monday.

It is imperative for your mobile number to be updated on the student self-service portal if you wish to make use of this service. 

Please note that this offer runs for one month from 20 April 2020, so please use the data responsibly for educational and learning purposes.

Should you encounter any problems – please contact  the service provider in the first instance and then the University via ithelp@wits.ac.za or log a query via https://witshelp-ism.saasiteu.com  on Monday. 

SENIOR EXECUTIVE TEAM

18 APRIL 2020

COVID-19 Update 24: Data access: All four major mobile service providers on board

- Wits University

Students will get 30GB of data if registered on MTN, Vodacom, Cell C or Telkom.

Dear Students

Wits University is pleased to announce that you can now access 30GB of data (10GB Anytime & 20GB at night) if you are registered with any of the four networks - MTN, Vodacom, Cell C or Telkom. This service is at no cost to students. The offer is valid for one month starting on 20 April 2020, and should be used wisely for online learning and educational purposes. 

Here are some tips to maximise your data usage:

Streamline social media apps to save bandwidth. Visit https://wits-e.wits.ac.za/x/FZjd2e to find information on how to reduce data usage on YouTube, Twitter, Instagram and Facebook.

  1. Turn off automatic media downloads in apps such as WhatsApp
  2. Turn off auto play in video apps like YouTube
  3. When viewing videos, select low resolution options. High Definition (HD) videos use high volumes of data.
  4. Turn off automatic system updates and if possible, choose critical updates only. Schedule these to take place at night.
  5. Email documents in a zipped format but use email as a last resort. Content should rather be loaded on Moodle/Sakai where possible.
  6. Turn off cloud storage and syncing options such as iCloud.
  7. If your device has low data or data saver modes, activate them.

 Use the following links to streamline data usage on your devices:

Android devices

Tips on how to reduce data usage for Android devices.

Visit https://wits-e.wits.ac.za/x/FZjd2e and under the Android devices section find information on how to:

  • Turn on data saver mode
  • Turn on “Lite Mode” on Google Chrome for Android
  • Check your mobile data usage
  • Set mobile data usage warnings or limits
  • Set a data limit and automatically turn off mobile data
  • Turn mobile data on and off
  • Explore Android version and user guides

iOS Devices

Visit https://wits-e.wits.ac.za/x/FZjd2e and under the iOS devices section, find information on:

  • Tips on how to reduce data usage for iOS devices. These steps will vary depending on the model of the device that you are using as well as the version of iOS you have installed. Please refer to the online user manuals if your version isn't covered here.
  • Turning on low data mode
  • Limiting apps using data
  • Limiting background data usage
  • Turning off the iCloud drive
  • Turning off automatic downloads

We hope that these are helpful. We wish you all the best on your online learning journey. 

SENIOR EXECUTIVE TEAM 

19 APRIL 2020

[COVID-19 UPDATE 25] Wits VC wishes students well as online learning begins

- Wits University

Video: Professor Adam Habib wishes students well as they begin their online learning journey.

Habib speaks on social justice and the inequalities in our society and elaborates on Wits’ efforts to ensure that all students have access to mobile computing devices, access to data and free access to Wits’ library and learning management systems and sites.

He elaborates on the 5 000 laptops that are being delivered to students who are disadvantaged and the 30GB of data available to every Wits student (at no cost to students) on any of the four major networks for one month from 20 April 2020, in order to kick-start the online learning process.

Habib also explains why it is important to complete the academic programme and encourages students to rise to the challenge and to defeat the effects of the pandemic through online learning. He concludes by saying that Wits University is ready to support students and to walk this journey together.

Debunking 9 popular myths doing the rounds in Africa about the coronavirus

- Neelaveni Padayachee and Lisa Claire du Toit

Some of the false claims about coronavirus may be harmless. But others can be potentially dangerous.

In the second week of March the World Health Organisation (WHO) declared COVID-19 a pandemic. By mid-March the disease had spread rapidly in many countries around the world.

Governments are taking drastic steps, including the complete lockdown of cities, as well as extensive health interventions to try and stem the disease which is caused by a new coronavirus called SARS-CoV-2.

There is still a great deal that’s not known about SARS-CoV-2. This limited scientific information has contributed to a slew of myths and misconceptions. Some claims being made are harmless. Others can be potentially dangerous.

We have identified nine misconceptions doing the rounds on social media in Africa and set out to counter them. The purpose of debunking these myths is to provide people with trusted information. And to provide people with valid scientifically backed answers which they can share on social media to counter the misinformation and disinformation out there.

Myth 1: SARS-CoV-2 does not affect Africans

Across the continent rumours have been rife that the virus does not affect black people. This was fuelled partly by the fact that a Cameroonian student in China, who was among the first people to contract the disease, responded well to treatment.

But there is no proof that melanin protects black people from the coronavirus. There is also no scientific evidence that African blood composition prevents Africans from contracting the coronavirus.

This misinformation persisted even after the deaths of high-profile black Africans, such as legendary Cameroonian musician Manu Dibango, and Zimbabwean media personality Zororo Makamba.

This myth is not limited to Africa. Twitter has recently been abuzz with claims of African-Americans being immune to coronavirus

Myth 2: SARS-CoV-2 cannot survive in Africa’s warm climate

This myth arose after research, which hadn’t been peer reviewed, pointed to temperature having a role in the survival of the virus. One of the most widely quoted sources was John Nicholls, a pathology professor at Hong Kong university who said that “in cold environments, there is longer virus survival than warm ones”.

This claim, however, was not based on verified research. It was nevertheless seized on as proof that the virus cannot thrive in Africa’s warm climate.

According to the WHO, the virus can be transmitted to all areas, event hot and humid countries.

The only continent that has no cases of COVID-19 is Antarctica. This could change.

Myth 3: Spray alcohol and chlorine all over your body

Using hand sanitisers that contain 60% or more of alcohol has been found to kill the coronavirus. But, there has been a myth that spraying alcohol and chlorine will kill the virus.

Alcohol and chlorine will not kill the virus if it has entered the body already.

Spraying alcohol all over your body can be harmful, particularly to your eyes and mouth. Importantly, the alcohol in the sanitiser is not the same as the alcohol that people drink. The latter ranges up to 40% while hand sanitisers need to be 60% and above.

Myth 4: Drink black tea first thing in the morning

The media in Kenya have been reporting on false claims that drinking black tea first thing in the morning is effective against the COVID-19 disease.

This is untrue. There is no evidence to suggest that tea can protect a person from the virus. These claims can result in a sense of false security and can be dangerous.

World-renowned Cameroonian musician Manu Dibango’s death from coronavirus hasn’t stopped people claiming blacks are immune to it. EFE-EPA/Daniel Karmann

Coronavirus can be prevented by maintaining a safe social distance and washing your hands with soap and water for 20 seconds.

Myth 5: Pepper soup with lime or lemon flushes out the virus

The pepper soup myth has been circulating mostly in Nigeria.

Pepper has anti-oxidant, detoxification and antimicrobial properties. But, there is no evidence that it prevents or kills SARS-CoV-2. It is also a rich source of vitamin C, which helps maintain a good immune system.

Likewise, lemon and lime also contain high amounts of vitamin C. But there is no evidence to support the claim that they flush the virus out of an infected person’s system.

Myth 6: Steam your face with and inhale neem tree leaves

There have been claims, mostly in Ghana, that steam therapy with neem can prevent COVID-19. What we know is that according to ayurvedic medicine experts, neem can assist in strengthening the immune system and prevent viral infections.

Neem is known to exhibit immunomodulatory, anti-inflammatory, antihyperglycaemic, anti-oxidant and anticarcinogenic properties. But, the Centres for Disease Control and Prevention has emphasised that there is no clinical evidence to suggest that steaming and inhaling with neem will prevent coronavirus.

Myth 7: Vitamin C tablets prevent COVID-19

Vitamin C is a known anti-oxidant. It prevents damage to tissue in the body by neutralising free radicals, which are charged particles that cause damage to cells and tissues and result in inflammation. Vitamin C is also known to protect against pathogens.

But there is no proof that vitamin C can prevent one from contracting COVID-19 though there are trials being undertaken on the use of vitamin C among COVID-19 patient. None has provided conclusive proof.

Myth 8: Having had malaria makes one immune

There have been several social media posts that suggest that malarial endemic countries have a decreased risk of acquiring new coronavirus cases.

There is no evidence to support this.

Malaria – which is caused by a parasite and is transmitted from the bite of an infected Anopheles mosquito to humans – used to be treated with the drugs chloroquine and hydroxychloroquine. These have been used, respectively, as an anti-malarial and as an auto-immune disease drug for inflammation.

The over-hyping of chloroquine has led to worldwide shortages and resulted in people self-medicating. Experts have warned that high doses of the drug are toxic.

Myth 9: The flu injection will protect you

The fact that health practitioners encourage people to vaccinate themselves against the flu, might have led to the mistaken view that the flu shot protects against the new coronavirus.

No, it does not. The flu vaccine is only effective against the influenza virus – and even then against only some flu viruses.

Humans have been known to be affected by six coronaviruses, four causing the common cold. The other two were the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2002 and 2012, respectively.

Now there is a seventh coronavirus, the SARS-CoV-2.

There is no scientific evidence that a flu shot can protect people against coronaviruses.The Conversation

Neelaveni Padayachee, Lecturer, Department of Pharmacy and Pharmacology, University of the Witwatersrand and Lisa Claire du Toit, Associate Professor, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

South Africa is bent on austerity and should change track

- Dr Gilad Isaacs

The South African government should be spending more, not less, to boost economic growth and create jobs.

As government, economists, activists, business leaders and the public debate the size and scope of government support to the COVID-19 hit economy, it is worth asking a simple question: what is the impact of government spending?

This forms part of a wider debate over whether South Africa should continue on the path of austerity – cutting expenditure with the aim of reducing debt – or undertake a fiscal stimulus – spending with the aim of growing the economy.

Recent research by Professors Enno Schröder and Servaas Storm from Delft University of Technology throws useful light on this question. The research was prepared for the Institute for Economic Justice’s on-going research into the viability, scope and nature of an appropriate fiscal stimulus for South Africa. The research was undertaken before COVID-19 hit. It is even more relevant now.

The research shows that for every R1 billion government spends, gross domestic product (GDP) increases by R1.68 billion and 6,900 jobs are created. This means that spending 6% of GDP, R305.6 billion, would increase GDP by R513.4 billion and support the creation of 3,542,460 jobs.

Thus government spending is able to grow the economy, to the extent that it could lower the debt-to-GDP ratio. It also shows that additional government expenditure could sustain the economy through the current crisis period.

Does the economy have room for expansion?

An economy’s ability to grow can be constrained by factors that limit its ability to produce goods and services – “supply-side” factors like poor infrastructure or a lack of education. It can also be constrained by a lack of funds to purchase the goods and services it does produce – “demand-side” factors.

The International Monetary Fund and South Africa’s national treasury argue that the country’s poor growth performance over the past decade is due to supply-side factors. These include infrastructural bottlenecks in electricity generation and supply, over-regulated (formal) labour markets, and increases in product market concentration (as seen in rising profit mark-ups).

The IMF and treasury therefore support budget cuts, labour market deregulation and tax cuts, all of which purportedly will promote private-sector led and inclusive growth.

Here the assumptions lead to the conclusions obtained. If the South African economy is assumed to be supply-constrained then naturally only supply-side interventions such as lowering labour costs will enhance growth. If this is the case, so the argument goes, then fiscal stimulus, which aims to raise demand in the economy, is a blunt tool, providing little opportunity for economic revival.

But this does not factor in the room for economic expansion that clearly exists.

According to the country’s statistics agency, Stats SA, utilisation of production capacity – the capacity of the economy to produce goods and services, for example, through factory output – is on the decline. Between 2018 and 2019, production capacity declined by 2%, with eight out of ten manufacturing sectors showing a decrease.

At the same time, unemployment is unconscionably high, at 29.9% in the last quarter of 2019, and inflation is falling, now below the middle of the South African Reserve Bank’s target range.

It is true that infrastructural shortages such as expensive internet or inefficient rail transport can constrain economic performance. But targeted fiscal expansion – investment in free broadband or investment in rail freight services – can remove these bottlenecks and expand supply capacity, while also boosting demand.

South Africa’s fiscal multipliers

The impact of fiscal expansion (and fiscal consolidation) is ultimately determined by the size of the fiscal multiplier. A fiscal multiplier measures the impact that each additional rand of government spending would have. Schröder and Storm estimate both the “income multiplier” – the impact of spending on GDP – and the “employment multiplier” – the impact of spending on employment growth.

In their first estimation, increasing demand in the economy (via government spending) will initiate additional production. That will require more labour input (a direct effect). The higher demand for labour services will increase labour income. This will cause higher consumption spending in a particular industry (an indirect effect) and in connected industries (an induced consumption effect).

The results of this first technique indicate that a fiscal stimulus of R1 billion will raise South Africa’s GDP by R1.5 billion and create 6,100 jobs. This is in line with previous studies using this technique.

In their second estimation, they include an induced investment effect. This refers to a change in output, income and employment that would come from firms investing a fraction of the additional profits earned in supporting industries.

For this technique, the estimated income multiplier shows that R1 billion increases GDP by R1.87 billion and generates 7,700 jobs.

The authors prefer an average of the two techniques, showing that a fiscal stimulus of R1 billion will generate R1.68 billion extra income and create 6,900 new jobs. This is because the first technique leaves out investment effects, but the second overestimates these because the data does not distinguish between private-sector and public investment.

These figures allow us to calculate the impact of different levels of additional government expenditure. Increasing spending by 3% of GDP, or just over R150 billion, leads to an expansion of GDP of just over R250 billion and almost 1.8 million jobs. Spending of 6% of GDP (just over R300 billion) leads to over R500 billion in additional GDP and 3.5 million jobs, and spending of 10% of GDP leads to an increase in growth of just over R850 billion and also 6 million new jobs.

Yet the path that the South African government has chosen is to reduce rather than increase government expenditure.

Fiscal consolidation and growth

South Africa’s 2020 budget proposes, over the next three years, tax relief and rebate measures combined with reductions in public spending of approximately R48 billion (when taking account of both government cuts and increases, and comparing these to what an inflation-based increase would be). The argument goes that austerity will help revive the stagnating South African economy and kick-start economic growth by inspiring “confidence” in the business sector and global financial markets and contribute to the sustainability of public debt. This is the conventional wisdom.

Another view has it that austerity has in fact contributed to the slow growth of the South African economy and to the growing income inequality experienced in the 2010s. Schröder and Storm argue that continued fiscal tightening is counter-productive to the aim of raising the country’s long-run growth performance.

In fact, the multipliers above suggest that the proposed cuts in public expenditure, of R48 billion, will likely reduce South Africa’s GDP by R81 billion over the next three years 2020-2022. This amounts to a decline in GDP growth of around 0.5 percentage points, accompanied by the likely destruction of around 330,000 jobs.

The 2020 austerity budget is socially and economically destructive.

The present moment

The present context has made the picture more complicated, but this analysis even more essential. It has become clear that the economic fallout from the COVID-19 pandemic, and measures taken to stop its spread, will be massive. The economy could shrink by as much as 8.3%, some estimates show. This calls for bold interventions by government.

These interventions will not take the path of a traditional economic stimulus as the lockdown and associated measures purposefully attempt to slow the economy. Rather, the economy is being put on life support.

This life support must ensure that a viable economy still exists when the spread of COVID-19 is eventually contained. This will require an unprecedented increase in government spending. It’s therefore essential to know how effective each rand of government spending will be in sustaining GDP.The Conversation

Dr Gilad Isaacs, Co-Director, Institute for Economic Justice, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 risks forcing SA to make health trade-offs it can ill afford

- Karen Hofman and Susan Goldstein

South Africa could lose many children due to a measles outbreak which is completely preventable.

South Africa’s health authorities are testing, quarantining and treating individuals who have been exposed to the new coronavirus. And the country is in lockdown in an attempt to slow the spread.

Much has been said about balancing the economic trade-offs with the lives the country needs to save versus the social and economic costs of doing so. Less discussed are the trade-offs being made within health care as services are focused on COVID-19.

Child health is of particular concern. South Africa has 5.8m children under 5 years of age. This group appears to be less susceptible to COVID-19. But, if the country doesn’t pay attention, the death rate for these children will soon increase.

The reason for this is measles, a highly contagious disease that mostly affects children under the age of 5. The basic reproductive number of measles in a susceptible population is between 12 and 18. This means that on average every person with measles will infect between 12 and 18 people. While we don’t know with certainty, the reproductive number of symptomatic cases of SARS-CoV-2 is thought to be between 2 and 3.5.

Measles remains a threat in countries across the world despite the fact that a safe and effective vaccine has been available since 1963.

Most measles-related deaths are caused by complications. The most serious includes brain swelling, severe diarrhoea and related dehydration, pneumonia, blindness and deafness. Severe measles is more likely among poorly nourished, young children. With 27% of the country’s children either stunted or wasted, any relaxation of the vaccination regime would place them at high risk of severe disease.

As it is, the country’s isn’t achieving its 91% immunisation target. The global target set by the World Health Organisation is 95%. South Africa’s vaccination regime involves providing the first measles vaccine at 6 months, the second dose at 12 months.

The danger is that health workers will be diverted to other tasks related to COVID-19, further compromising immunisation. This could well mean that South Africa will lose many children due to a measles outbreak which is completely preventable.

The measles threat

Previous research on the impact of measles catch-up campaigns on routine immunisations in 2010 can help inform the country’s thinking. These campaigns – or supplementary immunisation activities – required the mobilisation of a large health workforce from within health system.

This had a severe effect on the delivery of health. For example, the research showed that during a three week campaign in 52 districts in 2010 there was a 30% decrease in children completing the primary course of immunisation. In addition, there was a 10% decrease in antenatal visits and a 12%-17% decrease in use of injectable contraceptives.

The COVID-19 epidemic has resulted in the provision of only “essential” health services in some provinces. If routine immunisation is not classified as an essential service there will likely be severe consequences.

In particular, measles will start rearing its ugly head and children will die needlessly. This has occurred in pockets all around the world as a result of campaigns run by parents who refuse to have their children vaccinated. Globally there were 140 000 deaths in 2018 – all avoidable.


Read more: Explainer: a history of the measles virus and why it's so tenacious


The South Africa government should urgently put in place a plan that can be implemented once the lockdown is over. It should, for example, consider opening schools or day care centres as sites for immunisations. The campaign could use a mobile – information providing cell phone application called Mom Connect to send messages to those caring for children under 2 asking them to bring them to the chosen sites. School nurses together with a volunteer corps of retired doctors and nurses could administer vaccines.

Additional trade offs

The country risks making other health trade offs too.

South Africa is still in the midst of an HIV epidemic – with 7.9 million people infected. Some 2 million, however are not on treatment, which puts them at high risk for COVID-19

An important lesson the country has learnt about the HIV epidemic is that prevention is critical. And that it needs to be started early (in the epidemic and in life) and needs to be continued for decades. This lesson has not yet been extended to health overall and health literacy for the whole population is a critical base on which to engage a population when it comes to an epidemic.

South Africa has other areas of vulnerability when it comes to health. The country lags behind other comparable developing countries. We don’t achieve “a good bang for the buck” in terms of health. Peer countries such as Thailand and Brazil spend less on health and achieve better outcomes. For example, under 5 mortality in Brazil is half of South Africa’s 32 deaths per 1000 live births.

The danger is that these statistics will get worse as a result of efforts to curtail COVID-19.

Other areas of concern are the growing burden of obesity-related disease such as hypertension, diabetes and common cancers, diseases related to tobacco use and alcohol misuse. Over the past two decades South Africa has not maximised cost effective investments in preventing and treating these conditions.

This means that millions of South Africans are now more vulnerable to COVID-19.

What needs to be done

South Africa needs to begin with prevention of disease and promoting health by focusing on risk factors, many of which are in sectors other than health. These include inequality and poverty, access to clean water and sanitation, healthy nutrition, alcohol and tobacco control.

Without this we will be even less prepared for the next pandemic.The Conversation

Karen Hofman, Professor and Programme Director, SA MRC Centre for Health Economics and Decision Science - PRICELESS SA (Priority Cost Effective Lessons in Systems Strengthening South Africa), University of the Witwatersrand and Susan Goldstein, Associate Professor in the SAMRC Centre for Health Economics and Decision Science - PRICELESS SA (Priority Cost Effective Lessons in Systems Strengthening South Africa), University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus myths: Lessons from an AIDS study

- David Dickinson

Attempting to defeat these folk theories with science achieved little; the myth busters of the AIDS epidemic talked past those they were trying to convince.

The coronavirus pandemic is accompanied by what the World Health Organisation describes as an “infodemic” – misinformation, disinformation or conspiracy theories: “coronavirus myths”. These circulate on social media and are further disseminated by influencers, the click-bait infotainment “penny dreadfuls” of the internet, mainstream media which repeat them for audiences to shake their heads at the apparent credulity of others, and some world leaders.

In response, myth-busters attempt to squash coronavirus myths. The modus operandi is to report the myth and then rebut it with science, medical research and expert opinion. The problem with this approach is that science, medicine and experts are, for now, handicapped. There is no vaccine and they have no other easy solution to offer. Given this, alternative explanations are bound to emerge.

All epidemics are accompanied by what leading academic Paula Treichler described, in the context of HIV/AIDS, as epidemics of signification. The key difference with the internet is that contestation over the disease is easier to access.

But, just as in the early years of HIV/AIDS, science is once again on the back foot. This means that today’s batteries of myth busters will be just as ineffective as their pre-internet predecessors.

In 2008 and 2009, before residents in South Africa’s townships – where much of the poor and predominantly African population lives – had significant internet access, I conducted an action research project with working class HIV/AIDS peer educators to investigate and combat the many non-scientific explanations of HIV/AIDS .

The project took seriously the HIV/AIDS myths that the peer educators were encountering. In doing so we were able to gain insights into the origin of these myths and why they were so durable in the face of public health campaigns. As an action research project we used these insights to develop responses based not on repeating scientific information, but on messages that would resonate with beliefs and ideas within the communities of the peer educators. I believe there are lessons here for the current coronavirus pandemic.

Insights

One myth doing the rounds at the time was that whites created AIDS to control the African population. This had circulated for decades despite sustained public health messaging.

Then, as now, science was on the back foot, with no cure for the disease.

I came to see these alternative explanations not as myths, or nonsense, but folk theories which, in the minds of many, were legitimate alternative explanations to that science. Along the lines of the explanation provided by Hungarian philosopher of mathematics and science Imre Lakatos of scientific research programmes, these myths about the disease were “auxiliary theories” linked, within the South African AIDS epidemic, to a trinity of “core ideas”: a belief in God, racial oppression, and traditional African beliefs.

Attempting to defeat these folk theories with science achieved little; the myth busters of the AIDS epidemic were talking past those they were trying to convince.

Convincing people to follow public health responses is much easier when the peril can be seen. But with AIDS the long incubation period, and stigma, hid the disease. One of the challenges with COVID-19 is that someone can be infected, but not show symptoms. And once they are visible the opportunity for effective public health responses in poor and crowded communities is compromised.

A different approach

Rather than repeating accurate, but ineffective, public health messages over HIV/AIDS, I worked with peer educators on alternative ways of shifting attitudes.

We identified HIV/AIDS folk theories circulating in their communities and ran workshops designed to develop stories, sketches and parables in local idiom that could counter these in easy to grasp and engaging ways. For example, to the belief that God could cure AIDS and that antiretroviral treatment was unnecessary, they developed the story of a man who encounters a lion and, kneeling to pray, pleads with God to save him. The lion devours him. The message? He should have run and asked God to help him run faster. The lesson? Take antiretroviral drugs and pray that God will keep you healthy.

Verifying the impact of specific interventions aimed at behavioural change within the complex reality of an epidemic is all but impossible. Nevertheless peer educators reported the interventions positively, and said that they helped them move from previous efforts too often limited to “preaching to the choir”.

As the coronavirus pandemic unfolds so too a matrix of folk theories, reflecting deep beliefs, fears and concerns, is becoming visible. These include xenophobia, nationalism, new technologies, surveillance, and distrust of global elites.

These folk theories resonate with people whose trust in science or experts is, at best, conditional. Confronting them with science in an attempt to overcome resistance to public health measures and social distancing practice will have limited impact.

An approach that reaches beyond “the choir” is needed.

Next steps

Front-line health and community workers should be linked to storytellers, comedians, directors, scriptwriters and others to develop, in local idiom, easy to understand messages about the virus and preventative behaviour in entertaining and catchy formats. These should, indirectly, be aimed at countering the impact of identified folk theories and promoting behavioural change, not in headlong, hectoring attacks but using softer power and where possible acting in tactical unity, as with The Man Who Met A Lion.

The HIV/AIDS peer educators had to slip their stories and parables one by one into ongoing, real-time conversation. Today, the outputs from collaborations could be inserted into social media networks, to “fight fire with fire”. They could be released as amateurish-feeling and unbranded video clips, voice messages and memes.

The degree to which these were forwarded, and effective, would depend on how arresting and entertaining they were.

Such a response will not solve the increasingly recognised cause of the pandemic’s ferocity on precarious individuals and groups. But it would provide a low-cost, complementary approach to mitigate the impending catastrophe in poor communities.The Conversation

David Dickinson, Professor of Sociology, University of the WitwatersrandThis article is republished from The Conversation under a Creative Commons license. Read the original article.

South Africa needs a post-lockdown strategy that emulates South Korea

- Alex van den Heever, David Francis, Francois Venter, Imraan Valodia, Lucy Allais, Martin Veller, Michael Sachs and Shabir Madhi

South Africa cannot afford to embark on a strategy of extended periodic lockdowns. It needs to shift to mass testing and contact tracing.

What strategy should South Africa follow to contain the outbreak of the SARS-CoV-2 virus after the current 35-day lockdown? Any strategy should be informed by the trajectory of the disease, the effectiveness – or otherwise – of the current lockdown and how the particularities of the country will interact with the virus. These include high levels of HIV infections and the complexities of social distancing in lower-income neighbourhoods.

It must also be informed by economic considerations as these have their own, real impact on public health. South Africa has this far relied exclusively on epidemiological criteria for ending the lockdown.

What is clear is that the lockdown has an extremely high economic cost. The country should be looking to alternatives that will be less costly and also more effective in the long term at protecting its communities, its health system and its economy.

We have developed a model that draws on the experiences of other countries, particularly South Korea. We argue that South Africa needs to urgently prioritise its mass testing and contact tracing capacity, which gives it the best chance of saving the nation’s health and economy.

The cost of this programme, even at its most expensive, would be a tiny fraction of the costs of a prolonged lockdown. The South Korean programme had the benefit of attacking the epidemic when it was still small and containable. South Africa retains this advantage over the worst hit European countries. The question now is how to effectively use the time under lockdown to ensure that it is able to contain the spread of SARS-Cov-2, manage the health risks and minimise the economic costs.

Early responses

The implementation of the country-wide lockdown on 27 March 2020 was timeous and necessary. It bought the country valuable time to increase its testing and contact tracing capacity, and to prepare its health system. But South Africa’s initial response to the emergent epidemic in Wuhan, China, in January 2020 was similar to much of the rest of the world – watchful waiting but, with hindsight, perhaps insufficient contingency planning.

South Korea is a notable exception. Due to its experience of the MERS outbreak in 2015, it was better prepared. Instead of embarking on a total lockdown, the country had a more nuanced approach by enforcing, with citizen buy-in, extensive social distancing coupled with scaling up of other preventative and precautionary measures.

Crucially, at the centre of that strategy is aggressive screening for the SARS-CoV-2 infection and isolation of infected individuals, and the tracing and quarantining of their contacts. This enabled South Korea to keep a substantial proportion of its economy open. It did, however, rapidly close its borders, thereby minimising imported infections.

Mass testing and contact tracing work best when the epidemic is still at a relatively low level. This is because the reproduction rate of the disease, often referred to as R or Ro, is so high that a country needs only to be off guard for around two weeks before effective public health intervention options seriously narrow.

Roughly speaking, the R for SARS-CoV-2 is estimated to be about 2.5 every four days. That is, one person infected by the virus infects approximately another 2.5 people over a period of four days. That may not appear fast – but at that rate everyone in this country will get infected within the space of a couple of months, if no prevention to reduce this infection rate is implemented.

Where transmission of the virus becomes widespread, at the community level, the scale of the infections severely limits the effectiveness of mass testing and contact tracing. This is because the infected population is so widespread and growing all the time, while many of those infected are asymptomatic – by some estimates up to 80%.

The only option then is to drag the infection rate down to manageable levels by severely limiting the movements of the population for a period of up to two to three months – a generalised and long-term lockdown.

Mass testing and contact tracing

South Africa’s saving grace is that it implemented the lockdown at a much earlier stage of the epidemic than many other countries. At that point most new infections were those who had returned from international travel and at the time it seemed that community-based infections were confined to the affluent population.

As the country then did not have the capacity to undertake mass testing and contact tracing, precious time was bought with a lockdown that was gradually scaled up. But it came at a very high economic cost.

We have developed a COVID-19 intervention model which is able to analyse some possibilities for the course of the epidemic, and to assess possible responses and costs. Models are a useful and effective tool (although of course not infallible), under conditions of uncertainty, for providing us with an informed and systematic way to compare the impact of a range of policy interventions.

We estimate that if South Africa were to rely exclusively on lockdowns to keep the epidemic under control during 2020, approximately 192 days of lockdown would be required, divided into three episodes. This is because the epidemic is likely to resurge the moment any lockdown is removed unless there are strong public health interventions in place. These interventions include testing at scale, isolation of infectious cases, and high levels of tracing and quarantine of their close contacts.

The cost of lockdown

Given that the lockdown effectively closes down both the supply and demand sides of the economy, the loss of gross domestic product (GDP) is nearly complete – by our estimates roughly R13 billion per day. Over 192 days, the loss of GDP is of the order of R2.5 trillion – almost 50% of GDP.

The lockdown strategy will clearly lead to an economic collapse of a magnitude that will impact health, lives and livelihoods. This is why it is so important that the next stage in the country’s COVID-19 strategy is informed by both health and economic considerations because the two are so tightly intertwined. It would be a grave mistake to rely only on epidemiological factors and ignore the looming economic catastrophe and its dire impact on public health.


Read more: South Africa needs to end the lockdown: here's a blueprint for its replacement


Our projections are based on South Korea’s successful prevention strategy of mass testing and contact tracing. Early evidence shows this is also working in Hong Kong. If successful, this strategy reduces the probability of having to resort to repeated and extended generalised lockdowns. Lockdowns would only need to be implemented selectively if localised outbreaks were identified and could be contained.

The opening of the economy would, however, still be subject to:

  • continued social distancing;

  • strict implementation of health protocols for employers;

  • ongoing self-isolation of high risk groups; and

  • measures to mitigate the risk of viral spread in the country’s mass transport systems.

It would also require very careful systems and support to manage risk and spread within health care facilities.

At the South Korean levels of testing of around 17,000 per day, the annual cost of this strategy would be around R5 billion. At 36,000 a day (the Department of Health target for 30 April), this grows to R10.5 billion. At the target set by the UK of 100,000 per day, the cost would be R29.2 billion per year. This is cheap if it is considered that these annual costs represent respectively 0.4, 0.8, and 2.2 times the single-day cost of a lockdown.

A programme of mass testing and contact tracing is challenging, particularly in the South African context. The persistence of spatial apartheid, and a large number of multigenerational households, and concerns about our state’s capacity, mean that South Africa faces a number of challenges not present in South Korea.

Despite these risks, South Africa cannot afford to embark on a strategy of extended periodic lockdowns. It is critical that the capacity for mass testing and contact tracing is in place prior to the end of this lockdown. The country’s health system must be given every support to ensure its success.The Conversation

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; Francois Venter, Professor and Deputy Executive Director, Wits RHI, 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; Lucy Allais, Professor of Philosophy, University of the Witwatersrand; Martin Veller, Dean of the Faculty of Health Sciences, University of the Witwatersrand; Michael Sachs, Adjunct Professor, University of the Witwatersrand, and Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Tackling gender-based violence during lockdown

- William Gumede

Women and children face even more alarming levels of abuse due to COVID-19 lockdown.

The Covid-19 emergency package of government fails glaringly to provide protective measures to save vulnerable women and children from violence and abuse during the lockdown and the follow-on lockdown.

The lockdown may have been effective so far in slowing the spread of Covid-19, but confining people to homes raise the specter of all ready alarming levels of violence and abuse against women and children, to explode to terrifying levels.  

South Africa already has among the highest levels of violence and abuse against women and children per capita outside war zones.

The “cabin fever” phenomenon, whereby long isolation leads to fear, anxiety and a sense of powerlessness could increase the incidents of violence against women and children.

In addition, the Covid-19 related economic downturn, business closures and looming unemployment, increasing fear, stress and anxiety and stress, which can often result in men taking out their frustrations against women and children.

Moreover, because of inequality, most men are still the major or only income earners, which means abused partners are often financially dependent on their abusers. 

The movements of vulnerable women and children during the lockdown are restricted, like everyone else, so they cannot easily leave violent or abuse households or seek help. The restrictions of movement during the lockdown also constrains the reach of civil society organisations dedicated to fight violence and abuse against women and children.

Sadly, the army and the police, 26 years since the end of apartheid are still stunningly poorly trained, sensitized or emphatic to deal with violence against women and children.  In fact, many of their members often perpetrators of violence and abuse against women not only within their own ranks, but against the very same vulnerable women and children they are supposed to protect.

Incidents of domestic violence and abuse in many other countries have also dramatically increased during lockdowns.

United Nations Secretary General Antonio Guterres in a video message posted on Twitter this week warned about a “horrifying global surge” in domestic violence during the Covid-19 crisis.  “We know lockdowns and quarantines are essential to suppressing Covid-19. But they can trap women with abusive partners,” he said.

The South African Police Services said it had received 87 000 gender-based violence calls during the first week of the lockdown.

The French government this week for example approached hotels to have women victims of violence to stay in vacant and for the state to pay for it during their Covid-19 lockdown. Some countries have created pop-up counselling centres at retail stores, pharmacies and other essential service points for women who are experiencing violence and abuse.

The UK this week released a £750million Covid-19 emergency funding package for charities and civil society organisations, including those work with women and children victims of domestic violence and abuse. Australia released US$100million for support services to combat Covid-19 related domestic violence and abuse.

Brazil, like South Africa, has high levels of gender inequality and gender-based violence, has given women money directly, to empower them, by providing a basic income grant of US$125 over three months over the period of their lockdown. India, another developing country with high levels of gender inequality and gender-based violence has paid cash amounts to vulnerable women with bank accounts who are already linked to a government backed financial inclusion programme to empower them; and food parcels are directly given to women.

In South Africa, the police and army patrolling the streets to enforce lockdown must be given instructions to listen to women and children complaining about abuse. Off course, it goes without saying the police and the army should not themselves be perpetrators of violence and abuse against women and children. Prosecution of perpetrators of violence and abuse against women must be swift; with special courts set up if necessary.

Retailers, pharmacies and other essential services could serve as pop-up counselling centres. Funds must also be set aside to support victims of violence and abuse during the Covid-19 lockdown period. As part of the emergency economic measures, civil society organisations dealing with abuse against women and children should get special funding during the lockdown to continue what they do. Food vouchers that can be used at retail stores or food parcels which can be distributed by the army, must be given to all those in need. A basic income grant to all indigent will make them less dependent on men during the Covid-19 lockdown.

Hotlines, shelters and legal assistance for victims of gender-based violence must not only remain open, but should be generously resourced. Individuals who can, must volunteer to help at hotlines and shelters and provide financial, legal and accommodation assistance. Telecommunications companies such as Telkom, Vodacom and MTN, could make a simple key or function available on mobile phone platforms, similar to if one wants to dial for airtime or data, which serves as free hotline to report violence and abuse against women and children.

William Gumede is Associate Professor, School of Governance, University of the Witwatersrand; and author of Restless Nation: Making Sense of Troubled Times (Tafelberg). This article was first published in the Sunday Times. 

If you think lockdown is bad, spare a thought for SA’s prisoners

- Nkateko Mabasa and the Wits Justice Project (WJP)

How more restless are those living in prison and confined to a small cell, who are now completely cut off from the outside world and their families?

A “stay at home order” means different things to different people living in South Africa. Confined to our homes, we are now experiencing the restlessness that comes with being held in one place. Some are restricted to their small apartments, while others are in crowded shacks and lucky few have a piece of land. For the most part, we are locked in with loved ones and have some access to the outside world.  

For the 164,000 or so prisoners in South African prisons, on the other hand, a coronavirus lockdown is a different experience. The four walls of a prison cell are small, and in South Africa’s case, the cells are often overcrowded. 

The Judicial Inspectorate for Correctional Services (JICS) – a prisons oversight institution – in its annual report, noted that the prison population remains overwhelmingly overcrowded with a national bed space of a little under 120,000 across the 243 facilities nationwide, leaving more than 45,000 inmates without proper accommodation. 

On 20 March 2020, five days after President Cyril Ramaphosa announced the National State of Disaster, the Minister of Justice and Correctional Services, Ronald Lamola, announced, at a media briefing in Pretoria, the measures that the department was “currently implementing in all centres to protect offenders”.

 

These included sanitising and cleaning strategic areas across all centres, availing basic hygiene essentials to offenders and officials, distributing essential equipment such as gloves and masks, and “disinfecting keys and shackles”. And more stringently, prohibiting prison visits by family members and friends as well as suspending the parole boards. 

The Department of Correctional Services (DCS) would also be “identifying isolation areas in all our centres,” added Lamola.

So far there have been 94 cases of Covid-19 recorded within correctional services facilities, half of which are inmates. Most of these cases are concentrated in one facility. Of the confirmed Covid-19 cases, 87 are at the East London Correctional Facility for Women and six are spread out across St Albans in Eastern Cape, Worcester Correctional Facility in the Western Cape, Kutama Sinthumule Private Facility in Limpopo and Warm Bokkeveld in the Western Cape. The DCS head office in Pretoria has recorded one case from a staff member. 

Nationally, as of Monday 20 April, there were 3,158 confirmed Covid-19 cases and 54 people had died of the virus. While most people are able to self-quarantine at different homes, according to the justice minister, “infected prisoners” have “been placed in single cells on a separate quarantine site” of the prison. 

This raises questions of whether this will not infringe on the UN Mandela Rules’ basic standards for the humane treatment of prisoners where prison isolation can be torturous

Only after the National Institute for Communicable Diseases (NICD) conducted a mass screening at the East London centre on 8 and 9 April, was the DCS able to get a full grasp of the spread of the virus. However, according to Professor Salim Abdool Karim, a clinical infectious diseases epidemiologist, who spoke to Newzroom Afrika it takes about two weeks for an infected person to show symptoms. He said the confirmed cases so far are infections that occurred two weeks prior to testing, so the real current figures could be higher.

During a prison visit to the East London Facility for Women, on 12 April, Lamola remarked how the spread of the virus initially began with a prison official “who tested positive” after having “attended a funeral where she interacted with people from overseas”. And when she came back to work, she came into contact with “30 officials” who were subsequently requested to self-quarantine while waiting for their test results. 

On the outside, suspending basic civil liberties on the population to combat the pandemic might be frustrating to most citizens, but it is an entirely different matter from the more drastic change of daily routine for prison life. According to Africa Check, “problems plaguing SA prisons” include overcrowding, a lack of accurate prison data and transparency, the prevalence of infectious diseases such as TB, and human rights violation such as assault, torture and isolation. 

Further precautionary measures to combat Covid-19 include the restriction of access to the courts, court precincts and justice service points and limiting the number of persons entering court buildings. And the number of trials are limited to urgent matters only. Concurrently, there are more than 46,000 inmates in remand awaiting trial. 

These restrictions, although meant to protect prisoners, infringe on the rights of those waiting to argue their case in court. The high numbers of those awaiting trial, coupled with limited court functions during the lockdown mean that those in remand face longer periods in remand and risk exposure to the coronavirus while locked up.  

Remand centres are a hotbed for respiratory illness transmissions. Most overcrowding in prisons happens in remand centres. In 2016, Sonke Gender Justice and Lawyers for Human Rights launched a court challenge against the “inhumane conditions suffered by detainees awaiting trial in Pollsmoor Remand Detention Facility”, after an inmate contracted TB. 

Lawyers for Human Rights found that as of “24 October 2016, Pollsmoor Remand was operating at around 249% capacity”. According to Africa Check, after the Western Cape High Court ruled the conditions at the Pollsmoor prison unconstitutional, the department was able to reduce prison overcrowding to 149% – which is still uncomfortably high. 

And although DCS has so far achieved an 83% TB cure rate within its facilities, the lockdown regulations will disrupt any programmes to stop TB infections amid overcrowding. These conditions – the lack of social distancing space and prevalence of a respiratory disease – are the perfect breeding ground for the spread of Covid-19, and substantially increase the numbers of those who are at risk of developing life-threatening complications from the virus due to weakened immune systems.

Any efforts to combat the pandemic in South Africa’s prisons will mean a serious disruption to the already limited prison infrastructure and further limits to the few privileges offenders are afforded on their journey to rehabilitation. It begs the question then, is DCS not one step behind the pandemic’s spread inside prison facilities? And is adequate personal protective equipment afforded not only to the prison officials but to the prisoners also?

Before any cases were discovered in the East London prison, the Department of Correctional Services had initially stated that:

“DCS reassures all officials that care for our staff remains one of our highest priorities. Every precaution is being taken to safeguard the department against the coronavirus and to ensure a safe working environment. This includes provision of the necessary tools to prevent the spread of the virus, and increasing protection in the workplace.”

The prison official who exposed inmates and other officials at the East London Correctional Female Facility subsequently became a super spreader – where one person spreads the virus to large groups of people at different social events and work space. And for prisoners, whose daily lives are dependent on their routine interaction with prison officials, the DCS is their only recourse for safety from the virus within the prison facilities.   

At the St Albans facility, 85 officials are waiting for their results. And at Worcester Correctional Facility, DSC is still conducting contact tracing. While this is going on, those who are under the care of the state for rehabilitation are stuck together with infected individuals in overcrowded cells and have to interact, daily, with prison officials.

Further compounding the issue, the Judicial Inspectorate for Correctional Services, the institution responsible for carrying out prison oversight, has suspended all its prison visits during the lockdown. JICS has to, during the lockdown, depend on the department it is supposed to oversee for information regarding prison conditions. Without proper oversight, it’ll be difficult to know whether DCS is indeed complying with safety standards and preventative measures.

There have been recent reports, by Daily Dispatch, about prison officials feeling neglected by the DCS because they have not been provided with proper protective gear. Those who have tested positive for C0vid-19 report being told to self-quarantine at home or at a DCS guesthouse. The Eastern Cape-based media outlet reports that officials feel like they “have been left to die” by the Department of Correctional Services. 

Further reports include a large crowd of prisoners in the Mdantsane Prison, in East London seen playing soccer outside in contravention of the lockdown regulations. It is understandable, of course, how hard it must be for those already living in prison to stick to the self-distancing rules and the “stay at home” order in their cells. 

Since the 21-day lockdown was extended by an extra two weeks, citizens have made representations for the president to loosen some restrictions for recreational activities, business dealings and other essential services to continue.  

How more restless are those living in prison and confined to a small cell with barely enough room to move around, who are now completely cut off from the outside world and their families?

This article was produced for the Wits Justice Project (WJP). Based in the journalism department of the University of the Witwatersrand, the WJP investigates human rights abuses and miscarriages of justice – including wrongful convictions – related to SA’s criminal justice system. This article was first published in Daily Maverick.

The case for a citizens’ basic income grant in South Africa

- Vishwas Satgar

With Covid-19 and the lockdown there is no room for denial of how large parts of South African society suffer.

High-income earners have gone online, fridges are stocked and uncertainty is mitigated by healthy bank balances. Low-income households are writhing with anxiety at job losses, are pushed into hunger by the suspension of income-generation opportunities, even in the informal economy, and informal settlements do not have stocked fridges.

We are a society marked by a racialised and gendered social class divide; a cruel society, even 26 years into post-apartheid democracy.

However, the irony of our situation is that we have had black rule in post-apartheid South Africa. The African National Congress (ANC) has led the post-apartheid order and it has nothing short of a strange commitment to black lives.

On the eve of lockdown, the Minister of Education, Angie Motshekga, on national television, trumpeted that “our people have coping mechanisms” thus implying all will be well. This “we know best” attitude gave South Africa a glimpse of the disconnect between the ruling party and lived realities. The reams of economic data on racialised and gendered inequality in South Africa speaks for itself as a counter to ruling party arrogance.

A few years ago we were told ANC cadres did not struggle to be poor. Due to their mythic role in a complex struggle, involving sacrifices by people from all walks of life, they deserved a post-apartheid dividend; we owed our liberators. And of course, they cashed in on this with rampant looting. It is time the mangled, hypocritical and tortured soul of the ANC-led alliance, which is there for all to see, gets a speedy send-off.

However, before then and just maybe somewhere in the Kafkaesque world of the ANC, driven by jostling self-serving factions, there is a residue of genuine concern for black lives and South Africa in general. Just maybe, in the decisive leadership being provided on Covid-19 and ostensibly out of concern for us all, it is capable of understanding that now is the time to give concrete expression to the living hope of the many. This of course does not mean authoritarian populism Malema-style, but rather there still might be an intellectual capacity to grasp the opportunities for strategic transformative change.

Covid-19 and the space for transformative change

While South Africa has been busy coming to terms with the shock of lockdown, two important developments have taken place.

First, the shift towards systemic state intervention to enhance the societal response to Covid-19. Despite the silo approach to governance and competition between Cabinet ministers to shine, and with strategy being about what your ministry can bring to the challenge, some important shifts in state practice are happening in the midst of incoherence and uneven capability.

Announcements by state armaments parastatals, Denel and Armscor, that they would be repurposing production for ventilators, sanitisers and even converting military vehicles into ambulances is a welcome shift from arms production in a time of crisis.

Such a breakthrough confirms the potential of repositioning these enterprises to also play a part in producing renewable energy technologies and public transport systems for the just transition to avert a 2ºC increase in planetary temperature and bring down South Africa’s carbon emissions.

Minister of Human Settlements, Water and Sanitation, Lindiwe Sisulu, announced she would be commandeering all water resources in the country under the control of water boards, water associations and other mechanisms. Through ministerial control she effectively ensured water as a public good was now nationalised in terms of government control.

Minister Sisulu was also at pains to clarify that water used by the government would be compensated. In a water-constrained country, in which 62% of water resources are controlled by commercial farmers, this is a crucial move to ensure the water needs of citizens are met during Covid 19. Her rollout of 41,000 water tanks (only 17,631 had been delivered by 9 April) and commitment to use schools as sources of clean water for communities is a crucial crisis management intervention, but has to be tracked and monitored by communities. Many of these communities have been denied water due to mismanagement, corruption and failed ANC government leadership, including during South Africa’s drought.

Similar potential exists with integrating public and private health into a functional, affordable and citizen-driven system. But the leadership provided by the minister of health will determine the fate of our post-Covid-19 health care system.

Reframing the role of the state

Nonetheless, all these systemic shifts, actual or potential, are crucial to reframe the role of the state to allocate structural capacities and resources to meet societal needs. More can be done in post-Covid-19 conditions, given the struggles from below, to also ensure these changes bring workers and society into these processes. In other words, we shift from state provisioning to democratic provisioning including democratic public utilities.

But will these shifts endure as we confront the dramatic impacts of Covid-19, economic recession and climate crisis? Or will South Africa merely revert to a financialised market-centred script that has benefited a few corporations and a few wealthy individuals? The battle lines are being drawn right now as we grapple with our post-Covid-19 future. Despite the outcome, what is clear is that the arguments for climate emergency measures have just been strengthened in the midst of the pandemic.

Finance capital is not standing back and is trying to shape a post-Covid 19 world. This relates to the second important development in this conjuncture.

On Friday 27 March, Moody’s followed two other credit rating agencies and downgraded South Africa’s sovereign debt rating to junk. This means the cost of borrowing for South Africa is on its way up and will increase financial stress. These credit-rating agencies are part of a globalised disciplinary complex protecting the interests of globalised finance and the Dollar-Wall Street regime. They do not care what the needs of countries are except to ensure return on capital. They are also dubious and certainly not the bastions of creditworthiness integrity, given they were giving triple-A ratings to Wall Street finance houses before the crash of 2008-2009.

South Africa has been in the grip of global finance for too long and has had to forego its democratic commitments to its people, to ensure the “sovereign interests” of global finance come first. Moody’s and credit rating agency downgrades have laid the basis for austerity macro-economic policy; cutbacks in state social spending and a further squeeze on the precariat coming out of Covid 19.

This will be disastrous. We have to break the grip of global finance on the South African economy now.

In the midst of the global pandemic there is space to break with a one-size-fits-all approach in economic thinking so we can innovate, be bold and heterodox in how we deal with economic and climate challenges. Liberal globalised capitalism and its finance-centred economic orthodoxy has been suspended in this crisis. Credit rating agencies, creditors and multi-lateral institutions and neoliberals in the state will want to bring it back from the dead after the pandemic. This is not going to be easy given the state of the world economy and the challenges facing the three main economic centres that drive global capitalism.

China, US and the Germany-led European Union

China is not going to lead the bounce-back of the global economy any time soon. It went into the Covid-19 crisis with high levels of debt in its financial system, property bubbles, declining trade with the US and even if it uses its surplus ($3-trillion) to launch an expansionary stimulus there is no external demand for Chinese manufacturing, at least for the next few months and possibly for the duration of the pandemic.

China will have to rethink its role as a globalised economy in this context. Also, dependencies built on China for essential medical goods, inputs and other critical manufactured goods are certainly going to be rethought by importing countries, given the prospects of more pandemics and climate shocks. It would be naïve to think a China-centred low-wage manufacturing world is returning after Covid-19.

The US is currently in turmoil and will be the worst impacted Western country by current trends. Trump will realise his wish of making the US great in everything, including Covid-19. On 7 April, the US had more infections (367,650 ) and already had more deaths (10,943 ) than 9/11 (about 3,000 at the Twin Towers).

The US spent trillions on the war on terror (according to Brown University’s Costs of War project almost $6.4-trillion), one of the longest wars in the modern world. Yet Trump and the ruling class are playing partisan games with the Covid-19 response and are merely willing to make modest concessions.

The trillion-dollar stimulus plan, while providing for $1,000 cash transfers to adults and $500 to children is an immediate relief measure, merely about $500 billion. A lot more will go to small business and mainly big business like airlines and shipping for bailouts.

Like 2007-2009, business is going to win again in terms of state support, affirming a neoliberal truism: the people are not too big to fail.

However, the US is still in the upswing of Covid-19 infections, unemployment is skyrocketing, a global recession has kicked in and climate shocks like wildfires in California are coming soon in the summer.

The US has already incurred massive costs due to climate crisis-induced tornadoes (including over Easter weekend in Louisiana) and hurricanes (Harvey cost $125-billion). A few more of these extreme weather events will certainly induce fiscal limits and also challenge the capacities of the US state, in the midst of dealing with Covid-19 or its aftermath.

Quantitative easing, the favourite monetary policy tool of the US state, from printing money to the Federal Reserve purchasing financial securities, is going to face limits with synchronised systemic crisis tendencies hitting at once. Moreover, Trump’s divisive politics also makes the US dollar and US government bonds risky as a safe haven. China might also, given worsening domestic economic constraints, cash in on US bonds to re-adjust its own economy.

Germany, the strongest economy in Europe, is also facing serious challenges. Already in 2019, it was experiencing a slump in economic growth. The steep drop in car exports has placed major stress on one of its leading manufacturing sectors. Massive layoffs of metal workers were instituted and have continued in the context of Covid-19. Retail and commercial industries are also facing massive contractions, bankruptcies and retrenchments.

The stimulus package of the Merkel government is inadequate and still heavily credit-driven, providing a debt-based lifeline to stressed enterprises. The European Union is facing closed borders and an ineffectual European Commission in terms of co-ordinated and effective fiscal policy. Unconventional economic tools, measures and responses are coming to the fore.

South Africa’s Covid-19 state managers have thrown existing fiscal resources, within key institutions, such as the IDC, Department of Agriculture and small business relief funds towards failing businesses. Tax relief and unemployment benefits ( a temporary employee relief scheme) have also kicked in with the UIF making R30-billion available. Just before lockdown the Climate Justice Charter process called for stronger mitigation measures such as a substantive basic income grant, together with the trade union federation Saftu. This has also been echoed by the C-19 People’s Coalition.

Many economists and academics have questioned the lack of stronger mitigation measures and have also called for a citizens basic income grant (BIG) to be considered in the context of lockdown.

What will South Africa be like if a substantive BIG is implemented now?

If South Africa implements a substantive basic income grant during the pandemic, a cash transfer to all citizens of R4,500 per person, per month, and subject to progressive taxation if your income exceeds R20,000 per month (currently South Africa has about 7.6 million taxpayers), these are its implications.

  • Providing a means to address hunger – about 14 million people went to bed hungry in South Africa in 2019 and we can assume this increased with the suspension of livelihoods when lockdown kicked in. In rural areas, 80% of 700,000 farm workers (plus their families — about 2.5 million people) experience hunger, given the exploitative wages earned (the minimum wage is R18.68 per hour). About nine million children receive a nutritious meal during school, but under lockdown this has been compromised in various parts of the country.
  • Provide a cushion for unemployment – before South Africa’s lockdown, and based on the narrow definition of unemployment, 5.9 million were unemployed. It is estimated that between 900,000 and three million more workers will lose their jobs due to the lockdown. According to the International Labour Organisation, due to digital technologies, global value chains and other structural factors, unemployment is very likely to go up on a global scale in the foreseeable future. For South Africa, the much-vaunted Fourth Industrial Revolution is certainly a strategy to displace labour.
  • Handwashing and sanitation will be enabled – about 1.4 million people living in informal settlements do not have access to water in their homes or yards.  Almost three million (of 19 million) in rural areas lack access to a reliable supply of water.
  • End precarity — 2.6 million in the informal sector (and about 60,000-90,000 waste reclaimers, who save municipalities about R750-million a year in landfill costs) and an additional one million domestic workers, are all precarious without benefits including unemployment benefits.
  • Increase the redistributive bargaining power of labour – by ending dependence on low-wage work. The fragmentation of labour unions has weakened their institutional power to ensure higher wages and non-wage benefits. This was reflected in the minimum wage secured of (R20.76 per hour) R3,653. Other categories without powerful union densities or unions earn less, such as domestic workers (R15.57 per hour) and public works programmes (R11.42 per hour). A higher wage floor based on a BIG of R4,500 and with workers having pooled household income, gives labour greater bargaining power.
  • Increase household income and fiscal stimulus — South Africa has 18 million very poor households  (about nine million in rural areas) that have five members with a total monthly income of R2,600. Many of these households are highly indebted. Social grants mitigate this situation for 17.6 million beneficiaries but not all these households have grant recipients. Moreover, the child-support grant (R445 per month covers 12.5 million children), old-age grant (R1,860, or older than 75, R1,870, covers 3.5 million people) and the disability grant (R1,860 covers just more than one million people) are just not keeping pace with increasing living costs. A family of four needs at least R2,500 per month just to cover food staples. Competing needs for transport and now sanitisers and soaps place immense pressure on such limited resources. More income in households will also have impacts on aggregate demand and kick-start the economy.
  • Fiscal consolidation – currently the state spends R162.9-billion (2018/2019) on social grants. This is meant to go up to R202.9-billion in 2021/22. The Unemployment Insurance Fund, even after allocating its R30-billion for Covid-19, has R160-billion in investments. A BIG can also be funded through a wealth tax based on income, inheritance and land, as well as a progressive carbon tax on wealthy consumers and carbon-intensive industries. All of these resources can be consolidated together with all grants into one consolidated BIG budget, effectively laying the basis for a “post-work” society.
  • Institutional rollout — to all South Africans through consolidating biometric information contained in Sassa, SARS, the Home Affairs department (based on identity document data) and from banks. In this regard, either Sassa and/or the Post Office could be crucial mechanisms to achieve the disbursement, including digitally.

Time has come to build an emancipatory future

South Africa cannot continue a lockdown and confront this pandemic without stronger mitigation measures like a BIG. In the midst of Covid-19, Spain is the first country to commit to rolling out a BIG as a response to the crisis and this will be a democratic systemic reform that will persist beyond the pandemic.

The BIG has a history that goes back to the Enlightenment. In the 2oth century, many experiments and forms of BIG interventions have been tried since the 1970s in the US, Canada, Kenya, Namibia and Finland. Each of these trials were based on specific parameters: target groups, social objectives and levels of income.

All the research shows positive outcomes when assessing the social efficacy for the BIG. This has ranged from more investments in human development, less stress, lower health costs, greater labour market leverage for workers and less food vulnerability. In the context of the climate crisis and deep just transition the BIG is an absolutely necessary democratic system reform to enable the ecological restructuring of our society without harming those least responsible for the problem.

If South Africa does not embrace the BIG in the context of Covid-19, together with other public goods, this will be a serious historical mistake and a missed opportunity for a more emancipated future.

Vishwas Satgar is an Associate Professor of International Relations at Wits University. This article was first published in Maveric Citizen/Daily Maverick.

Covid-19: Treatments, but at what cost?

- Marisol Touraine and Malebona Precious Matsoso

Accessible & affordable medicine: We cannot wait for treatments to be available in high-income countries in order to negotiate prices for the rest of the world.

The World Health Organization (WHO) has sounded the alarm. While we race against time in our own countries, absorbing our resources and energy, we must not forget the world’s most vulnerable populations.

Solidarity is first and foremost a moral duty. All of humanity is affected today, and our prosperous societies would be wrong to abandon the most vulnerable. This moral duty is also a practical one; in the face of a global pandemic, only a global response can be sustainable. A disjointed response would run the double risk of allowing the disease to migrate further or to re-emerge.

Twenty years ago, the certainty that only a global effort could overcome pandemics led to the creation of new organizations, which in recent weeks have mobilized to confront COVID-19: Gavi, which specializes in vaccines, is stepping up its campaigns; the Global Fund is enabling countries to use up to five percent of approved grant funding to help protect and treat vulnerable communities (about US$500 million is available for that purpose); Unitaid, which promotes innovative projects that promote equitable access to health care, is investing in diagnostics, treatment and triage tools for respiratory diseases.

But we need to go further.

Traditional development assistance programmes, as indispensable as they are, will not be enough. Initiatives are springing up, all of them useful. We must prepare for the time when treatments and vaccines will become available. But these treatments and vaccines must be accessible to all, everywhere and at the same time.

This is an appeal to the international community.

We cannot wait for treatments to be available in high-income countries in order to negotiate prices for the rest of the world, as happened in the case of HIV. The exceptional circumstances of the COVID-19 pandemic call for an exceptional response. The World Trade Organisation (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS, 1995), including those recognized in the Doha Declaration (2001), already allow countries to issue compulsory licences for treatments in the case of pandemics.

We propose to go further.

We ask that governments and institutions currently financing or contributing to the development of drugs, vaccines or technologies for COVID-19 agree from the outset in their contracts with industry to the sharing of intellectual property rights taking into account the urgency we find ourselves in. We are talking about sharing, not giving up. In practical terms, once public money is invested in the race to find treatments for this pandemic that threatens the entire planet, states must demand in return from the outset that companies give up their licences without geographical limitations to a structure that would guarantee the production of treatments that are effective and safe, and – in return for public investment – at affordable prices, everywhere.

This is not a utopian dream.

Ten years ago, Unitaid created the Medicines Patent Pool (MPP), which allows pharmaceutical companies to license their rights on a voluntary basis. This has enabled the production of generics that treat tens of millions of people around the world. Thanks to the MPP, for example, an annual treatment for HIV/AIDS costs less than US$70 in Africa, compared to the US$10,000 it costs in Europe.

Back then we had to wait almost ten years between these medicines being available in high-income countries and their arrival in less well-resourced countries. In the face of COVID-19, we must act now to ensure that everyone, everywhere, has access to treatment at the same time.

This would be a first. The shortage of several important health products and equipment caused by COVID-19 has galvanized and encouraged both governments and industry to cooperate and share technology, and enter into agreements to cooperate and to enable an increase in manufacturing capacity. Already countries including Germany, Chile, Australia and Canada have passed resolutions allowing them to move in this direction.

South Africa itself adopted a policy on intellectual property in 2018 and should prioritize enactment of legislation that allows for the use-all policy tools needed to address urgent public health concerns. Some companies have also said they are ready. The World Health Organization is working to increase transparency of the more than 700 trials ongoing around the world looking into COVID-19 treatments and vaccines.

It is the entire international community that must commit itself and move forward together, in a spirit of solidarity. We call on all the G20 governments and international institutions to make this commitment, along with the World Health Organization. The world needs your dedication to eradicate COVID-19, and to save lives in Europe and around the world.

Marisol Touraine, Former French Minister of Health and Social Affairs, and Chair of the Executive Board of Unitaid. Malebona Precious Matsoso, Director of Health Regulatory Science Platform, Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa; and Member of the Executive Board of Unitaid. This article was first published in Daily Maverick/Maverick Citizen.

Wits COVID-19 dashboard gets grant award from the IEEE

- Wits University

New features added as inter disciplinary and inter-institutional collaboration data on the pandemic grows.

Wits University’s COVID-19 dashboard has received a grant award by the IEEE. The IEEE is the world’s largest technical professional organisation dedicated to advancing technology. The IEEE has over 400,000 members from all continents. Through its members the IEEE promotes the development of research and technology transfer activities across 40 societies, which span a wide range of disciplines ranging from Aerospace to Vehicular technology, going through computing, electronics, industry applications and many others.

Covid dashboard gets IEEE fundingThe grant award supports COVID-19-related visualisation and analytics for Southern Africa. The nature of the project is interdisciplinary, where medical data and expertise need to be combined with the wealth of methodologies and algorithms used in advanced analytics, Big Data and Data Science. Assumptions used in the project revolve around our current level of understanding of advanced analytics driven by Data Science and other disciplines. Both main-stream statistical frameworks, frequentist and Bayesian are an underlying assumption to model development. Input from the different medical, virology and custodians of static data pertaining to populations, social and medical vulnerabilities, access to medical infrastructure, prevalence of various relevant pre-existing conditions are also underlying assumptions. 

"The project encapsulates methodologies in Data Science and Artificial Intelligence that effectively combine medical and other data to provide a comprehensive synthetic view of the predictive landscape.” says Professor Bruce Mellado of Wits University and iThemba LABS.

The chief goal of the project supported by the IEEE grant award is to control the number of people infected, hospitalisations, ICU admissions and mortality in South Africa and other countries. These outcomes will be predicted as a function of non-pharmaceutical interventions in the post-lockdown period to allow for the economy to reactivate. Analytical and predictive tools developed by these projections will assist policy makers to enact rules and regulations with which to revive economic activity, while preventing a massive outbreak of the virus. This is essential to alleviate the economic impact of the virus in African countries, in particular to slow down the rate of job losses.

This grant award provides various forms of support, including support for the organization of monthly webinars. “These webinars will be hosted by Wits University’s Joburg Centre for Software Engineering (JCSE) and will bring together panels of experts who are actively collaborating and working on the Wits COVID-19 dashboard project, including data scientists, modellers, medical experts and software engineers. The webinars will be open to all and will be advertised shortly,” says Professor Barry Dwolatzky.

Wits University’s COVID-19 dashboard continues to expand. A dashboard for the Gauteng Province has been put in place. Following a successful collaborative model developed with the Botswana International University of Science and Technology, three new dashboards have been launched: Nigeria, Eswatini and Namibia. This takes place in collaboration with local universities and institutions. Collaborative efforts have been established with Zimbabwe, Morocco and Senegal. 

Wits’ COVID-19 Dashboard

https://www.covid19sa.org

iThemba Labs

https://tlabs.ac.za

 

Saluting all Witsies combating the COVID-19 pandemic

- Wits University

These Wits heroes represent just a fraction of the clinical, academic, professional and administrative staff, alumni and students responding to this disaster.

The COVID-19 pandemic has disrupted life as we know it. But it has also galvanised our rapid adaptation to change and the adoption of new technologies. 

This newsletter acknowledges all those Witsies on the frontline in testing stations, hospitals, laboratories, computer centres, innovation labs and those who from their homes confront this pandemic and its effects on South Africa and the world.

The Wits heroes mentioned here represent just a fraction of the clinical, academic, professional and administrative staff, alumni and students who are contributing in multiple ways to respond to this disaster.  

We salute them all.

Practical protection for people

With personal protective equipment (PPE) in short supply globally, Wits engineers and students last week custom designed, manufactured and delivered their first batch of laser-cut face shields to protect healthcare workers. As COVID-19 infections and hospitalisations increase, respiration and ventilation become literally a matter of life or death.

These same Witsies have now turned their engineering prowess to devising assistive breathing devices for patients. We invite you to contribute to this life-saving innovation.

Students and staff in the School of Molecular and Cell Biology further advanced the PPE cause by sourcing and donating medical gloves for healthcare workers. This School also formulated a virus-killing disinfectant for Witsies on campus to prevent COVID-19 contamination.  

Combatting contamination through biomedical engineering, PhD candidate Michael Lucas pioneered a revolutionary self-sanitising surface coating. This infection control solution helps mitigate hospital-acquired infections and Lucas’ biomedical alchemy can prevent COVID-19 contamination.

Diary of a disease

Understanding the coronavirus pathogen is critical to protection and prevention. In concert with the National Institute of Communicable Diseases (NICD) and the National Department of Health (NDOH), Wits epidemiologists, virologists, biologists, and others at the vanguard of science are working to decode, predict, tame, and suppress COVID-19, and manage the public health and socio-economic impact.

Wits Professor of Epidemiology Cheryl Cohen analyses the distribution, patterns and determinants of disease. Now a household name, Cohen is at the forefront of COVID-19 case-finding, diagnosis and public health response, management and coordination. She recently delivered an on-air COVID-19 masterclass.

Cohen works closely with Dr Kerrigan McCarthy, a clinical microbiologist explaining here how the coronavirus is transmitted:

Amongst the virus sleuths is microbiologist Lynn Morris, a Research Professor in the School of Pathology and the Interim Executive Director of the NICD. Morris explains in this in-depth interview why COVID-19 is one of the greatest challenges of our time.

Fellow microbiologist, Professor Adriano Duse, Head of the Department of Clinical Microbiology and Infectious Diseases, gives insight into superbugs in this Masterclass.

Drawing Big Data battle lines​

Predicting and anticipating the trajectory of the virus to mitigate casualties and inform policy requires number crunching, modelling, and analysis of Big Data. Physics Professor Bruce Mellado leads a multidisciplinary team that developed the comprehensive COVID-19 South Africa Dashboard – a data dashboard to help track and visualise local COVID-19 infections, as well as in Africa, and the monitoring tool can be used to provide predictions for the virus’ spread and impact.

COVID-19 South Africa Dashboard https://www.covid19sa.org/

Similarly, the Gauteng City-Region Observatory (GCRO), of which Wits is partner, developed an interactive map showing the province’s vulnerability to COVID-19. In the Wits Biomedical Engineering Research Unit, Professor David Rubin and Adam Pantanowitzare developing a model to demonstrate the effect of intermittent quarantines, which may help maintain essential services and sustain economic activity.

Advocating mass testing

Test! Test! Test!” is the message from Professor of Vaccinology Shabir Madhi, who advocates physical distancing, mass testing for COVID-19, and quarantining the infected as the optimal public health strategy.

In this interview Madhi explains how the virus infects bodies and describes how big and bad the coronavirus is. In partnership with Gift of the Givers, Wits now hosts a COVID-19 testing station.

Helping the healthcare workers on the frontlines

Expert analysis informs us of the impact COVID-19 will have on our world but how will our healthcare workers in hospitals cope?

Professor Feroza Motara is the Academic Head of Emergency Medicine in the School of Clinical Medicine at Wits and the Charlotte Maxeke Johannesburg Academic Hospital. She has prepared her team and the hospital to care for those infected with COVID-19. Feroza explains how healthcare workers on the frontline cope.

Towards treatment 

Professor Helen Rees, the Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI) and Professor Jeremy Nel lead the South African research team in the Solidarity clinical trials. Rapidly constituted by the World Health Organization (WHO), these 10-nation clinical trials aim to identify the most effective treatment against COVID-19. (Note: not a vaccine – this could take 12-18 months – but see why Professor Chris William Callaghan proposes scientific crowdsourcing as a promising approach to biomedical research and development).

Rees discusses South Africa's role in the global Solidarity study.

On our best behaviour

Physical distancing, hand-washing, and cough etiquette govern our mobility and behaviour like never before. Listen to renowned HIV scientist and activist Professor Francois Venter, Director of Ezintsha and Deputy Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI), discussing the fundamental role that behaviour change plays in reducing COVID-19 infection.

Distinguished Professor of Medical Anthropology and Public Health Lenore Manderson delivered a COVID-19 webinar applicable to public behaviour.

Behaviour extends to social relations and solidarity. Professor Jo Vearey from the African Centre for Migration & Society (ACMS) cautions against hypocrisy in a time of COVID-19 and advocates for foreign migrants to be included in the COVID-19 response. She explores what South Africa’s impending winter, a historical HIV/AIDS pandemic and xenophobic attitudes mean for the spread of the pandemic, while Matthew Wilhelm-Solomon and Siyabonga Mahlangu advocate for the protection of inner-city communities during the lockdown.

Influencing policy

President Cyril Ramaphosa has appointed Professor Martin Veller, the Dean of the Faculty of Health Sciences to a Ministerial Committee to provide clinical management advice on COVID-19. He, together with five leading Wits professors proposed a blueprint to replace the current lockdown.

Several other Witsies including Professor Glenda Gray have also been appointed to government committees or sub-committees.

Professors Karen Hofman and Susan Goldstein from the SAMRC/Wits Centre for Health Economics & Decision Science, PRICELESS SA, in the School of Public Health have advocated for proper hand-washing hygiene, which has since become standard COVID-19 protocol. However, environmental lawyer Dina Lupin Townsend cautions that there is nothing simple about washing your hands when you have extremely limited access to clean water.

Economy on the edge

Economist Professor Imraan Valodia, Dean of the Faculty of Commerce, Law and Management says:

The COVID-19 crisis is first and foremost a health and humanitarian crisis that we are all living through, which is likely to have lasting impacts on how we live.

He explains how we can manage the economic impacts in a way that does the least long-term harm and writes with David Francis, that South Africa won’t flatten the curve unless all citizens have the means to stay home.

Seventy-eight economists and activists, including several from Wits, wrote an open letter to the President encouraging government to do more to stabilise the economy and to protect the most vulnerable in society, a view echoed by Professor William Gumede in the Sunday Times. He recently compared the COVID-19 emergency stimuluses of selected countries and analysed what South Africa could learn from these countries.

Wits economist Lumkile Mondi asks how we can save SA whilst Adjunct Professor Alex van den Heever analyses the health and economic ramifications of COVID-19Kamal Ramburuth-Hurt  wrote on the deepening economic crisis, while Wits Journalism lecturer Kevin Davie commented on the fragile economy as did Professor Keith Breckenridge, Deputy Director of the Wits Institute for Social and Economic Research (WiSER).

Wits voices on COVID-19 

Wits researchers and academics across faculties have articulated the impact of COVID-19 in their disciplines and displayed social leadership to educate, advocate, influence, and inspire:

Brave new world?  Professor Achille Mbembe, renowned philosopher at WiSER, has commented as has Professor John Stremlau from the Wits Department of International Relations, has shared their views on the global impact of the virus.

So has Associate Professor Ivor Sarakinsky, political philosopher in the Wits School of Governance, in this interview:

Dr Bob Wekesa from the African Centre for the Study of the United States (ACSUS) wrote about what will happen to Africa after COVID-19. 

Winter weather or not – While COVID-19 aggravates an existing climate emergency, social and climate activist Professor Vishwas Satgar suggests that the coronavirus pandemic provides an opportunity to end the war with nature whilst Professor Matthew Chersich from the Wits RHI says that South Africa’s warmer weather could slow the spread of the virus.

Books not braais – Professor Chris Thurman has explained the impact of COVID-19 on the arts, while biomedical ethicist Harriet Etheredge tackles issues related to personal versus public freedoms during lockdown.

Family matters – Dr Ajwang' Warria explains how parents and caregivers can support children during the COVID-19 lockdown whilst the Centre for Deaf Studies is breaking the silence on COVID-19 for the Deaf community.

Lockdown language – Wits students also helped Jive Media to translate the Hay’khona Corona! Spreading the word, not the virus poster series into multiple languages and made freely available to all. Please share widely.

There are numerous other experts from Wits who comment regularly in the media.

Keep informed, safe and healthy

Visit wits.ac.za/covid19 regularly for the latest updates, news, analysis and expert opinions in our fight against the coronavirus.

Witsies are tackling the COVID-19 pandemic on all fronts and we laud each and every person who is playing a role in combating this pandemic. We are in a crucial moment in the life of this pandemic and it is important that we work as a collective for the benefit of our society.

We urge all members of the Wits community to heed the words of President Cyril Ramaphosa:

This epidemic will pass. But it is up to us to determine how long it will last, how damaging it will be, and how long it will take for our economy and our country to recover. It is true that we are facing a grave emergency. But if we act together, if we act now, and if we act decisively, we will overcome it.

Toward a risk-based strategy for managing the COVID-19 epidemic: A modelling analysis

- Alex van den Heever

Given the protracted nature of the risk posed by the COVID-19, this paper seeks to address the need to match health prevention and a viable economy.

The central premise of this paper is that there are no zero-sum options. By this it is meant that the health prevention strategy most compatible with the maintenance of continued economic activity is an unavoidable policy imperative for South Africa.

This paper addresses this discussion in three stages. First, it examines the factors that should influence the main strategic choices. Second, it examines the consequences of two alternative pathways leading to a preferred approach. Third, it offers an overview of the key features of a preferred approach.

The paper engages with the above through the use of a model (van den Heever, 2020) which attempts to compare alternative health prevention strategies. As a consequence, part of this paper involves a brief write-up of the methodology used.

Introduction

As yet, there are no proven formula to balancing the effort to fight the Covid-19 pandemic with the simultaneous and equally important need to sustain livelihoods and keep open pathways to economic participation. Whereas these objectives are sometimes argued to be in opposition – save lives versus save the economy – crude distinctions are not helpful when facing the complex set of risks implied by the prospect of a protracted struggle to contain the epidemic.

In the absence of a cure or a vaccine, disease prevention approaches need to find ways to separate the infected from the uninfected members of the population. When interventions occur late, the intervention options narrow considerably to cruder forms of social separation, such as lockdowns. If caught early, however, mass testing coupled with rapid contact tracing offer surgical approaches to separating the infected from the uninfected.

As a preventive strategy for COVID-19, according to emerging experience, mass testing and contact tracing should occur together with social distancing measures, border closures and the observance of health protocols (such as the requirement to wear masks when outside the home) where people cannot avoid some form of social contact. The distinction between the lockdown approach and mass testing and contract tracing is that the former shuts down a substantial part of the economy while the latter is compatible with continued economic activity.

This distinction is an important consideration where the direct effects of a lockdown disproportionately harm vulnerable workers and businesses. While Government can attempt to support the vulnerable, the extent to which this is possible depends on whether the institutional mechanisms exist to identify compromised individuals and businesses sufficiently for them to be supported. It also depends on the length of time for which support is required. The longer the period, the harder it is to keep businesses open, and the harder it is to raise the tax revenues and the debt required to finance support for vulnerable individuals.

In the early phases of the COVID-19 outbreak, it is clear that Government lacked the capabilities to introduce the most effective strategy. The need for urgent action left no opportunity to scale up the measures required to prevent an exponential increase in infections. South Africa was just not geared for an epidemic of this nature. Consequently, the 21-day lockdown implemented on 27 March 2020 was appropriately timed and self-evidently essential.

The extension of the lockdown for a further two weeks however raises important concerns. Two implications can be drawn. First, the extension suggests that the lockdown period has not been adequately exploited to ramp up the testing and contact-tracing regime. Second, it indicates that the narrow testing regime adopted to date (designed to merely identify imported infections rather than community-based outbreaks) cannot be relied upon to confirm whether the lockdown has succeeded outside of the affluent communities where the epidemic started.

While the two-week extension could be argued to provide some breathing space for the implementation of the preferred strategy of mass testing and contact tracing, any continued failure to put in place the required machinery will result in incremental extensions to the lockdown with all the economic and social consequences that will go with it.

An obvious further concern with this trajectory is the high likelihood that a successful lockdown within the South African context is essentially a leaky bucket. While it may prove effective in the more affluent suburbs, it may fail in the townships and informal settlements. The current lockdown may have therefore only reduced, but not prevented, the spread of the disease into the general population. Although these infection levels may be relatively low at present, it won’t take long for them to become uncontrollable.

Background

The pandemic resulting from the SARS-COV-2 virus has elicited an emergency response from virtually all countries around the world. The high levels of transmission, taken in this analysis at 2.5 (over a period of four days)[1] for every infected person, would not be a serious concern if the disease (COVID-19) did not also result in sufficient severity for a proportion of the infected population to require hospitalisation, and, more importantly, access to ventilators that are typically only located in intensive care units (ICUs).

Where ventilators are not available for those who need them, the health outcome will be death. For those that require access to ventilators and obtain treatment, over 70% will in any case die. Patients who develop severe symptoms appear to be associated with weaknesses in the immune system, either due to age or co-morbidities typically correlated with age (hypertension, diabetes, and various cardiac conditions). People with co-morbidities associated with the respiratory system are also at risk regardless of age.

Given this context, to avoid significant preventable levels of morbidity and mortality, the most efficient approach to reduce the spread of the disease is to reduce the reproduction rate of the disease (referred to as R) from 2.5 to below 1 (the rate at which the disease will ultimately be eliminated). This is achieved through various interventions, the most effective being the introduction of a vaccine to a sufficient number of the population such that herd immunity is achieved.[2]

Where a vaccine is not available, and the mortality would be too high to permit herd immunity to occur naturally, the only option is to actively interrupt the spread of the disease from person to person such that R is held below 1 for a long enough period to eliminate the disease. Quite simply, such strategies involve keeping infected people away from uninfected people.

There are two broad options. Either infected people are identified quickly and isolated; or, where infected people have not been identified quickly enough, everyone is separated from everyone else for a sufficient time for the disease to self-eliminate. In practice strategies involve a mix of associated interventions.

Internationally, two distinct approaches have emerged. The first is to test, trace and quarantine at scale. The second, involves a generalised lockdown on the movement of people. The first option tends to be exercised by countries that are well-prepared and intervene at scale at early stages of the epidemic. The second, tends to be applied where countries are poorly prepared to react, and a runaway community-based epidemic is well underway before interventions are considered.

South Africa’s response to the emerging pandemic was slow at first, with no border closures considered, and only very basic forms of border screening applied at airports. Given that we knew early on that many infectious persons are also asymptomatic, this approach was ill-advised and exposed the country to the inevitability of imported infections.

This (arguably) casual response to the emerging pandemic changed when the first cases were diagnosed in South Africa in early March 2020 and also where it had become evident that many other countries were experiencing full-blown epidemics arising from imported infections.

Evidently informed by standard epidemiological modelling of the emerging epidemic, aided by a wealth of information collated by international researchers and the World Health Organisation (WHO), the South African government acted immediately to implement social distancing, followed on 27 March 2020 by a generalised lockdown. However, as the modelling has never been made public, it is unclear what scenarios were presented. Needless to say the analysis was clearly compelling at the time.

The lockdown was however implemented at an early stage of the epidemic, as there was very limited evidence at the time of a generalised community-based outbreak.[3] This differs from some other countries where lockdown approaches were introduced only when they had lost control of the epidemic and they were all out of options.

However, the countries that avoided lockdowns and managed their epidemics did this through rapid border closures, the rapid development of tests for the disease, generalised testing with rapid turnover (12 to 24 hours), contact tracing and quarantining of infected individuals.[4] Broadly speaking their approach can be characterised as getting ahead of the disease rather than chasing it.

Consistent with countries that have not been able to manage their epidemics, South Africa also adopted the testing regime characterised as “chasing the epidemic”. It did not test the general population, or even those with mild symptoms. Instead it tested only people who had travelled internationally (when they came forward voluntarily), had contact with a traveller or had contact with someone diagnosed with COVID-19. This effectively blinded the testing regime to community-based outbreaks. In addition, the testing programme was so constrained that the public sector had only performed 3% of the total tests, with the remainder performed by the private sector. This has apparently changed, with more generalised testing on the increase, although still low.

So what does this mean for South Africa’s strategy going forward?

  • First, we are left without a clear measure of the success or failure of the lockdown. On the one hand we cannot fully trust the incidence reports. On the other hand, the mortality levels appear consistent with a contained or low-level epidemic.
  • Second, the economic consequences of a lockdown are so large, that it cannot be relied upon as the principle prevention strategy if the epidemic is protracted. This requires that a health strategy compatible with reopening the economy is imperative.
  • Third, the public reports on readiness by the public health team to implement a benchmark strategy are unclear at best, and suggest undisclosed challenges regarding readiness. The question is whether the bottlenecks to a more nuanced strategy can be rapidly addressed.

How effective is a generalised lockdown?

Of considerable concern is the possibility that a generalised lockdown approach applied within the South African context will only be successful in relatively affluent communities, with townships “unlockdownable”.

As mentioned above, the testing protocol applied to date has been biased toward (implicitly) measuring the (imported) outbreak in affluent communities. The publicly reported new infections would therefore accurately reflect the lockdown impact on the relatively affluent population, but not on outbreaks in the general population.

The apparent containment of the epidemic in affluent communities is therefore potentially misleading.  It can create the impression that the lockdown is working (false evidence of success), but it may equally fail to offer the required evidence that a generalised lockdown cannot work successfully in South Africa (false evidence of failure).

As the outbreak in South Africa derived from the affluent population, as they tend to travel internationally, the initial lockdown was probably the best available strategy to block transmission from the affluent communities to the population at large. However, to the extent that the population at large has been infected, a general lockdown may prove equivalent to no intervention.

As a form of contingency planning for the South African context, therefore, the following should be noted:

  • A lockdown may be a viable prevention strategy, but different approaches would be required for different contexts (i.e. what works in relatively affluent areas may not work in townships or informal settlements); and
  • An undetected outbreak may have already occurred in the general population which is invisible to the current testing regime (noting that there are significant moves to expand the testing protocol and programme).

Given the need for a “must not fail” health prevention strategy, it makes sense to prepare for what will work in all scenarios, rather than an approach which will only work if we are very lucky.

Strategic options

Important considerations

There remains considerable uncertainty as to whether the pandemic can be completely eliminated during 2020. Strategies that are successful in bringing country-level epidemics under control therefore face the realistic prospect of a resurgence for an extended period of time. Within the South African context this requires that effective containment of the epidemic will require public health interventions of one form or another throughout 2020.

The need to maintain public health interventions for such an extended period of time therefore has important implications for the design of the 2020 strategy. A brief public health crisis addressed through emergency interventions can be expected to have a different design to a protracted affair. However, if the state of readiness is not adapted to reflect the protracted nature of the crisis, the strategy may unwittingly default into treating the protracted crisis as a series of brief crises.

Two clear strategic options emerge. The first defaults back to generalised lockdowns when surprised by a resurgence, and the second actively manages all the risks associated with a protracted epidemic.

  • Option 1  Lockdown dependent approach, where the lockdown is extended on some basis after the 35-days as the central pillar of any response to contain the epidemic; and
  • Option 2 – Risk-based strategy, where a prevention strategy compatible with the local domestic social context and a safe re-opening of the domestic economy is pursued.

A brief description of the methodology required to model the above two options is outlined below.

Method

Approach

The options are examined using a model, the COVID intervention model (van den Heever, 2020), to determine the length of time a particular public health intervention package needs to be in place to keep the local epidemic controlled for the entire 2020 period.

Generating parameters from international contexts

This section examines the trajectories of various country epidemics following the introduction of major prevention strategies and uses them to calibrate the model. First, a range of countries are reviewed to identify those that may exemplify particular interventions. Second, from those countries two are selected, that best reflect a lockdown intervention and a mass testing and contact-tracing intervention.

The selection criteria for the group of countries was based on: those with significant epidemics (United Kingdom, Italy, Spain)[5] that are engaging in lockdowns; countries that have experienced significant epidemics and have successfully contained them using lockdowns (China); and countries that avoided lockdowns through early interventions that made substantial use of mass testing and contact tracing (South Korea).[6] Data on new infections is examined in each country after the first 100 cases.[7]

An attempt is made in Figure 1 to compare all five countries.

The patterns for the three European countries are strikingly similar on the upward trajectory. As the countries are at different stages in their epidemics, only two of them, Italy and Spain, show a downward trajectory after the introduction of the lockdown. The United Kingdom is yet to reach a turning point (at the time of writing this brief). The post-lockdown downward trajectory for China is however a lot steeper than Italy and Spain, and is as steep as that achieved by South Korea using mass testing and contact tracing.

The lockdown trajectories for Spain and Italy are consistent with a relatively high R, although still less than one. The implied intervention Rs for South Korea and China are however more pronounced. It should however be noted that the both Spain and Italy intervened at a very late stage in their epidemics, which may have complicated their outcomes in ways that are not yet understood. With China, there is a question concerning the reliability of their reporting.[8] As a consequence, for the purposes of parametrising the model, it makes more sense to use the more conservative trajectory consistent with either Italy or France. As Italy effectively has a longer time series, it is therefore preferred over France for this purpose.

Figure 2 illustrates the Rs that best match the Italian epidemic, both before and after the lockdown intervention. Here different values of R are used to drive a model result that is close to the actual trajectory of all phases of the epidemic. This suggests that a lockdown in cold weather is broadly consistent with an average R of 0,96. The early stages of the epidemic are consistent with an R of 1.98, dropping to 1,58 as a consequence of initial, but inadequate, interventions. The lockdown R is however quite close to 1, suggesting a fairly tenuous impact.

An estimate of the R consistent with the South Korean mass testing and contact tracing intervention is provided in Figure 3. The period prior to the main public health intervention is consistent with an R of 1.6, while the mass testing and tracing intervention results in an R of 0.7 in cold weather. This is a superior result relative to protracted lockdowns in Italy and France. This could be the result of many factors, such as, inter alia, the early stage of the intervention and the efficiency of a well-prepared country response. It is therefore possible that other countries may not implement the same response with the same efficiency. This is however not taken into account in the parametrisation for this exercise.

 

The intervention packages used by both Italy and South Korea however extend beyond lockdowns and mass testing and contact tracing. For instance, all include border closures, social distancing requirements (including requirements to wear masks when outside the house) and targeted lockdowns (to address disease clusters). The intervention packages generated through the parameterisation exercise take this into account. This is discussed further in the next section.

Model parameters

This section provides an indication of the model parameters used, guided by the analysis of Italy and South Korea discussed above.

The model parameters are specified at three levels. First there are individual interventions, each with an associated reduction in R (Table 1).[9] Second, there are combinations of interventions, or packages, each resulting in an aggregate R (Table 2). Third, there are scenarios over the 2020 period, where different packages are applied by day of the year, depending on the seriousness of the epidemic.

It is important to note that the Rs for the individual interventions do not have a strong empirical basis. The true test of their usefulness is therefore how well they match the South African epidemic thus far when combined within packages of responses (i.e. no intervention occurs in isolation of some others). To the extent that they do, they can be used to estimate the trajectories resulting from different packages over the full 2020 period.

 

As indicated in Table 2 there are five overall response levels provided for, from level 0 (L0) (do nothing) to level 4 (L4) (lockdown). There are two versions of each response level depending upon whether or not it occurs in warm or cold weather conditions.

For the purposes of this analysis the package configurations associated with a general lockdown (L4) and mass screening and contact tracing (L3) reflect the outcomes in Italy and South Korea respectively discussed above.

Mass screening and contact tracing is treated as a level 3 (L3) intervention as this is naturally prior to the full lockdown – at least for countries with well-prepared public health response systems. South Africa’s adoption of a level 4 (L4) response before level 3 is assumed to have occurred because it was not prepared for the epidemic and was therefore not in a position to implement mass testing and contact tracing in the natural sequence of escalating responses.

The application of the parameters to the South African epidemic

This section discusses whether the parameters developed for the model are able to predict the known part of the South African epidemic.

Figure 4 illustrates how interventions associated with assumed reproduction rates (R) generate estimates of new infections for the periods where we have reported information on new infections.

Three intervention packages are applied to specified periods broadly in accordance with actual events.

  • First, there is the “limited intervention” from the early period of March 2020 to around 22 March 2020, which has an R of 2.2.[10] Here it is assumed that no meaningful public health prevention intervention is in place. The value of R is reduced to account for the warmer climate.
  • Second, there is stepped up “social distancing” (referred to above as a level 2 (L2), or “intermediate”), which occurs from 23 March 2020 to 26 March 2020, with an associated R of 1.6.[11] This period includes the closure of international borders, schools and universities.
  • Third, is the 27 March 2020 “lockdown” intervention package, which has an associated R of 0.7 (which is lower than that for Italy to account for the warmer weather). The lockdown period includes the social distancing interventions and border closures. It therefore has the deepest overall impact.

Figure 5 shows that the warm weather and social distancing interventions on their own do not bring R below 1.0 (the rate at which the disease will dissipate). The R of 1.3 for this period therefore appears justified.

The lockdown intervention does however appear bring R to below 1.0, apart from the most recent reported infection data. There is therefore some uncertainty about the trajectory of the lockdown.  Whereas during the initial period of the lockdown the reported new infections went into decline as expected, the trend from 29 March onward could be regarded as ambiguous. While the model suggests a more pronounced decline, the actual trend could be consistent with a range of Rs from 1.0 to 0.6.

One possible interpretation is that the lockdown, in context, is not sufficient to eliminate the disease. Consistent with this possibility, this trend (i.e. relatively flat after the initial decline) could reflect a transition from the imported outbreak in the affluent community to a domestic community-based outbreak in the general population. While the former may be sensitive to a lockdown, the latter may not, with an R greater than 1.0 even with the lockdown. This period could therefore reflect a simultaneous decline of one outbreak with an increase in another.

Nevertheless, based on information to date, and using the data from the Italian epidemic, an assumed R of 0.7 for a lockdown with warmer weather appears (for now) consistent with the reported information. Using the model to estimate the effectiveness of the Italian lockdown produced an R of 0.96 for winter. The 0.7 assumption used for South Africa includes an adjustment for warm weather and is therefore only applied to the remaining days of summer. The cold weather assumption is applied during winter.

Scenario results – options for 2020

Overview

Two scenario options for 2020 are examined here. Option 1 involves a lockdown-dependent strategy, where any surge in the epidemic involves the package associated with a general lockdown (L4). Option 2 however limits the use of a lockdown to the period already designated for lockdown in South Africa. Thereafter, it reverts to periods of mass testing and tracing (L3), with periodic reversions to L2 (intermediate interventions). Both options are required to eliminate the risk of a serious epidemic during 2020.

It is important to note that the model results are stylised reflections of the trajectory of the epidemic and unknown real world factors would also be expected to play a role.

Option 1 – Lockdown-dependent strategy

In this scenario option the lockdown is permitted to end from 1 May, with a reversion back to an intermediate intervention package. However, according to the model, the disease resurges and requires a further lockdown toward the end of May, extending all the way to October (Figure 6). During October an intermediate package is implemented. A further lockdown of 16 days is required in November/December to prevent a further resurgence. The required overall number of days for lockdowns is 193 days.

The headline results, reflected in Table 3, are consistent with an overall strategy that keeps the epidemic in check for 2020. In total 29,046 people test positive with mortality of 439. The demand peak for ICU beds (used as a proxy for ventilators) is 175, which would be well within the capability of the overall health system. There would only be a slight risk of insufficient High Care (HC) beds in the public sector. When seen together with the private sector capacity and the timely reorganisation of public sector beds, there are sufficient beds.

 

Option 2 – Risk-based strategy

The risk-based strategy looks to minimise the use of lockdowns as the primary measure required to bring the epidemic under control. Although it retains the lockdown as implemented to date from 27 March to 30 April, it moves to an aggressive mass testing and contact-tracing regime thereafter. This lasts until the epidemic is brought under control. In total there are 35 days of lockdown, 184 days of mass testing and contact tracing and 61 days of the intermediate package. (Figure 7)

The headline results shown in Table 2 reflect the total containment of the epidemic, with only 2,595 people infected and total mortality of 39. It should be noted that the actual trajectory of the disease could take the overall totals over these numbers by the end of April. These estimates should therefore be treated as indicative of a direction rather than offering a predicted outcome with a high level of specificity. This scenario indicates that bed demand is kept low, and no crisis of access to critical care beds would materialise. The demand for ICU beds peaks at the relatively low value of 43, with High Care at only 63.

Discussion of results

Both options modelled contain the epidemic, and, to that extent, reflect equivalent levels of success in the management of the health crisis. The differences in headline results (reported in Tables 3 and 4) should be disregarded, as they reflect an artificial structuring of option 1 – to fit a pattern of reverting to lockdowns when the disease resurges. Option 1 could also be structured without significant resurgence. This would however require a slight increase to the number of lockdown days.

The main result from this exercise is the number of days required to control the epidemic in 2020 using lockdowns as the primary intervention package. In total, the requirement for 193 days in 2020 is significant, and raises serious questions about the sustainability of this approach as the default strategy. While an economic analysis would provide concrete information on the implications for South Africa’s gross domestic product (GDP) of option 1, it is self-evident that this option would be ruinous.

The model indicates that the epidemic will resurge after a lag when the most effective interventions are withdrawn. In the real world, a resurgence would occur if merely one asymptomatic positive case was left in the community, or where a failure to eliminate the pandemic internationally resulted in a single undetected imported infection. In the former instance, the resurgence would be expected to be faster than the model suggests (as the model trajectory escalates based on fraction of a residual single person).

Given the protracted nature of the public health risk, the analysis suggests that an economically viable health prevention strategy will be required for most of 2020. As the implications of option 1 cannot be shouldered by the South African economy, the selected health strategy should be designed to be compatible with as broad an opening of the economy as is possible. Under these circumstance, a strategy broadly consistent with option 2 appears necessary. The specific features of such a strategy are broadly outlined in the next section.

Features of a risk-adjusted strategy

Overview

The COVID-19 epidemic poses a complex set of risks for South Africa over-and-above the morbidity and mortality associated with the disease itself. The knock-on effects of border closures, restricted movement and closed businesses, if not well addressed, will have long-term consequences for the economy.

While it could be argued that economic considerations should not be given precedence over health risks, in reality economic failure on the envisaged scale will have serious short- and medium-term implications for society at large, well before we get to the long-term. Shocks to employment levels will shift many into poverty, including many who were on a pathway out of poverty.

While Government could provide an economic bridge for some (but not all) where the periods of economic closure are limited, protracted lockdowns and business closures will result in a fiscal death spiral, with tax revenues falling precipitously while expenditure commitments rise precipitously.

The only viable pathway out of the COVID-19 crisis is therefore to integrate the health and economic strategies into a single all-of-government approach. This requires a total strategy of Government – one that is weighted proportionately to address the principal risks facing the country at this time.

There are five strategic considerations to such an all-of-government risk-adjusted approach.

  • First, the health prevention strategy must be organised with two objectives in mind: first, it must be compatible with an opening of the economy; and second, it should be designed to have positive economic spinoffs.
  • Second, social programmes aimed at income protection, such as social grants and unemployment insurance, should be implemented at scale to simultaneously address social protection needs and the need for domestic economic demand stimulation.
  • Third, non-health-related economic strategies need to address the shocks to both the demand and supply sides of the domestic economy.
  • Fourth, those parts of the strategy that require ongoing rapid decisions and the deployment of resources need to be supported by an all-of-government command structure that is fit-for-purpose.
  • Fifth, all parts of the strategy require rapid feedback on performance and constant useful public communication.

Once the only viable strategic approach has been determined by Government, it has to adopt it together with all the associated interventions with a high degree of urgency, commitment and adaptability.

An indicative approach to the health prevention strategy

This section provides a brief overview of a strategic approach to the risk-adjusted health prevention strategy. This involves a five-level response framework, a post-lockdown approach, transparency requirements and the achievement of operational integrity.

Five-level response-framework: Consideration should be given to a formalised five-level response framework for this epidemic and all future epidemics. The lowest level would be activated when an epidemic risk is identified. A set of pre-prepared responses would then be triggered. Each subsequent (triggered) level would involve increases in risk and urgency. A lockdown would only be considered as a last resort (last level) if the interventions in the previous levels fails to cope.

South Africa should have had a level 3 option, mass testing and contact tracing, but was not adequately prepared. As a consequence, arguably two levels were skipped, at great cost to the economy. While this may be seen as a long-term issue, it is relatively easy[12] to implement in the current crisis, and would prove to be a useful tool for decision-making in 2020. This is because there may be a need to move up and down levels all through the year depending on the success or failure of a response level. These movements up or down could also be area or cluster-specific, rather than seen purely at a national level.

  • Level 0: Routine surveillance of risks. When there are no threats, redundant capacity in infectious disease responses needs to be readied. This can involve: the identification of quarantine sites; the maintenance of contact-tracing machinery; and the preparation of a legislative framework for infectious disease outbreaks. This legislation should, inter alia, cater for emergency test development, requisitioning of equipment, rapid contact-tracing frameworks and preparations for mandatory quarantining of suspected and confirmed cases. Both public and private hospitals should be required to maintain a minimum number of isolation wards.
  • Level 1: Trigger – identification of a threat, by which is meant a highly infectious disease with significant morbidity and mortality. This may involve: the implementation of a central response platform for Government; the development of tests; the identification of possible shortfalls in testing equipment; the preparation of treatment facilities; the maintenance of basic border surveillance; the identification of high risk transport routes; mandatory testing and quarantining for people from high risk zones; the establishment of testing machinery for all persons presenting with symptoms; and where no test has yet been developed, suspected cases should be quarantined for appropriate periods. In all this, it would be important to coordinate with the private health system to agree on aspects that require a joint response.
  • Level 2: Trigger – imported infections identified together with first community-based infections. This would involve: border closures, together with mandatory across-the board testing and quarantining of travellers entering the country; the mandatory wearing of masks (if the disease has an airborne elements; mandatory social distancing; and mandatory (pre-prepared) health protocols implemented at workplaces, transport hubs and bulk transport; the temporary closure of schools and universities; the prohibition of mass meetings of any form (funerals, church gatherings, etc.); and an expansion of the testing framework to be able to detect community-based infections.
  • Level 3: Trigger – significant increase in community-based infections, but below 100. In addition to the level 1 and 2 interventions, implement mass testing and contact tracing, together with the quarantining of suspected cases and those identified as positive. This testing regime supplements the testing of suspected cases introduced from level 1.
  • Level 4: Trigger – community-based infections continue to increase exponentially. This would involve: general lockdowns initiated in areas with identified disease clusters; the closure of all non-essential businesses; and the closure of all bulk transport systems.

Post-lockdown health strategy: It is imperative that from 1 May 2020 South Africa is ready to implement a health prevention strategy that allows for a measured and safe movement from a level 4 response framework to level 3. The key elements of this approach could be expected to include:

  • Mass testing and contact tracing. This needs to be complemented with the rapid identification and follow-up of outbreak clusters.
  • All laboratory results must be available within 12 to 24 hours after the test.
  • Ambulances need to be in place for the transportation of confirmed cases.
  • At all times doctors, nurses and paramedics working in clinical areas should wear three layered surgical masks as well as gloves. Where close contact with patients are anticipated, full PPE is required, including N95 masks.
  • Health protocols must be developed for all organisations. A compliance framework to ensure adherence is also required.
  • Health protocols are required for all transport hubs and all forms of mass transport.
  • Health protocols are required for all places of education.
  • A distance learning framework needs to be developed for scholars without appropriate access to the internet and online teaching platforms.
  • Health protocols are required for social grant collection sites. This includes sites for food parcel distribution. These are also appropriate sites for mass testing and the distribution of masks.
  • The general public requires access to basic methods of personal protection. This includes hand sanitisers, masks (reusable) and gloves.
  • During the entire period of the emergency, it should be mandatory for all to wear a mask outside of their homes.

Transparency

The successful pursuit of a public health strategy relies on a high degree of voluntary consent to comply with appropriate public health measures as well as personal preventive conduct. In addition, researchers and businesses constantly need to make sense of the epidemic. This requires that detailed information on the trajectory of every aspect of the epidemic needs to be made public. Furthermore, the actions taken by Government need to be justified through the disclosure of the information upon which major decisions are made.

Operational integrity

An epidemic is a moving target which requires a whole-of-government response. However, the platform established to make rapid decisions needs to be fit-for-purpose and regularly reviewed. It is presently unclear how effective the current command structure is. In particular, whether it is able to constantly adjust to changing circumstances and configurations of risk and priorities.

Conclusion

This brief has provided an overview of the possible trajectory of the COVID-19 disease in South Africa under different intervention scenarios using an intervention model. The purpose of the modelling approach is to support decision-making in the face of the complex set of risks facing the country in 2020, and possibly beyond.

The modelling analysis suggests that it is unlikely that the disease will be eliminated as a risk in 2020. Given the protracted nature of the emergency, the public health strategies need to be designed to be compatible with continued economic activity.

Were South Africa to rely exclusively on lockdowns to contain the epidemic, a total lockdown period of 193 days may be required. This assumes, however, that lockdowns actually work in the South African context. At this stage it cannot be confirmed that the lockdown approach works in the densely populated informal settlements and townships. A total lockdown period of 193 days is however inconceivable from an economic perspective, and an alternative risk-based approach is therefore appropriate.

A risk-based approach seeks to manage all the risks associated with the epidemic, and not only the disease itself. The current health strategy places the economic welfare of more than 70% of the population in jeopardy, with Government only in a position to provide remedial support to only a subset of the group at risk of destitution. The sustainability of the programmes of support also ultimately depend on the sustainability of government finances, which in turn depend on the existence of a working economy. A lockdown-dependent strategy substantially erodes the ability of Government to bridge the social and economic impacts.[13]

Given this, strategic decisions are required at this point in the emergency which favour a risk-based approach rather than a lockdown dependent approach. However, a risk-based approach requires that the groundwork is properly laid. It is far from clear, however, that this necessary work has been done. But there is still time. But much depends on what use is made of the limited time.

References

European Centre for Disease Prevention and Control. (2020). Geographic ditribution of COVID-19 cases worldwide. Retrieved from: https://www.ecdc.europa.eu/en/publications-data/download-todays-data-geographic-distribution-covid-19-cases-worldwide

Kim, H. J. (2020, 4 February 2020). South Korea learned its successful Covid-19 strategy from a previous coronavirus outbreak: MERS, Online article. Bulletin of the Atomic Scientists. Retrieved from https://thebulletin.org/2020/03/south-korea-learned-its-successful-covid-19-strategy-from-a-previous-coronavirus-outbreak-mers/

Liu, Y., Gayle, A. A., Wilder-Smith, A., & Rocklöv, J. (2020). The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of Travel Medicine, 27(2). doi:10.1093/jtm/taaa021

van den Heever, A. (2020). COVID-19 Intervention Model for South Africa.

Zhang, S., Diao, M., Yu, W., Pei, L., Lin, Z., & Chen, D. (2020). Estimation of the reproductive number of novel coronavirus (COVID-19) and the probable outbreak size on the Diamond Princess cruise ship: A data-driven analysis. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 93, 201-204. doi:10.1016/j.ijid.2020.02.033

[1] There are numerous attempts to estimate R for COVID-1 (Liu, Gayle, Wilder-Smith, & Rocklöv, 2020; Zhang et al., 2020), Estimates do range from below 2 to around 3. The baseline assumption used in the report is merely used as the point-of-departure for assumed reductions in R due to interventions.

[2] This is where immunity levels are sufficiently high that R is always significantly below 1.

[3] The number of infected individuals totalled only 1,170 on 27 March 2020 when the lockdown began.

[4] See for instance (Kim, 2020)

[5] The United States was excluded as the lockdown is incomplete (or partial) and the peak of the epidemic has not been reached. It therefore cannot assist in the development of parameters for the model.

[6] Note that the South Korean data in Figure 1 is presented on a different scale to that for the other countries. This is because the size of the epidemic in Korea was far less than for the other countries, making it difficult to compare them side-by-side.

[7] The data source for international trends was from (European Centre for Disease Prevention and Control, 2020).

[8] The new infection data from China reflected so many inconsistencies however that it was necessary to smooth its upward trajectory. The new infection data from China has also been adjusted to iron out clear timing errors in reporting. This involved developing a linear equation for a period of apparent consistent reporting and extrapolating for the period of inconsistent reporting. The total number of infections was however retained. Only the trajectories were smoothed.

[9] These reductions in R effectively work back from the overall R totals developed using the Italian and South Korean epidemics.

[10] The 2.2 assumption is lower than the assumed average in cold climates of 2.43. The reduction from this baseline of approximately 0.3 is to account for the warmer climate at this time in South Africa.

[11] While this is shorter than the official intervention period, it is assumed that actual social distancing occurred with a lag of a few days.

[12] This is however subject to the release of public information indicating whether there are any fatal bottlenecks to the timeous expansion of testing to the scale required to manage the epidemic.

[13] It is worth noting that conventional views of deficit-financing rescue packages don’t fully apply to the current economic situation. The indefinite closure of businesses raises the uncomfortable prospect that the sale of government treasury bills could dry up – leaving the Government in a state of default. Virtually every revenue source for Government is compromised by a lockdown. Maintaining a posture of uncertainty regarding future lockdowns clearly places government finances in an untenable position. It should also be noted that industrialised countries can withstand these circumstances for a far longer period than South Africa.

Professor Alex van den Heever holds the Chair in the field of Social Security Systems Administration and Management Studies at the Wits School of Governance. This paper has been published in full on Maverick Citizen/Daily Maverick.

Numbers can kill: politicians should handle South Africa's coronavirus data with care

- David Everatt

We’d all love to know more about our neighbours – from COVID-19 data, census data and other official data sources – but we shouldn't.

Numbers tell stories. Usually, stories of people – often happy stories, like births, marriages, finishing school, getting a degree, getting a job. Even paying taxes. Sometimes they tell sad stories – death, divorce, disease, liquidations.

Statistics do not provide a cold or inanimate way of dealing with the world – they are one key part of the world, waiting for someone to spin the tale they tell.

At a time of heightened fear such as the world is currently living through, ensuring statistics of death and disease are handled with sensitivity should be self-evident, most particularly to politicians.

It appears not.

No one controls who talks to data once they’re in the public domain. No one stops journalists or students or politicians from analysing official stats as they see fit, thus creating their own narrative. That is why there are clear ethical and legal protocols in place.

The most basic of these is never to release data that may allow respondents to be identified.

In the case of South Africa this means that, in practice, Statistics South Africa (Stats SA), the country’s national statistical service, anonymises data it does release and has legal rules for the “level” at which data can be made available. This refers to both individuals and small, identifiable communities.

This is appropriate. It prevents the potential violation of confidentiality – the ability to point accusatory fingers because you choose to read (or misread, exaggerate, over-state) numbers in a particular way.

But is this basic protocol being adhered to during the COVID-19 pandemic?

Sadly not. An early case in point is the Western Cape, where premier Alan Winde released remarkably detailed figures on the local level sites of COVID-19 infection in the province.

As Winde put it,

Today (March 29) we have started providing sub-district information across the Western Cape, including in the city of Cape Town. The stats show us that this virus is spreading, reaching communities across our province. Each and every one of these cases, from Khayelitsha and Mitchells Plain to Mossel Bay — is of very serious concern for my government.

He went on to give detailed data for the Cape. Winde’s example has since been followed by other premiers, mayors and many others. This is not a party political point-scoring piece.

The obvious question is: why tell us, at such granular level?

Winde was no doubt acting from good intentions, one most people would share, which is that the more information people have, the more they may appreciate risk, and the better they may respond to the constraints of the COVID-19 lockdown.

Police monitor compliance with COVID-19 regulations in the Diepsloot informal settlement, Johannesburg. Michele Spatari/AFP/GettyImages

And, quite rightly, he was trying to put out the flames of potential stigma – as every politician subsequently repeats as they intone the nightly death toll. He and others have tried to say the disease knows no race or age or class. It can get anyone.

But the path to hell, as we know, is paved with good intentions.

The politics of death

When the first South African COVID-19 infection was reported on 5 March, almost immediately a video was circulated by some political figures that made it clear this was a rich white problem. Who else visits Italy in March?

It pointed to the immediate racialisation of the first South African infection. This was a disease of white globe-trotters. This was a problem for rich whites, not for “us” (mainly poor black people). It fed on the political discourse that marked the 2019 election – “protect our borders” (from “them”), take back “our” land and jobs (from a different “them”).


Read more: Zimbabwe's shattered economy poses a serious challenge to fighting COVID-19


The same reaction greeted HIV when it debuted in the 1980s and was written off as the gay-related immunodeficiency syndrome. It was a disease of moffies” – a derogatory term used to describe gay people in South Africa – a Western disease, a white disease, and a “them” disease. It was self-evidently not “our” macho, heterosexual problem. Until it was. And then it slaughtered people, and is still doing so.

Have people really learned absolutely nothing?

COVID-19 is everyone’s disease as well, as people are grudgingly accepting. But the race and class profile – of this being a problem for rich white people, that started with South Africa’s infection #1 – created a discourse that has not disappeared. It is fuelled by the country’s existing racialised inequality and people’s genuine fear of this invisible virus.

The release of data showing that “rich white” suburban parts of Cape Town and Johannesburg are the epicentres in both city and province is problematic. It feeds into and amplifies South Africa’s tendency to default to race, and creates real local divisions that mirror and deepen those already hardcreted into South Africa’s cities by apartheid spatial engineering.

Controlling the narrative

But why did stigma exist (and why so early)?

In no small part, because government didn’t control the narrative from day one. As a result, every session now includes the repetition that the virus cares not a jot for race. But, though government spokespeople also reassure South Africans that it doesn’t care if you’re rich or poor, a new narrative is taking root, that “the poor” are “the problem” – that enforced proximity coupled with poverty and compromised health means the epicentre will be informal settlements.

This is because we are so fundamentally unequal that this virus (like HIV before it) is going to disproportionately affect the poor. And the poor are overwhelmingly black. So the prejudice that welcomed COVID has created its own truth.

Statistics do tell stories. But they are understood in different contexts. So while everyone would love to know more about their neighbours – from the census, from COVID-19 data, from income and expenditure surveys, and other official data sources – they can’t. And they should not be able to – that way lies stigmatisation, racist and nationalist narratives, and worse.

In many countries across the world narratives of “our” jobs apparently being “taken” by others are becoming increasingly common in the wake of COVID-19. This, as has been shown in South Africa prior to the pandemic, leads to xenophobic violence and more death, as happened immediately after the 2019 national elections.

Politicians should take heed. Good intentions do not guarantee good outcomes. Stop imagining that granular data helps – it doesn’t. Stick to the protocols – and the law. Statistics South Africa does not release this type of data, precisely to protect people from one another. Leaders need to do the same, or the country may be divided after the COVID-19 crisis than it was before it hit.The Conversation

David Everatt, Head of Wits School of Governance, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Africa must make sure it’s part of the search for a coronavirus vaccine

- Gale Ure

To refuse inclusion would prevent Africa’s researchers from being significant players in the universal fight against the virus.

The search for a COVID-19 vaccine has sparked international media controversy and negative sentiment around the potential harm of people taking part in clinical trials once the research enters its human testing phase.

A wave of anger was ignited when two top French doctors said on live TV that coronavirus vaccines should be tested on poor Africans. The doctors later apologised for suggesting that COVID-19 vaccine trials should be carried out on a continent where the people were largely impoverished, with limited resources, and unable to protect themselves.

The statements made by Camille Locht and Jean-Paul Mira fed into a world already fissured by deep-rooted racial and economic discrimination.

Stigmatisation and discrimination in previously colonised African countries swung into focus, resulting in research becoming the target of populist rhetoric. Didier Drogba, a retired footballer, raised the issue that African people should not be used as guinea pigs in a testing lab. Samuel Eto’o, another retired footballer, called the doctors “murderers”.

The comments also resulted in the launch of a social media initiative in the form of a Change.org petition to stop coronavirus trials in Africa. The reasoning was that “Africa and developing countries have been testing grounds of large pharmaceutical companies” using the poor as the “guinea pigs of the wealthy”.

Not unlike fake news, the resultant outcome of the doctor’s racist comments was worldwide misinformation. Modern day research and clinical trials are highly regulated. In a COVID-19 world, scientific activity to develop a vaccine for global use is under careful scrutiny. Short of finding a cure, a vaccine is the only viable means to manage the devastating future outcome of the disease. A vaccine will need to be tested, and the world is watching. The doctors’ racism, however, unequivocally reminded the African continent of past medical discrimination at the hands of European countries. The result was a gratuitous attack on scientific research.

Finding a vaccine for COVID-19 is a worldwide medical emergency, necessary to prevent the death of millions of people. Should Africa participate in a global clinical trial? Absolutely. To refuse inclusion would prevent Africa’s researchers from being significant players in the universal fight against the virus.


Read more: Few clinical trials are done in Africa: COVID-19 shows why this urgently needs to change


The history

The extreme reaction from Africa was not entirely without merit. There are countries on the continent where vaccines and medical research are viewed with suspicion, and where both have been linked to activities, in the name of medicine, which were carried out in a grossly unethical manner.

During a meningitis outbreak in Nigeria, pharmaceutical company Pfizer tested Trovan, an experimental antibiotic drug, on 200 children without proper consent. In Malawi, during an AZT trial, in spite of there being alternative treatment available, a placebo was given to pregnant women enrolled on the trial. There is an ethical standard in research where a placebo, a substance which is of no therapeutic benefit, may not be given when investigating the efficacy of a new drug or drug regimen in cases where there is appropriate treatment available.

The legacy of this is that some people are afraid of being infected with diseases by vaccination.

That medical research and medicine were involved in historical abuse cannot be argued, but clinical trials in the 21st century look very different.

A changed environment

Globalisation in the past decade has shifted the trend in research activity from being done in developed countries to include trials in low- and middle-income countries.

Fears that countries may not have the institutional capacity to carry out research to the same ethical standards as their western counterparts have disappeared. Instead global health research partnerships have sprung up across continents. This has led to increased collaboration between European and African research organisations.

Research which takes place in Africa is predominantly funded by northern sponsors, with national academics and clinicians partnering in the research process. This has had a balancing effect – sponsored projects assist African research institutions to acquire funding for their own projects, to facilitate publishing of results, and to upscale research knowledge.


Read more: Coronavirus: never been a more compelling time for African scientists to work together


The ethical frameworks of these trials are stringent. International research organisations provide oversight to ensure that participants are protected.

Research carries risk, which is why there are international codes which protect participants. Each country has national legislation and standards to ensure that research is carried out ethically. This means that:

  • No person can be enrolled in a clinical trial without first giving their informed consent. To give informed consent, the potential participant must have the entire process of the project explained to them. This includes all of the possible risks and harms, as well as the expected outcomes. This must be done in a language and at a level that the participant is able to understand.

  • Participants may not be enrolled without being given the opportunity to leave the project at any time.

  • A participant’s personal information must be confidential, and the researcher may not use the participant’s information if the person has withdrawn.

  • There are agencies where the participant can lay a formal complaint.

  • All participants must be followed up after involvement in a research project, and there must be a plan in place to assist any participant who requires additional care arising from the trial.

COVID-19 trials

COVID-19 medication trials are taking place around the world. In Asia 1000 participants have already been recruited in to test Remdesivir, a drug developed by an American pharmaceutical company, Gilead. In the US the first trials of a vaccine are being run on 45 healthy participants.

Legitimate medical research activities are important to ensure that pandemics like the COVID-19 tragedy can be managed. Should Africa not be involved in the fight, it will be an indictment against medical research’s basic foundation – to allow people to choose to be part of the solution or to refuse on informed and valid grounds. The alternative is to sit idly by, as part of the global furniture waiting to be saved.

Gale Ure, Research Specialist: Life Healthcare Group, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Unpacking Ramaphosa’s COVID-19 rescue package

- Gilad Isaacs

A major step forward, but some warning lights are flashing. President Cyril Ramaphosa’s social and economic rescue package leaves some questions unanswered.

The Covid-19 economic rescue package announced on Tuesday night by President Cyril Ramaphosa is a major step forward. If effectively implemented, it will make a material difference in the lives of millions of people, and support tens of thousands of businesses. However, although the absence of details makes the package difficult to analyse, a number of weaknesses exist.

The size

Last week the Institute for Economic Justice (IEJ) argued that the rescue package should be commensurate with the scale of crisis.

As a rule of thumb, special Covid-19 government spending announced around the world has been roughly equal to the size of the expected economic contraction in each country. This is because, in the economics of lockdown, each rand spent is likely to have less of a stimulatory impact than in normal times.

In South Africa, estimates of the economic contraction have increased from 4% of Gross Domestic Product (GDP) two weeks ago, to 6 to 8% last week, to around 10% before the announcement of the package. 10% of GDP is just over R500 billion. This is the total the President announced.

But not all of it is new spending, nor necessarily government spending at all.

On the revenue side, R130 billion is to come from “reprioritising” existing planned budget expenditure. It makes sense to use money that may have been saved during the lockdown. But shifting money from one budget line to another will not necessarily be a long-term net gain for the economy. This is particularly true if we underfund long-term “capital expenditure” (investments in roads, ports, trains and so on).

On the expenditure side, R200 billion is in the form of loan guarantees, and R70 billion in the form of tax deferments or deductions. This is not additional government spending, though it will be an important lifeline for businesses and households.

This means there is R230 billion in spending, or 4.5% of GDP (shown in the table below). If R130 billion of this is from “reprioritisation” and R100 billion from the Unemployment Insurance Fund (UIF), then the package doesn’t necessarily cost the fiscus anything. This means that far greater spending should be leveraged for additional rescue measures and to set the economy on a new footing in the medium term.

Breakdown of R500 billion spending

Health interventions

R20 billion

Municipalities support

R20 billion

Social grants

R50 billion

Job support

R100 billion

Wage guarantees

R40 billion

Loan guarantees

R200 billion

Tax and payment deferrals and holidays

R70 billion

Income support

Researchers, activists, and some admirable government officials won the day and forced the National Treasury to concede to R50 billion in additional spending on social grants. This was a month-long battle that should never have had to be fought. The top-up to existing social grants will directly benefit over 18 million people, and indirectly another 14 million, many of the most vulnerable.

Unfortunately, the numbers don’t add up so it’s difficult to tell what’s going on here.

The proposed increase to the child support grant amounts to R36 billion, and increases to other grant beneficiaries amount to R8 billion – R44 billion in total.

A special Covid-19 grant is to benefit those “who are currently unemployed and do not receive any other form of social grant or UIF payment”. The President didn’t tell us how many people this will reach.

The most recent proposal on the table covered 8 million people – aged 21 to 59, earning below R3,500, not employed, and not getting another social grant. But at R350 a month for six months, that would amount to almost R17 billion. Those who proposed the grant originally sought to cover between 13 and 15 million people (R27 to R32 billion).

This amounts to a total package of at least R61 billion, as opposed to the R50 billion total announced by the President.

Presuming this R61 billion is correct, this will cushion the rise in extreme poverty and hunger. But depending on the fall in incomes in both formal and informal economies, a rise in poverty may still occur. Further, despite proposals on the table, the Covid-19 grant at R350 per month is too small, and its targeting will be complex to administer. A once-off universal basic income grant, at a significantly higher level (certainly not less than R500 per month), would be a better option.

Protecting jobs

How the R100 billion set aside “for the protection of jobs and to create jobs” is to be spent is also unclear.

R40 billion is allocated for supporting wage payments for businesses unable to pay their workers – presumably via the current Temporary Employer / Employee Relief Scheme (TERS) administered by the UIF. It’s unclear whether this includes the R30 billion already allocated to TERS, or is in addition to it. The IEJ showed that the original R30 billion did not guarantee a minimum wage and would only be enough to cover about 2.4 million workers, a share of those affected.

It is also uncertain whether the other challenges facing TERS will be attended to. It is slow, cumbersome, and difficult to access. The UIF seems ill-equipped to administer the scheme and it should be moved to the South African Revenue Service. And the current, illogical, requirement that it only covers businesses who have experienced a total or partial closure of operations as a direct result of Covid-19, must be removed. Restrictions on other funding streams, for example, a requirement of local ownership, also need to be relaxed.

Tax

R70 billion is dedicated to tax relief. Most of these measures delay the payment of taxes, although there are some tax deductions and holidays. How households (as opposed to businesses) will benefit is unstated.

There is also, it seems, no concrete package of compulsory measures around deferral of rent, mortgage or other loan payments. This can’t be left to the goodwill of the private sector to offer, and must be regulated.

Loan guarantees

The largest chunk of money – R200 billion – is dedicated to a loan guarantee scheme. Essentially, banks will extend special loans to struggling businesses and the National Treasury and South African Reserve Bank will bear the risk of default.

This is an important step forward and the commercial banks should be effective at getting this relief to businesses. But there are four issues to consider:

  1. The Reserve Bank, not the Treasury, should stand behind these loans and absorb any losses, protecting funds for future expenditure.
  2. Some businesses need bailouts not loans. As the IEJ notes: “additional debt, even at concessional interest rates, will not be appropriate for businesses facing a risk of insolvency. Similarly, it may prove optimistic that short-term tax deferrals will be an adequate or effective measure given the likely persistence of severe disruption and low demand beyond the end of the lockdown.”
  3. Strict conditions should accompany these loans. For banks, the loan guarantee scheme should impose maximum interest rates and fees, limiting the scope for profiteering. For the businesses, borrowing conditions restricting executive bonuses, safeguarding jobs, and promoting equity requirements should be considered. These should not be so onerous as to discourage businesses from making use of the scheme.
  4. There doesn’t seem to be a provision for big business (with turnover above R300 million a year). How many of these businesses are in trouble isn’t clear, but support may be needed. This support should also come with strings attached, and if the money is in bailouts, then government should receive a commensurate equity stake in the companies.

Financing

The President says that we will pay for all this from “local sources, such as the UIF, and from global partners and international financial institutions”.

This is the weakest element of the package.

The President’s plan is silent on additional tax measures. (The IEJ has estimated that “solidarity taxation” on rich people could yield R48 billion.) It is also silent on a special Covid-19 solidarity bond that would secure funds, on favourable terms and at low interest rates, from public and private institutional investors. Only an estimated R108 billion can be safely unlocked from the UIF. Private local finance must step up to the table.

The World Bank and International Monetary Fund are viewed, rightly, with great suspicion in South Africa. They are notorious for accompanying loans with anti-poor, pro-market measures of deregulation and slashing government and social spending. The IMF appears to have stepped back from this during the crisis but a flashing neon “proceed with caution” sign is required. While we should support global transfers from developed to developing countries, we should ensure that these loans come without strict anti-poor conditions, and that the loan terms are agreed to by all major social partners.

The bigger picture

The President’s address is bookended by references to the need to ensure “structural reforms” in the post-Covid recovery phrase. While economic reform is certainly needed, “structural reform” – as articulated by the Minister of Finance – is usually code for privatisation, cutting wages, and slashing spending. In line with this logic, the rescue packages do not include the necessary measures to stabilise the economy – further reducing borrowing costs, stabilising the exchange rate, and imposing measures to limit money leaving South Africa.

These worrying elements are, however, at odds with more progressive pronouncements by the President, for example that we should not “merely return our economy to where it was before” but “forge a new economy”.

The Covid-19 crisis is teaching the world that there is a need for more effective governance and a more proactive role for the state. It is showing South Africa that despite a decade or more of waste, corruption, and mismanagement, the state can play a developmental – and life-saving – role.

Gilad Isaacs is Co-Director of the Institute for Economic Justice and School of Economics and Finance, University of the Witwatersrand. This article was first published in GroudUp.

Wits publishes first clinical data on COVID-19 in South Africa

- Wits University

Health professionals will face difficult ethical decisions when it comes to dealing with COVID-19 patients.

For example, do they resuscitate patients even though the prospects of recovery are slim and the risk to the healthcare team high? How should healthcare workers respond?

This is one of the topics covered in the COVID-19 Special Issue of the Wits Journal of Clinical Medicine. The journal, published by Wits University Press under open access conditions, presents the first clinical data on COVID-19 published in South Africa.

The special issue covers a range of aspects of the pandemic, from the clinical, through ethical, to the social dynamics of its impact.

Highlights include:

Editor-in-chief of the Wits Journal of Clinical Medicine Professor Pravin Manga says it is important for health professionals and the public to have access to scientific information: “Social media is awash with all sorts of quackery regarding prevention and treatment remedies for COVID-19 and it is during these times that we need to be rational and be guided by science rather than by emotion.” Manga is Professor of Internal Medicine, School of Clinical Medicine, in the Faculty of Health Sciences at Wits.

In addition to being a public resource, more than 10 articles in this issue aim to guide healthcare workers.  These address the ethical aspects related to the pandemic – which patients should healthcare workers admit to already-filled intensive care units and who decides this? Associate Professor Kevin Behrens, Director and Head of the Steve Biko Centre for Bioethics discusses such ethical conundrums in his review.

Professor Laurel Baldwin-Ragaven in the Department of Family Medicine and Primary Care presents a sobering overview of how some of South Africa’s vast social disparities may manifest during COVID-19 and outlines our clinical and social responsibilities.

Professor Charles Feldman in the Division of Pulmonology, Department of Internal Medicine at Wits interrogates the aggravating issue of South Africa’s additional burdens of HIV and tuberculosis and the risk of COVID-19 infection in HIV-positive patients.

Professor Ismail S. Kalla in Pulmonology in Internal Medicine and Professor Abdullah Laher in Emergency Medicine in the School of Clinical Medicine explore whether herd immunity offers possibilities as a strategy for fighting COVID-19 in South Africa.

This special issue includes a guide to worldwide Medical Resources on COVID-19, as well as a handy poster-style patient guide for healthcare workers.

Enquiries: Corina.vanderspoel@wits.ac.za

*Covid-19 Resources for Academics and Students: Access the entire Wits University Press eBook collection in your university library through JSTOR and Proquest until 1 July 2020.

 

SA faces food riots and breakouts from the lockdown

- William Gumede

Getting food to the vulnerable, needy and poor during the COVID-19 lockdown is now increasingly urgent.

Getting food to the vulnerable, needy and poor during the Covid-19 lockdown is now increasingly urgent.

If not, South Africa face the specter of slowing down the spread of Covid-19, but large numbers of people dying of starvation, and possible food riots and breakouts of the hungry from the lockdown.  

The overwhelming majority of South Africans are either unemployed, eke out a living in the informal sector or survives on one form of government social grant. Those who are unemployed, working in the informal sector or are self-employed have no income during the movement, trading and buying restrictions of the lockdown.

The restrictions on movement of the lockdown makes it difficult for civil society organisations who distribute food to assist the needy. Even so, civil society organisations and charities do not have the funds and resources to distribute food to all who need it.

So far, even the few food parcels being distributed by the state, private sector and civil society organisations, hardly reaches those who need it most.

Large numbers of poor South Africans get their food from community feed schemes every day; whether run by the state, civil society organisations or the private sector. Furthermore, millions of children from poor families who received their meals from the state school feeding scheme now are at home under lockdown with no food.

Roughly 10 million school-going children get their basic daily food from school feeding schemes. During lockdown such daily meals are not available. They face mass starvation. Not providing food to millions of needy, is a shocking omission in government’s Covid-19 emergency plan. There has to be a simple way of food reaching the needy quickly.

Providing food to the needy during the lockdown is a government responsibility, but the private sector, and well-off individuals who can contribute, should also do so. Individuals of means can donate food to the needy. As part of a solidarity social pact, government, private sector, civil society and ordinary citizens can club together to provide and distribute food to the needy over the lockdown period.

Government must partner with civil society organisations, charities, churches, business and citizens to distribute food to the poor. Retailers could make unused food available to the poor, rather than it to be allowed to go to waste.

Food must be distributed door to door to vulnerable families. Civil society organisations and charities who are traditionally involved in distribution food to the need must be given essential service status, given government and business funding. Well-off private citizens must also donate to such food distribution civil society organisations. They must also volunteer their expertise, if practical.

The private sector involved in logistics could help with the transport of food. Retailers almost everyday transport food from depots to stores. Food distribution to the poor in outlaying townships and informal settlements could for example piggy-back on such transport.

Telecommunications companies could help with either a short message system, social media application or an easy toll-free number for the needy to request or make application for food relief.

Every city, township or village could have a coordinating committee of civil society organisations, private sector, government and private individuals which can coordinate the receiving and distribution of food into the community. Government halls, community centres, churches or schools could be used as local food distribution hubs.

Although a better food relief strategy during the Covid-19 lockdown for the poor given the complexity of distributing food to the vast numbers of the poor, is to make food vouchers available which can be redeemed at certain retailers. The success of providing food relief to the poor during the lockdown will ultimately determine whether the lockdown explode into social upheaval, riots and breakouts.

Off course, the best strategy to provide food is to give a basic income grant to all the unemployed and poor, over the period of the lockdown, which will give people cash in hand, which could be paid out at Post Offices, banks or retailers. As for the argument that there is no public money to provide regular food, a food voucher or a grant to the needy over the lockdown period; the R50bn that government has set aside to foster “big” black economic empowerment (BEE) industrialists should instead to be used to feed the poor.

The terrifying social costs of not providing food to the needy: food riots, people dying of starvation and the deaths that will be caused by an accelerated spread of Covid-19 because the hungry break out of lockdowns, makes it crucial that money be found for food for the needy.

William Gumede is Associate Professor, School of Governance, University of the Witwatersrand, and author of Restless Nation: Making Sense of Troubled Times (Tafelberg). This article was first published in the Daily Dispatch.

Complaints against SANDF

- William Gumede

The SANDF and SAPS should not enforce the COVID-19 lockdown at the expense of undermining human rights, personal dignity and common sense.

The South Africa’s Military Ombudsman received at least 33 complaints from the public of excessive force, physical abuse and brutality against the military during the COVID-19 lockdown.

The Independent Police Investigative Directorate (IPID), which monitors police abuse, has registered 39 cases of complaint against police wrongdoing, with six incidents of “death as a result of police action” during the first week of the lockdown, and is investigation 13 complaints related to police shooting and 14 of police assault.

In the first few days of the lockdown, more people died from police and military heavy handiness then from the coronavirus itself.

A number of videos have circulated of police and army enforcing the lockdown who were beating people they believe were not confirming to lockdown rules. In Hillbrow in the Johannesburg inner city police sjambokked people they believed were not following lockdown rules. In Soweto, soldiers have forced people do push-ups for not adhering to the lockdown rules.

One policeman has so far been arrested for a killing a citizen who was shot dead by police after following the man from a bar to his house.

After 26 years since the end of apartheid, the South African police appear still not to have been trained, neither have they inculcated a culture of human rights-policing. Equally, the army, although it is now involved in numerous peace making missions abroad, are also not at times performing their duties in such a way to respect basic human rights, dignity and compassion.

It does appear that both the police and army culture is based on using violence, humiliation and aggression to enforce rules.

Nosiviwe Mapisa-Nqakula, the Minister of Defence said in response to the death of an Alexandra man allegedly assaulted by SANDF soldiers:  “We hang our heads in shame.”

But there has been incidents where the police and the army go against common sense and arrest law-abiding citizens who are within the rules. There has been a number of cases where people have legitimately gone to the shops, pharmacy or other essential business who have been then been arrested for contravening the rules.

Last week Allan Kirby, a diabetic, from Somerset West was fined by the police for going to his local pharmacy, because he did not have his prescription on hand.

The South African Human Rights Commission (SAHRC) has urged the South African Police Service (SAPS) and the South African National Defence Force (SANDF) to “exercise greater tolerance and apply minimum force in the execution of their duties as has been urged by the President”.

The police and army should not discriminate against people based on race, religion or class in their enforcement of the lockdown rules. Poor communities, already vulnerable people and the homeless appear to be particularly at the mercy of police and army abuse.

It was important that Minister of Communications, Telecommunications and Postal Servicers Stella Ndabeni-Abrahams was charged with contravention of regulation 11B of the Disaster Management Act; because the lockdown rules must be seen to be enforced without discrimination based on privileged, political connectedness or influence.

The family of an Alexandra township man, Collins Khosa, who died after allegedly been assaulted by soldiers during the lockdown enforcement in the township, has gone directly to the Constitutional Court to hold government accountable, have the soldiers involved fired and to seek compensation for his death. It is important that citizens use the courts to hold government accountable if other official oversight institutions do not so.

Freedom of expression during the lockdown must be defended. Criticism of the president or the government’s measures to tackle Covid-19 or the behaviour of the police or army is not illegal. Off course, spreading fake news is unacceptable, and should be dealt with by the authorities.  

Citizens must report police and army abuse even if they may not be able to precisely identify a particular individual responsible for manhandling them. The media, civil society organisations and oversight organisations such as the Human Rights Commission must monitor police and army abuse.

The media, civil society and oversight organisations must support vulnerable, marginalised and powerless communities and citizens who appear to be on the receiving of disproportional police and army brutality.

All complaints against the police and army must be thoroughly investigated. Police and army officers found to have to be abusive should be disciplined. They should be held to account publicly.

In the long-term, the training curriculum of the police and army must be overhauled to make it more human rights based.

The organisational culture of the police and army, which clearly is based on humiliation, aggression and abuse should be thoroughly shaken up to focus on compassion, human rights and decisions based on common sense.

William Gumede is Associate Professor, School of Governance, University of the Witwatersrand, and author of Restless Nation: Making Sense of Troubled Times (Tafelberg). This article was first published in the Daily Dispatch.

Coronavirus: why South Africa needs a wealth tax now

- Aroop Chatterjee, Amory Gethin and Léo Czajka

A wealth tax on the top 1% of South Africans could raise R143 billion. This corresponds to 29% of the R500 billion COVID-19 package announced by the government.

The consequences of the COVID-19 lockdown are yet to be fully determined and understood. But one thing we can be fairly certain of – in South Africa its impact will be shaped by the country’s inequalities.

Our study reveals that half of the adult population survives with near-zero savings, while 3,500 individuals own 15% of the country’s wealth. The response to the crisis must take this into account to help the most vulnerable while still safeguarding fiscal sustainability.

Based on our new study on wealth inequality in South Africa, we propose a progressive solidarity wealth tax. This would allocate the fiscal burden of current interventions on those most capable of paying. It is in line with the recommendations recently made by the International Monetary Fund to equitably attain fiscal sustainability and better position the economy for post-COVID recovery.

We show that a wealth tax on the richest 354,000 individuals could raise at least R143 billion. That equates to 29% of the announced R500bn fiscal cost of the relief package.

Unequal distribution

A lot of studies show how extreme income inequality is in South Africa, but little has been documented about wealth. Net wealth is the sum of all assets less any debts. Assets include cash, bank deposits, pensions, life insurance, property, bonds and stocks. Debt includes mortgages and other loans such as retail store credit accounts or loans from friends, family and money lenders.

In our new paper, we combine national accounts statistics, household surveys and exhaustive tax microdata to assess the reliability of available data sources. We also provide the most comprehensive possible picture of the distribution of wealth. This is the first time this has been done in South Africa.

Better data is needed – about direct ownership, capital income and assets held through trusts. Nevertheless, our results give a good sense of the magnitude of the disparities. Three key results are worth mentioning.

Firstly, in 2017, the 10% richest South Africans (all adults with a net worth over R496,000) owned 86% of wealth, with an average of R2.8 million per adult. In contrast, about 18 million (the poorest 50%) were either in debt or had near-zero savings. With an average net worth of R486 million, the richest 3,500 owned 15% of wealth. This was more than the 32 million poorest altogether.

Secondly, these extreme inequalities extended to all forms of assets. The richest 10% owned 99.8% of bonds and stock – which accounted for 35% of wealth. The top decile also owned 60% of housing wealth and 64% of pension assets. Housing wealth amounted to 29% of wealth and pension assets to 33%.

Thirdly, we show that wealth concentration has remained broadly stable since 1993, and may even have increased within top wealth groups. Wealth inequality remains significantly higher than what could be estimated in Russia, China, India, the US or France.

Why wealth inequality matters now more than ever

Our findings are particularly relevant to the current crisis. South Africans are unequally armed to survive the contraction of the economy produced by the lockdown. Our paper helps get a sense of the size of the population likely to be under intense stress in the very short term.

Before the lockdown, about half of the population was already in debt, or had near-zero net wealth. Therefore, this crisis will at best sink millions of people further into indebtedness or force them to beg, loot or starve. Conversely, our paper shows that a minority of individuals are in a much less vulnerable situation.

The policy solutions needed to absorb the shock and recover fast must be carefully designed to take these factors into account. Principally, they need to reallocate resources to give everybody equal chances to survive the shock.

In this unprecedented crisis, the government announced a relief package with a R500 billion fiscal cost. One key remaining question is how such a plan will be funded.

The possibility of collecting additional tax revenue from those most able to contribute has not yet been brought to the table. We believe it should be considered. Our estimation suggests it would raise significant revenues. And it would allow the country to allocate the cost of the national response on the least vulnerable.

In the spirit of solidarity, a wealth tax could be part of the solution to safeguard long-run fiscal sustainability and inclusive growth.

How much could a wealth tax raise?

We propose a progressive wealth tax, which would apply only to South Africans with a net wealth currently superior to R3.6 million, that is the richest 354,000 (1% of the adult population).

The first bracket – all wealth between R3.6 million and R27 million – would be taxed at a 3% rate, the second bracket (R27 million to R119 million) at 5%, and all wealth above R119 million at 7%. Individuals with less than R3.6 million would be exempt. A billionaire would face a 6.7% tax rate: she would pay 3% on the fraction of her wealth higher than R3.6 million but lower than R27 million; 5% on wealth higher than R27 million but lower than R119 million; and 7% of the R821 million she owns above R119 million. This would leave her with post-tax wealth of R933 million.

Other tax schedules could of course be designed. The objective here is to give an order of magnitude of the expected revenues.

Taking into account the recent Johannesburg Stock Exchange All Share Index drop in value and assuming a 30% evasion rate (as available evidence suggests), we simulate that such tax would raise R143 billion.

It would still leave rich individuals with very high levels of wealth: for each of the brackets, post-tax wealth would on average be R9.3 million, R50 million and R376 million respectively.

A realistic policy

Critics of a wealth tax argue that it would be too costly and complex to implement. But South Africa is well positioned to administer this tax cost-effectively.

Firstly, the tax base we consider covers very few individuals, reducing the administration required.

Secondly, South Africa already has in place third-party reporting by financial intermediaries straight into the South African Revenue Service, providing information on capital income and ownership. Existing municipal valuations could be used to value property assets. This would cover the major components of asset holdings, especially stocks and bonds.

Capital flight, through offshoring or migration, is a potential risk. We account for this by making conservative assumptions about avoidance and evasion, and still project sizeable revenues. There is also markedly more cooperation between tax authorities to clamp down on undeclared incomes and assets in foreign jurisdictions, including tax havens. The premise is not a given. Capital flight implies forfeiting opportunities that considerably enriched them for the sake of avoiding a tax that barely makes an impact on their total wealth. Importantly, the wealthy themselves have said now is the time for solidarity.

A wealth tax, contrary to popular opinion, would not necessarily discourage job-creating investments. Maintaining fiscal sustainability while sparing the most vulnerable is more important to ensure a quick recovery and attract investments. Moreover, inherited wealth has a significant role in South Africa: we find high levels of wealth concentration even among 20-year-olds. Diminishing the importance of inherited capital with a wealth tax may actually be a better collective strategy to improve social welfare, including growth.

In light of the lessons learned from the Zondo commission of inquiry into corruption, taxpayers would need guarantees that this special tax will be properly collected and spent. The national treasury already uses ringfencing mechanisms to make revenue and spending for specific projects accountable. To answer potential criticism, the government could build on such rules to generalise more transparent practices.

There may be theoretical implementation challenges of such a wealth tax. But we would argue that South Africa is well placed to overcome these.

When designing the radar for Britain during World War II, Robert Watson-Watt justified his choice of a nonoptimal frequency as follows:

Give them the third best to go on with; the second best comes too late, the best never comes.

This radar was pivotal in allowing Britain to overcome a larger, more sophisticated German air force.

In our situation, we cannot let perfection be the enemy of progress, or in this case, survival.The Conversation

Aroop Chatterjee, Research Manager: Wealth Inequality, Southern Centre for Inequality Studies, University of the Witwatersrand; Amory Gethin, Research Fellow - World Inequality Lab - Paris School of Economics, and Léo Czajka, Research fellow - World Inequality Lab - UCLouvain

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Communities, not government, can and are fighting COVID-19

- Karl von Holdt and Tasneem Essop

The heavy-handed, top-down approach during the lockdown has not worked; NGOs, coalitions and community networks have.

A popular movement has arisen with extraordinary rapidity in response to the Covid-19 pandemic. With the announcement of a state of disaster, activists in communities across the country mobilised to protect their communities.

For example, the Amadiba Crisis Committee, established to fight against the destruction of land by mining on the Wild Coast, formed teams to move from household to household distributing sanitiser and talking about the necessity for physical-distancing.

In Khayelitsha, Cape Town, the Social Justice Coalition formed a community action network (CAN) and mobilised to demand water tanks from the city — which actually arrived within a week. The CAN, too, organised teams to inform community members about how to respond to the pandemic. The broader CAN movement in Cape Town has expanded to play a similar role.

In Ekurhuleni, the General Industries Workers Union of SA and the Casual Workers Advice Office printed 700,000 pamphlets about the coronavirus, distributing these at taxi ranks and in communities, and also made their own sanitiser for distribution. The street patrollers in the Yeoville Community Policing Forum marshalled at the long queues at local supermarkets, encouraging physical-distancing and resolving conflicts.

These few examples show faster, more agile and more effective responses than most state activities.

Meanwhile, at the national level, a diverse network of activists came together with the aim of co-ordinating a popular response to the state of disaster and the pandemic.

They were motivated by three overriding concerns: to strengthen community responses; ensure government responses did not exacerbate inequality and exclusion; and propose measures that would not only counter the immediate social and economic crisis, but also lay the foundations for a different kind of future.

Within a week they had established a broad coalition, which, by now, is supported by 250 movements, NGOs, trade unions, informal sector workers, feminist groups, faith-based organisations, research centres and public health networks — the biggest coalition SA has seen since the 1983 formation of the United Democratic Front.

The coalition has about 20 working groups, undertaking work ranging from building community organisation to distributing food parcels, and from policy work to repression monitoring and gender organising.

These and other initiatives that are not part of the C19 People’s Coalition reveal a vibrant and resourceful set of movements and networks with deep roots in communities and workplaces. Yet despite efforts, and notwithstanding some ad hoc local collaborations, there has been no systematic engagement from a government which, it is increasingly clear, is too distant and disorganised to directly access communities and ameliorate desperation and social distress.

Its food parcel efforts are hindered by bureaucratic processes to limit beneficiaries to the “deserving poor”, and failed promises have provoked tensions and food riots in some areas.

Indeed, the state’s most visible presence in communities is in the form of the police, municipal law enforcement, and the army, which has been set the often unattainable task of enforcing the lockdown in communities where compliance is impossible. This has led to many instances of brutal, illegal and unjustifiable force being used against people across the country.

These have turned fatal in some cases — the death of Collins Khoza in Alexandra, who was allegedly assaulted by soldiers; the death of Sibusiso Amos in Vosloorus allegedly from the intervention of Ekurhuleni metro police and private security; and the Independent Police Investigative Directorate is now investigating the death of a man in Soweto, who was allegedly assaulted by police. Multiple reports received by the coalition provide a snapshot of the abuse of power, corruption, human rights abuses, humiliating treatment and violent assaults perpetrated by security forces.

Colonial roots

To make matters worse, local governments, together with security forces, have also carried out illegal evictions in Cape Town, Johannesburg and Ethekwini, where the ANC authorities have continued their vicious vendetta against Abahlali baseMjondolo [a shack-dwellers’ movement that campaigns both against evictions and for public housing] under cover of the lockdown.

In all three metros there are reports and images from informal settlements and land occupations of people being assaulted, shot at and dragged out of shacks by law enforcement who have been sent out to tear down these structures. Cape Town’s mass internment camp for the homeless in Strandfontein has also been severely criticised for being overcrowded, unsafe and flouting the health requirements for curbing the spread of the coronavirus.

This is not the way to fight the pandemic. Quite the opposite — it is more likely to accelerate the pandemic and produce non-compliance in alienated and starving communities. These failures by the government suggest it is still trapped in a view of its poor and working-class as passive recipients of charity incapable of agency; generally undeserving of support, unless at starvation’s door; sources of infection who must be quarantined; and “dangerous classes” who pose a threat to authority and order.

These attitudes have deep colonial roots. Using repressive state machinery for public-health purposes serves to further entrench the historic frictions that already exist between the police, army and society. It weakens the relationship between state institutions and communities even further and increases the frustration of individuals and communities.

If President Cyril Ramaphosa and his government are to have any hope of managing the public healthcare crisis they need to decisively dispense with this apartheid heritage and work closely with popular movements, unions and civil society to educate, provide services and food, and devise appropriate public-health strategies and lockdown codes for precarious, overcrowded and desperate communities.

Professor Karl von Holdt and Tasneem Essop are based at the Wits Society Work and Politics Institute. Both are involved in the C19 People’s Coalition. This article was first published in Business Day.

Where there is political will there is a way to work across sectors

- Lungiswa Nkonki and Sharon Fonn

COVID-19: There are lessons for the health sector - the need for more coherent integration is undeniable.

South Africa reported its first case of coronavirus disease 2019 (COVID-19) on 5 March 2020. In the weeks that followed the country saw decisive, strong leadership from President Cyril Ramaphosa. It has also seen significant, important and necessary co-ordination between different ministries. These have included education, justice, health, trade and industry, transport, public works and infrastructure and finance.

The rapid pace at which steps were taken was impressive. More important was the all-encompassing intersectoral approach. Ministries with different mandates and areas of focus are working in concert for a common cause.

Intersectoral action recognises that health and wellbeing is influenced by where and how people live, where they work, what transport they use, and their access to water, sanitation, economic hubs and services. Health is socially determined. To improve health, coordinated action is required between ministries that don’t have health as their core mandate.

This is what “Health in All Policies” is about – a coherent approach to health policies set out by the World Health Organisation that’s been adopted by a number of countries, but by no means all. Without this coordination a long and healthy life for all cannot be achieved.

COVID-19 has dramatically highlighted the need for a more integrated healthcare system.

In a letter published in the South African Medical Journal we argue that the threat that COVID-19 presents has resulted in both leadership from government and apparent willingness of all South Africans to play their part. It presents a number of opportunities that should be exploited to the full.

One stark insight is that pooling resources across the health sector is needed to address this pandemic. This includes the rational use of hospitals, high care beds and laboratory testing capability.

Exemption to help co-ordination

The trend for pooling resources is being encouraged by South Africa’s Competition Commission, which published a COVID-19 block exemption for the healthcare sector.

The exemption seeks to promote co-ordination, sharing of information and standardisation of practice across the entire healthcare sector. The aim is to facilitate cost reduction measures, allowing possible procurement efficiency in purchasing of diagnostic tests, treatment and other preventive measures.

In particular the exemption seeks to promote agreement between the national department of health and the private sector to make facilities available to the public sector. For example, if government wants to use private sector bed capacity it may be able to use its drug related single exit price experience to negotiate the cost.

The makings of a roadmap

Late last year South Africa released a Health Market Inquiry report. It found excessive use of private health care; more care was delivered than could be explained by the level of illness of the private sector population.

The report also found that the sector would benefit from better regulation.

It made a number of recommendations that promote standardisation and knowledge-sharing as well as a method to deal with pricing within the functions of the proposed supply-side regulator.

The supply-side regulator includes systems which would allow for a real time description of:

  • providers – which ones exist and where they’re operating

  • where beds are located, their purpose (medical or surgical) and level of care (general, high care or intensive care), and

  • information on utilisation rates.

The report set out how the regulator could rationalise various functions which are currently poorly coordinated or absent across the private and public sector.

The report emphasised that the efficiency of, and access to, care required having information about health sector capability and quality across the entire health sector. This would enable resources to be used rationally.

The COVID-19 pandemic has underscored that such an approach is essential.

Set up this way, the regulator would form an essential mechanism going forward to ensure that South Africa was prepared for possible future emergencies.

Learning from COVID-19

There are two lessons here. For the health sector the need for more coherent integration is undeniable. Perhaps this exemption and working together to protect South Africa from the effects of this pandemic can build trust between players and will ease South Africans into a more rational and integrated healthcare system.

The second lesson is about intersectoral action and Health in all Policies that South Africa has seen illustrated to mitigate the threat of COVID-19. Poverty, inequality and unemployment similarly threaten the wellbeing of individuals in South Africa.

Equally urgent is the need to develop a mindset that understands that all policies aimed at development require integrated action. This means involving a range of players across government departments, across the public private divide, and must include social mobilisation and engagement with communities. The response to COVID-19 illustrates this well.

South Africa has managed to do this for health. It must be possible to do it in other areas of public policy. This needs to be extended further to build a more equal South Africa.The Conversation

Lungiswa Nkonki, Senior Lecturer, Department of Global Health, Stellenbosch University and Sharon Fonn, Professsor of Public Health; Co-Director Consortium for Advanced Research Training in Africa; Panel Member, Private Healthcare Market Inquiry, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Can the philosophy of ubuntu help provide a way to face health crises?

- Evanson Z Sambala, Lenore Manderson and Sara Cooper

There are lessons for the health sector - the need for more coherent integration is undeniable.

South Africa reported its first case of coronavirus disease 2019 (COVID-19) on 5 March 2020. In the weeks that followed the country saw decisive, strong leadership from President Cyril Ramaphosa. It has also seen significant, important and necessary co-ordination between different ministries. These have included education, justice, health, trade and industry, transport, public works and infrastructure and finance.

The rapid pace at which steps were taken was impressive. More important was the all-encompassing intersectoral approach. Ministries with different mandates and areas of focus are working in concert for a common cause.

Intersectoral action recognises that health and wellbeing is influenced by where and how people live, where they work, what transport they use, and their access to water, sanitation, economic hubs and services. Health is socially determined. To improve health, coordinated action is required between ministries that don’t have health as their core mandate.

This is what “Health in All Policies” is about – a coherent approach to health policies set out by the World Health Organisation that’s been adopted by a number of countries, but by no means all. Without this coordination a long and healthy life for all cannot be achieved.

COVID-19 has dramatically highlighted the need for a more integrated healthcare system.

In a letter published in the South African Medical Journal we argue that the threat that COVID-19 presents has resulted in both leadership from government and apparent willingness of all South Africans to play their part. It presents a number of opportunities that should be exploited to the full.

One stark insight is that pooling resources across the health sector is needed to address this pandemic. This includes the rational use of hospitals, high care beds and laboratory testing capability.

Exemption to help co-ordination

The trend for pooling resources is being encouraged by South Africa’s Competition Commission, which published a COVID-19 block exemption for the healthcare sector.

The exemption seeks to promote co-ordination, sharing of information and standardisation of practice across the entire healthcare sector. The aim is to facilitate cost reduction measures, allowing possible procurement efficiency in purchasing of diagnostic tests, treatment and other preventive measures.

In particular the exemption seeks to promote agreement between the national department of health and the private sector to make facilities available to the public sector. For example, if government wants to use private sector bed capacity it may be able to use its drug related single exit price experience to negotiate the cost.

The makings of a roadmap

Late last year South Africa released a Health Market Inquiry report. It found excessive use of private health care; more care was delivered than could be explained by the level of illness of the private sector population.

The report also found that the sector would benefit from better regulation.

It made a number of recommendations that promote standardisation and knowledge-sharing as well as a method to deal with pricing within the functions of the proposed supply-side regulator.

The supply-side regulator includes systems which would allow for a real time description of:

  • providers – which ones exist and where they’re operating

  • where beds are located, their purpose (medical or surgical) and level of care (general, high care or intensive care), and

  • information on utilisation rates.

The report set out how the regulator could rationalise various functions which are currently poorly coordinated or absent across the private and public sector.

The report emphasised that the efficiency of, and access to, care required having information about health sector capability and quality across the entire health sector. This would enable resources to be used rationally.

The COVID-19 pandemic has underscored that such an approach is essential.

Set up this way, the regulator would form an essential mechanism going forward to ensure that South Africa was prepared for possible future emergencies.

Learning from COVID-19

There are two lessons here. For the health sector the need for more coherent integration is undeniable. Perhaps this exemption and working together to protect South Africa from the effects of this pandemic can build trust between players and will ease South Africans into a more rational and integrated healthcare system.

The second lesson is about intersectoral action and Health in all Policies that South Africa has seen illustrated to mitigate the threat of COVID-19. Poverty, inequality and unemployment similarly threaten the wellbeing of individuals in South Africa.

Equally urgent is the need to develop a mindset that understands that all policies aimed at development require integrated action. This means involving a range of players across government departments, across the public private divide, and must include social mobilisation and engagement with communities. The response to COVID-19 illustrates this well.

South Africa has managed to do this for health. It must be possible to do it in other areas of public policy. This needs to be extended further to build a more equal South Africa.The Conversation

Lungiswa Nkonki, Senior Lecturer, Department of Global Health, Stellenbosch University and Sharon Fonn, Professsor of Public Health; Co-Director Consortium for Advanced Research Training in Africa; Panel Member, Private Healthcare Market Inquiry, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Let’s talk about ethics and treatment for COVID-19

- Christopher Wareham and Kevin Gary Behrens

In this episode of The Conversation - Africa's podcast, Pasha, Wits bioethics researchers discuss the difficult decisions facing health professionals.

With COVID-19 cases continuing to rise in South Africa, health professionals will have to make important decisions on who gets what treatment. But how do these decisions get made?

In today’s episode of Pasha, Kevin Behrens, director of the Steve Biko Centre for Bioethics, and Christopher Wareham, a senior lecturer at the same centre, discuss the ethics surrounding coronavirus topics.

LISTEN TO THE EPISODE

This podcast was based on an article in the Open Access COVID-19 Special Issue of the Wits Journal of Clinical Medicine.The Conversation

Ozayr Patel, Digital Editor, The Conversation. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Wits needs 300 volunteers for COVID-19 rapid test study

- Wits University

Have you tested positive for coronavirus or been near someone who has? If so, your country urgently needs you for a South African COVID-19 rapid test study.

This study, led by the Wits Department of Immunology, aims to ensure that existing rapid tests for COVID-19 are accurate.

Research being undertaken in laboratory

Qualifying volunteers will need to submit blood and saliva samples for serological testing for COVID-19. This includes the rapid antibody tests and the formal serology assays. [An assay is a laboratory procedure to measure quantities].

Serological tests measure the amount of antibodies or proteins present in the blood when the body is responding to a specific infection (such as COVID-19).

Antibody tests check for the small molecules that the body produces to fight infection. These antibodies are very specific to particular infections and form the basis of serology testing for many infectious diseases.

Why this study is important 

South Africa urgently needs to increase testing for COVID-19 so that infection can be identified, traced, isolated and contained. Although a number of rapid diagnosis tests are already available in South Africa, they are not consistently reliable. Inaccurate test results could lead people to believe they do not have the coronavirus, so they don’t self-isolate and then inadvertently infect others.

“Although there are rapid diagnostic tests available that can test for antibodies in the blood and deliver a result within minutes, these tests have not performed consistently well,” says Professor Elizabeth Mayne, Head of the Division of Immunology at Wits and Principal Investigator for this study.

Associate Prof. Elizabeth Mayne is Head of Immunology at Wits and calls for volunteers for a COVID19 rapid test trial

“To check that the various rapid tests being brought into South Africa work, we need blood and saliva samples from 300 people who tested positive for coronavirus, or who were in close contact with someone who tested positive".

The role of volunteers

On volunteering for the study, you will be briefed fully and will have the opportunity to ask questions.

You will be asked questions about your age, any underlying conditions you might have, such as high blood pressure and chronic lung diseases, any medications being taken, when you tested positive, your travel history and whether or not you had any symptoms.

A nurse will be dispatched to your home. The nurse, wearing full personal protective equipment (PPE), will extract around eight teaspoons of blood from you, as well as some saliva and some mouth/throat swabs.

These bio-samples of your blood and saliva will be used to create banks of known positive and negative controls, which scientists around the country can use to quickly and accurately evaluate any rapid or serological tests.  

About the study

The study is approved by the Human Research Ethics Committee at Wits University.

A minimum of 300 participants are required for the study.

The study is ongoing, so participants can volunteer at any time.

Participation is entirely voluntary and participants can withdraw consent at any time without giving a reason. Such withdrawal will have no effect on participants' diagnosis or treatment.

Participants will not be paid or in any way be financially remunerated for participating.

Participants will not be able to get the results of their tests.

How to volunteer

If you meet the criteria and wish to participate please email Elizabeth.mayne@nhls.ac.za or call 082 337 6349 for a comprehensive briefing and enrolment. 

About the Principal Investigator

Professor Elizabeth Mayne holds an MBBCh and MMED in haematology from Wits University. She is a specialist haematopathologist has since 2018 been Head of Immunology in the School of Pathology in the Faculty of Health Sciences at Wits. She is collaborating with Professor Wendy Stevens and Professor Ian Sanne on this project. 

Why South Africa needs to ensure income security beyond the pandemic

- Hannah J. Dawson and Elizaveta Fouksman

Economic distress was the norm for many before the coronavirus outbreak. The pandemic is an opportunity to provide an economically secure future for all.

A slew of countries ranging from the US to Brazil to Singapore to South Africa have decided to give people money in response to the economic crisis caused by the coronavirus pandemic.

While the amounts and details of the grants have varied, these governments have all made it clear that such payments are a short-term emergency response to an exceptional situation. But is the economic uncertainty caused by COVID-19 as exceptional as it seems? Might the reasons for guaranteeing economic security be valid even without a global pandemic?

Take the case of South Africa.

The government has decided to substantially bolster the social security net, directing R50 billion to those most acutely affected by the crisis over the next six months. This will be distributed in the form of increasing the current child support grant. In addition, pensions and disability grants will go up. But the biggest change is the introduction of a special “COVID-19 Social Relief of Distress grant” to be paid to people who are currently unemployed and do not receive any social grant or unemployment insurance for the next six months.

The new COVID-19 grant is the first time unemployed working-age adults are being included in the social grant system. Since 1994, the African National Congress government has resisted including them. And the resistance remains.

South Africa’s treasury has been busy making it clear that the new direct cash transfers are exceptional and temporary. At a recent media briefing, finance minister Tito Mboweni repeated again and again that the additional grants were temporary. His anxiety that people will expect the additional grants to remain in place – and that they will become “agitated” when the grants are taken away – is palpable.

Economic distress – before the pandemic

The name of the new grant shows exactly what it’s meant for. Calling it the COVID-19 Social Relief of Distress grant makes it clear that this is an emergency measure, here only to relieve the distress of COVID-19.

But economic distress was the norm for many before the coronavirus outbreak. Illness, ill-fortune and economic precarity existed long before this pandemic. The outbreak only makes the economic crisis broader, deeper and more visible.

An accident, a family death, or a delayed train can happen to anyone. But for the large number of people in South Africa who work for low wages without a proper contract, or who simply cannot find work at all, one of these events can be the tipping point into destitution.

They don’t need a pandemic to experience economic distress.

We would argue that South Africa needs more than emergency provisions such as a short-term new social grant or an emergency basic income. Rather, it needs a permanent form of economic security, be it in the form of a universal basic income that is given to all and then taxed back from those that don’t need it, or some other form of income guarantee for all.

Work does not provide economic security for all

Politicians are now willing to guarantee citizens some measure of economic security through the state because they cannot ask them to leave their homes and find economic security through work. But in a place like South Africa, finding economic security through wage labour was never the solution. It is just wishful thinking.

The statistics are stark: South Africa has an unemployment rate of nearly 40%. And of those lucky enough to have work, about 54% of full-time employees earn below the working-poor line of R4,125 a month.

The current economic distress brought on by the pandemic is not a brand new crisis. It’s an amplification of what was already reality for many South Africans. Indeed, it deepens economic insecurity around the world: globally, over 60% of workers are in “non-standard” employment – that means it’s precarious, short-term or informal.

The link between wage labour and economic security has long been a mirage in South Africa. Mass unemployment and precarity are neither new nor temporary. They are structural and enduring features of South Africa, further compounded as companies collapse and invest in labour-saving technologies. The need to provide economic security beyond the labour market has long been political reality.

Guaranteeing economic security

The idea that economic security should be a universal right – much like universal access to health care – has been around for centuries. At its core, it’s simply the argument that no matter who they are or what they do, every human being should be guaranteed enough resources to stay alive.

Ray van Heerden, a car guard, from the poverty-stricken shantytown of Munsieville, cannot work due to the lockdown. EFE-EPA/Kim Ludbrook

There are many ways to provide this kind of economic security. It could be via a social grant given to everyone who needs it. Or a negative income tax, a payment through the tax system that tops up the income of the poor to a basic level. Or it could be via a universal basic income – a regular payment to every resident, with no conditions or targeting.

Universal basic income has the advantage of simplicity. There’s no need for a bureaucracy to decide who should get it and who should not. And while many people critique it for being expensive and going to people who already have money, this is not the case. It goes to everyone, but is taxed back from the wealthy who don’t need it – meaning it both costs less than you might think, and ends up helping only those who really need it.

The biggest source of resistance to providing economic security to all, be it through universal basic income or other forms of guaranteed income, is the idea that people have to work for money – that “you can’t get money for nothing”. This is why, despite a big push for basic income in the early 2000s, the South African state has always resisted the idea. But work has never been able to provide economic security for all in South Africa. Why keep expecting the poor to receive money through work only, when work is unavailable, or unstable and badly paid?

The fact that many countries are now giving citizens emergency cash could be a step in the right direction. Finally, anyone who needs it can access some form of economic support from the state. But this should not be a temporary measure. It does not address a new problem, but rather a very old one that is suddenly worse. What the country needs is not an emergency basic income, but a permanent income guarantee. In fact the Spanish government plans to maintain the basic income it is implementing beyond the pandemic.

No longer business as usual

The circumstances that necessitate an income guarantee have long existed in South Africa. It is time for the government to acknowledge this. There can be no return to business as usual, because business as usual means poverty, suffering and ongoing economic distress.

The poor and most vulnerable understand that the economic insecurity they face is not a state of exception. It is the default. It will not end after the easing of the lockdown.

This international Workers’ Day, the COVID-19 pandemic provides an opportunity to see things as they are – that work cannot be assumed to shelter everyone from economic distress. It also provides an opportunity to delink basic livelihood from wage labour, and begin to develop policies that deliver an economically secure future for all.The Conversation

Hannah J. Dawson, Post-doctoral fellow at the Society, Work and Politics Institute (SWOP) , University of the Witwatersrand and Elizaveta Fouksman, Leverhulme Early Career Fellow, University of Oxford. This article is republished from The Conversation under a Creative Commons license. Read the original article.

The impact of coronavirus could compare to the Great Depression

- William Gumede

And a corresponding rise in nationalism and xenophobia may follow, just as it did in the 1930s.

The coronavirus crisis will be the biggest financial crisis of our generation, much larger than the 2007-2009 global financial crisis.

It is very likely that the economic impact of the coronavirus crisis will be comparable with the Great Depression, the period of devastating economic decline between 1929 and 1939, which saw mass unemployment, factory closures and the accompanying personal trauma.

The coronavirus outbreak will bring an economic depression - that is, a severe and prolonged economic decline with high levels of unemployment and company closures.

Record numbers of people will likely suffer from post-traumatic stress disorder (PTSD), the combination of stress, anxiety and depression that develops in some people who have experienced a traumatic event.

The coronavirus outbreak is already such an event. More than three million people around the world have been infected by the virus and more than 200,000 have died of it. Estimates show that the coronavirus may kill 100,000 Americans, the equivalent to double the number of Americans who died in the Vietnam War.

By comparison, the Spanish flu pandemic of 1918-1919 infected 500 million people, or one-third of the world's population, with 50 million deaths, of which 675,000 occurred in the US. The world's population in 1918-1919 was estimated at 1.5 billion. If one translates this to today's figures, with a world population of 7.8 billion, it would be the equivalent of 2.6 billion people infected and 250 million deaths.

The United Nations Conference on Trade and Development (UNCTAD), the UN's trade and development agency, says the slowdown in the global economy caused by the coronavirus outbreak is likely to cost at least $1 trillion in 2020 alone, in terms of reduced growth measured in gross domestic product (GDP). 

Over time, the cost to the global economy is likely to be three or four times that figure.

As a comparison, it is estimated that the 2007-2009 global financial crisis cost the US around $4.6 trillion in terms of lost growth in GDP, or 15 percent of its GDP compared to the years before the financial crisis. 

During the Great Depression, unemployment in many countries hovered around 25 percent, with one in four people in industrial countries made jobless by it. In the US, nearly half of the banks collapsed, 20,000 companies went bankrupt and 23,000 people committed suicide.

The current pandemic will cause individual economies to plunge into recession; businesses will close down and jobs will be lost at similar levels to that of the Great Depression. Moreover, the pandemic is impacting both industrial and developing countries; whereas the Great Depression was largely concentrated in industrial countries.

The International Labour Organization (ILO) has predicted that the pandemic will wipe out 6.7 percent of working hours in the second quarter of this year - the equivalent of 195 million full-time workers. 

This is already playing out. In the US, more than 22 million people filed claims for jobless benefits in the four weeks ending April 11, according to the US Department of Labour. To put these latest numbers into context, in 2008, at the height of the global financial crisis, 2.6 million people in the US filed for unemployment in that year, making 2008 the year with the biggest employment loss since 1945. 

Suicides, domestic violence and murders increase during times of economic hardship and this may be further exacerbated by lockdowns and self-isolation.

Wealthier countries such as Germany, the UK and the US have rolled out large aid programmes - larger than those which appeared in the aftermath of the 2008 global financial crisis - to support businesses, the self-employed and the unemployed for loss of income during the lockdown. Germany will give unlimited loans to large companies, pay 60 percent of salaries of troubled companies to allow them to reduce the working hours of employees without having to lay them off and financial support to the self-employed.

The US has unveiled a $2 trillion coronavirus rescue package for struggling companies and employees, which includes loans, equity stakes for government in businesses in strategic sectors and direct cash payments to individuals.

While these bailouts might provide interim relief, they will plunge countries, companies and families into debt for years, while we will also have to deal with the social crises of deaths, suicides and mental disintegration for a long time after the coronavirus pandemic. 

After the Great Depression there was a rise in nationalism around the world - as a direct result of the financial, social and emotional hardships of the depression - creating the conditions that eventually led to the second world war. 

There has been a similar rise in nationalism, populism and xenophobia during the coronavirus outbreak. Of course, this had been growing for many years before the pandemic, in part as a result of austerity measures that caused financial hardship in the aftermath of the 2007-2009 financial crisis.

The coronavirus crisis will likely make those austerity measures worse.

Although there have been pockets of solidarity in response to the coronavirus - Cuba sending medical personnel to Italy and China sending medical equipment to Poland, for example - some countries have stopped vital medicines, equipment and food from being exported to other countries. 

Once the crisis has passed, some countries may continue turning themselves into fortresses, excluding outsiders, whether immigrants, refugees or foreign companies.

Nationalist, populist and extremist leaders and governments could ride the wave of post-coronavirus financial and emotional hardships, in the same way they did after the Great Depression. There is a real danger that the hardships caused by the coronavirus pandemic will lead to authoritarian governments coming to power in many countries, while those already in power become more entrenched.

If they do, the methods used to prevent the virus from spreading: sealing off borders, tracking infected individuals using surveillance technology and restricting people's movements, could be used for more menacing purposes.

William Gumede is Associate Professor, School of Governance, University of the Witwatersrand, and author of Restless Nation: Making Sense of Troubled Times (Tafelberg). This article was first published on Al Jazeera. 

 

African countries are moving to make masks mandatory: key questions answered

- Shaheen Mehtar, Lucille Blumberg and Marc Mendelson

Wearing masks is being introduced in conjunction with maintaining a physical distance of at least 1.5 metres; following hygiene measures such as hand washing.

Many countries, including South Africa and Nigeria in Africa, are moving to make it mandatory to wear non-medical cloth masks when people are outside their homes. The move is seen as a vital additional measure to prevent the spread of SARS-CoV-2, the novel coronavirus causing COVID-19.

Wearing cloth masks is being introduced in conjunction with maintaining a physical distance of at least 1.5 metres and strictly following hygiene measures such as hand washing, good cough etiquette, and decontamination of regularly used surfaces.

Medical face masks have been a vital part of COVID-19 prevention efforts in East Asian countries such as China, Taiwan, Hong Kong and South Korea.

In countries where medical face masks are preserved for healthcare workers or are scarce, fabric face masks provide a cost-effective alternative. These can be homemade and are reusable.

There has been a growing movement of homemade mask production. Factories have also repurposed to produce fabric face masks to support commercial and free distribution.

In South Africa wearing a cloth mask in public places is now mandatory. In our view, there is sufficient evidence to suggest if everyone wears a mask, droplet transmission from each person will reduce and minimise exposure.

Transmission

The early phases of the COVID-19 epidemic included an evolving understanding of the routes of transmission of the coronavirus. It is now well established that droplet transmission is of vital concern. In the case of the severe acute respiratory syndrome coronavirus in 2002, viral shedding via the respiratory tract happened mostly after people developed symptoms. But COVID-19 includes a pre-symptomatic phase where people can be infectious and still feel healthy and be unaware that they are infected. Mildly symptomatic and asymptomatic cases also occur.

Mandatory masking ensures that viral transmission by any potential carrier is markedly reduced. It emphasises the concept of “source control”, in other words controlling the amount of a pathogen that is present in the environment. This is well expressed through the slogan: “I protect you, you protect me”. This was popularised by the #masks4all initiative, started by a group of researchers and scientists to promote the scientific evidence showing that cloth masks limit the spread of SARS-CoV-2.

An additional benefit of the ubiquitous wearing of face masks is the reduced possibility that respiratory droplets will be released to settle on surfaces – or for smaller aerosolised particles to float in the air.

For those still in doubt, we have answered some key questions to address the biggest areas of controversy:

  • Why should I wear a cloth mask? To prevent potential transmission of the coronavirus that causes COVID-19 via respiratory droplets and particles released when you talk, laugh, sing, shout, cough or sneeze, or to prevent the potential inhalation virus laden particles. A cloth face mask also serves as barrier that prevents touch transfer from surfaces to your mouth and nose and a reminder not to touch other parts of your face – especially your eyes. In addition, a face mask reduces the extent to which droplets and particles end up on surfaces or float in the air.

  • When should I wear a cloth mask? As a general rule, any time that you are outside your home, and especially in close contact situations such as when using public transport, shopping, working, or in any crowded setting. If a person in your household is possibly infected with coronavirus, face masks must be used when in close proximity, in conjunction with separating living quarters. Helplines and healthcare providers are good places to go for additional steps to follow.

  • Can I make my cloth mask out of anything? The most effective approach is to use a thicker weave material such as cotton for the outer layer, and then to include at least two layers of softer material for comfort and additional barrier protection. Test the materials combined for breathability before sewing. There should be some resistance to airflow, but you should be able to breathe freely when using the completed mask. Fit is important to minimise air bypassing the cloth barrier via the sides. Materials used should be easily washable and heat tolerant for cleaning. Stretchy material should be avoided.

  • How do I wear the mask? Never share a mask with anyone and always use a mask that is freshly cleaned. Wash or sanitise your hands before putting on the mask and when removing. Ensure that it covers the area from the top of your nose to below your chin. When you remove the mask, move your hands forward so you can fold the front over itself. Hold on the sides and place in a safe area for cleaning.

  • How do I reuse a mask? A cloth mask can be washed in hot water with soap or washed in a washing machine. Iron or sun dry. You can also drop the mask into boiled water and leave to cool to a temperature that allows you to wash the mask with soap or washing detergent. Avoid harsh chemicals such as bleach as this will be toxic when wearing the mask. By having two masks available, you can wear one, and have one to wash.

Dr Warren Parker a public health communications specialist, and Dr Beth Engelbrecht from the Western Cape Department of Health contributed to this article.The Conversation

Shaheen Mehtar, Infection Prevention and Control specialist, Stellenbosch University; Lucille Blumberg, Deputy Director of the National Institute for Communicable Diseases and a member of the joint staff, University of the Witwatersrand, and Marc Mendelson, Professor of Infectious Diseases, University of Cape Town .This article is republished from The Conversation under a Creative Commons license. Read the original article.

WITS COVID-19 UPDATE 27 – FINAL YEAR MEDICAL STUDENTS RETURN TO CAMPUS

- Wits University

Final year medical students will return to Wits on Monday, 11 May 2020.

Following the directive issued by the Minister of Higher Education and Training on 30 April 2020, final year medical students will return to Wits on Monday, 11 May 2020.  This will require a limited opening of the Wits Junction Residence Complex and the Faculty of Health Sciences building, as well as the clinical training platform in various hospitals.

The University has prepared for the return of 314 medical students in their final year of the MBBCh and GEMP programmes. 91 students from this group will be housed in the Wits Junction on a self-catering basis.

An additional 142 medical students on the Mandela Castro programme will also be returning to continue their clinical training in hospitals. These students will be housed, as usual, in the Witwaters Building and at various hospitals.

We have implemented the following safety measures in compliance with all regulations and protocols, and with the advice of experts:

  • Residences and related facilities, offices and teaching venues have been decontaminated, including surfaces, equipment and ventilation systems. This has been confirmed by Wits’ Occupational Health and Safety Director and his team.
  • Sanitisers have been installed at all entry points, as well as at the entrances of all buildings.
  • Buses have been decontaminated and screens have been installed to separate bus drivers from students. Bus drivers have been instructed to ensure that buses are no more than two thirds full when transporting students to hospitals, in line with transport regulations. Physical distancing must be maintained on buses and masks must be worn at all times.
  • All students and employees will be expected to complete a confidential screening questionnaire every day (via an app) before being allowed onto campus, in line with national protocols. Temperature screening may be undertaken at the gates if this becomes necessary for any reason.
  • Staff and students will be issued with the proper Personal Protective Equipment, including the appropriate masks for medical students. At least two cloth masks will be issued to all other staff and students, who will be responsible for ensuring that they wear a newly-washed mask every day. It is compulsory to wear masks at all times when in open spaces, whilst using University transport and in clinical settings. 
  • Physical distancing and good hand hygiene (preferably by washing hands with soap and water for 20 seconds at a time and drying properly) is compulsory.

In order to ensure our collective wellbeing, students and staff members are required to adhere to the stringent measures outlined above and to report immediately any violations of protocol to the Office of the Dean of Health Sciences via david.gray@wits.ac.za. Anyone who does not adhere to these requirements may be escorted off the premises by Campus Protection Services.

We would also like to extend our appreciation to our returning students, and to all Wits’ staff members who have meticulously prepared f or the return of this cohort, and who will continue to support them in the months ahead. These include in particular staff members from the following departments: Student Affairs; Services; PIMD; ICT; Protection Services; OHS&E; Finance; Faculty of Health Sciences staff, and other supporting units. 

Remember to wear your masks and to practice physical distancing and good hand hygiene.

Keep healthy and safe!

SENIOR EXECUTIVE TEAM

8 MAY 2020

Health and safety in the spotlight as South Africa’s miners go back to work

- Nancy Coulson and Nicola Christofides

Miners face cramped working conditions, transportation in packed cages, and a high incidence of other respiratory diseases, posing considerable risks.

South Africa was put under strict social and economic lockdown on 26 March. By the end of April the government announced that it was easing some of the restrictions. This included allowing certain key sectors to begin operations once again. One of them was mining.

Mining is an important contributor to the South African economy. It employs around 450,000 people and makes a direct contribution of 8.1% to GDP. Approximately 78% of these people work on gold, platinum and coal mines that are largely underground operations.

Under the regulations easing the lockdown, mining can resume operation at 50% capacity and must provide health and safety protection from COVID-19. But the government guidelines were not binding on employers.

This decision led a trade union, the Association of Mineworkers and Construction Union, to take a case to the country’s Labour Court. At issue was the adequacy of the voluntary guidance about the COVID-19 response to protect mineworker health.

The case challenged the preparedness of the sector to protect workers.

The threat posed by COVID-19 on mines is considerable. Working conditions underground are cramped, transportation is in packed cages, and there is a high incidence of respiratory diseases.

The union argued that the hazard posed by the pandemic was too substantial for voluntary guidance and that both the mineral resources minister and the chief inspector of mines had failed to institute the necessary mandatory measures under the country’s Mine Health and Safety Act.

The judge agreed. As a consequence, measures to address COVID-19 are now compulsory for all mines.

One aspect of the union’s argument for compulsory guidance was that worker health and safety representatives appointed under the Mine Health and Safety Act would be unable to hold the employer to account without enforceable standards. Research we have done shows that worker health and safety representatives on South African underground mines are indeed in a weak position. Even with enforceable standards they will face an uphill task.

Case study research we conducted on four underground mines revealed the important, but hugely compromised role of health and safety representatives in a health response.

Health and safety representatives

The powers of safety representatives are largely universal. They include representing workers on all matters related to health and safety, conducting inspections and withdrawing workers from a dangerous workplace. They have the right to training and to resources to support them in their role.

On a large underground mine with more than 1,000 employees there are between two and four full-time representatives per shaft and sometimes hundreds of workplace representatives – those who take on the role of representative alongside his or her job of employment.

These arrangements are subject to agreements signed between the employer and recognised trade unions at a mine site. These agreements typically cover the number and election of representatives and their training and resourcing. Representatives are elected by workers and while the employer must ensure their training and resourcing, there is no requirement for workplace representatives to be paid. Full-time representatives are paid by the employer and this resembles arrangements for shop stewards.

Consultation by the employer with autonomous employee representatives is a central tenet of the Mine Health and Safety Act.

Our research made three major observations about worker representatives when it comes to health issues.

Firstly, that representatives were engaged in activities to address the existing triple disease burden on mines: occupational (lung disease and noise induced hearing loss), communicable (HIV and tuberculosis) and noncommunicable (diabetes and hypertension) diseases.

Workplace representatives acted as frontline health workers responding to the ill-health and emotional problems of production workers. They advised and counselled workers, encouraged visits to the clinic, escorted workers to the surface should they fall unwell, and reorganised workloads in the production team when workers were upset, weak or tired.

Full-time representatives acted as the compassionate voice for workers. This involved, for example, escorting individual workers to face bullying supervisors to address health related problems.

Secondly, representatives took on the responsibilities of the employer too. Full-time representatives took daily instructions (including some about health) from safety management. Representatives conducted inspections, gave education talks and policed the behaviour of workers on behalf of the employer. They also engaged in inappropriate problem solving, such as encouraging workers to use a cloth as a dust mask in the absence of personal protective equipment.

Representatives were often left feeling they would get into trouble with the employer if something went wrong. Representatives who challenged the production imperative by withdrawing workers from a dangerous workplace felt unsupported by the employer. We found approximately 30% of mineworkers who had withdrawn from a workplace went back despite believing it was still dangerous. Workers had little confidence that their health and safety representative could get the workplace fixed.

Thirdly, representatives were dominated on a daily basis by the employer and faced retaliatory employer actions. Supervisors threatened representatives who exercised their powers or had them removed from a workplace. In some instances, they lost their jobs.

We found that worker representatives were not an autonomous voice for worker concerns and therefore could not hold the employer to account. Nor could representatives rely on trade union support. The employer actively discouraged their reporting into trade union branch structures.

Employer appointed service providers, rather than trade unions, provided training and delivered the accredited skills programme. Not one representative in our research knew their powers correctly under the law – even after training. Neither did they have instruments for routine tests, such as for dust, or access to the internet to support their role.

Dangers

For worker representatives to fulfil their role, mandatory standards for COVID-19 protection are a first step. But more needs to be done.

International evidence shows there are broad preconditions necessary to support the effectiveness of worker representation. These include trade union training and support for worker representatives; a supportive steer from the regulator, which could include dedicated guidance about the role and resourcing of worker representatives; and an appreciation by the employer of the autonomous role of representatives.

Mine health and safety has become more complex under COVID-19. A bold step to resource and equip health and safety representatives is now needed.The Conversation

Nancy Coulson, Visting Senior Lecturer Wits Mining Institute, University of the Witwatersrand and Nicola Christofides, Associate Professor, School of Public Health, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

South Africa’s COVID-19 testing strategy needs urgent fixing: here’s how to do it

- Marc Mendelson and Shabir Madhi

Early reports by the National Health Laboratory Service indicated that it had the capacity to do 30,000 tests a day. But capability to do so has not materialise

The COVID-19 epidemic in South Africa is now in its exponential phase. Cases are rapidly increasing in many areas. This is most apparent in the Western Cape province, which could be due to higher rates of testing per capita, coupled with a more selective testing strategy than in other provinces.

The doubling time of mortality in the province’s Cape Town metro is now 8-9 days, indicating a rapid increase in the number of severe cases and deaths from COVID-19. Although the health system is better prepared as a result of the initial lockdown, major cracks are starting to show. This is causing a deterioration in clinical service which, if not stemmed, threatens the country’s response to the epidemic.

Globally, rates of testing for SARS-CoV-2 infection have varied between and within countries. For example, testing rates (per 1,000 people) range from 148 in Iceland to 0.76 in India. In South Africa, as of 3 May 2020, the testing rate was 4.5. The high demand globally for molecular assays (known as PCR) to identify infectious cases has led to a shortage of samples and kits required in laboratories.

In South Africa’s case, the rise in the number of cases in the Western Cape, and the pressure this is putting on laboratories charged with processing tests, is only the forerunner. Here, we explain what needs to be done, and why.

Turnaround time

Diagnosis of COVID-19 relies on a laboratory test that is simple, but laborious. The time taken from the sample being taken to communication of the result – the “turnaround time” – is influenced by a number of factors. These include the speed at which the sample reaches the lab, the lab’s capacity to run the test – access to reagents and test kits, number of analysis machines, availability of staff, errors leading to a need for re-testing – and the communication process.

Early reports by the National Health Laboratory Service indicated that it had the capacity to do 36,000 tests a day by the end of April 2020. But capability to do so has not materialised.

Currently, the number of tests received in laboratories exceeds their capacity to deliver results within 12-24 hours of sampling. In many parts of the country, turnaround time has increased from 24 hours to over 5-14 days. According to correspondence we have seen, some labs with the capacity to do 1,000 tests a day have a backlog of 10,000.

Why is “turnaround time” so critical?

South Africa’s ambitious community testing programme relies on identifying infected persons, isolating them, tracing their contacts, and isolating or quarantining them.

Identification of infectious cases – even if only a quarter of those who are infected are identified – coupled with adequate tracing of their contacts and ensuring isolation (of cases) and quarantine (for up to 14 days) of test-negative contacts, could assist in slowing the rate of community transmission of the virus.

This would mitigate the expected surge in severe COVID-19 cases occurring over a very short period of time. Healthcare facilities could be better equipped to deal with the expected surge of COVID-19 cases over the next 2-3 months.

But for such a strategy to be effective requires a clear line of sight in terms of efficiency of testing, isolation of cases as quickly as possible (within 12-24 hours of being tested), and effective and immediate tracing of their close contacts.

It is estimated that any single case will, on average, have 20 close contacts (probably higher in South Africa) who should be traced. These include any close contacts (someone who spends more than 15-30 minutes within 1.5 metres of the person) occurring from at least 2-3 days prior to symptom onset in the identified case, and up until the case has been isolated. Assuming that isolation occurs on the third day after symptoms appear, for each case there would be approximately 120 close contacts to be followed up.

For this strategy to assist with slowing the spread of the virus requires tracing (and physical contact for screening for symptoms) of approximately 80%. Although possibly achievable in the initial phase of the epidemic, it becomes an unrealistic goal to aspire to when identifying 400 “new cases” each day, as that would require tracking and physical tracing of approximately 5,200 contacts.

This is why the turnaround time matters. A delay means that the current “new” cases reported in South Africa reflect cases that were likely sampled approximately a week ago.

This points to the need to shift the focus of PCR testing to patients being admitted to the hospitals. This would inform the management of the patient and limit the likelihood of spread within hospitals.

But the turnaround time for this cannot be anything more than 12-24 hours if it is to achieve any of these goals of testing. When a person with COVID-19 is admitted to a hospital, it is critical that they do not infect others. We achieve this by triaging patients into those who are COVID-19 suspects (a “person under investigation”) and those who are not. We separate patients into different wards accordingly.

Slow turnaround time for tests means a delay in diagnosis. The longer the turnaround time, the worse it gets. As the epidemic accelerates in South Africa, the number of patients needing to be admitted to hospital as a “person under investigation” and subsequently COVID-19-confirmed cases rapidly rises, and the system becomes overwhelmed.

This is why we are arguing for a wholesale change to the current system.

How to fix the faults

We believe the following crucial steps need to be introduced as a matter of urgency.

  • Stop the testing and contact tracing components of the community surveillance programme, in favour of self-reporting of symptoms via an app-based programme on mobile phones. We believe there is sufficient mobile coverage and access to do this. This would allow monitoring of disease activity, and self-isolation of symptomatic people for 14 days on the probability of COVID-19 infection. If resources allow for testing to confirm negative status sooner than 14 days to accelerate early return to work, that should be considered, but not at the expense of undermining turnaround times in hospitalised patients.

  • Steps need to be taken to map the spread of SARS-CoV-2 in communities. This should be done by gathering evidence on the seroprevalence, which can be measured using rapid antibody blood tests to detect recent or past SARS-CoV-2 infection (but not whether currently infectious). Geospatial mapping of the epidemic could assist in a more measured and informed approach for developing district or regional strategies to reduce the rate of community transmission. It could also help inform anticipated demands on healthcare services.

  • Focus testing resources on specific groups of people for whom a rapid turnaround time result will effect significant change.

  • Allow rapid diagnosis of hospitalised people under investigation, which allows optimal case management of severe COVID-19, optimal infection prevention and control, and patient flow to enable hospitals to cope with the escalating numbers as we climb the exponential curve to the peak.

  • Rapidly isolate and quarantine symptomatic healthcare workers and their close contacts to limit hospital outbreaks.

  • Introduce high risk group surveillance and testing, including patients and staff at long-term care facilities.

  • Convene an intersectoral government task force to analyse the barriers to operational flow of the entire testing system and make recommendations for a new testing strategy.The Conversation

Marc Mendelson, Professor of Infectious Diseases, University of Cape Town and Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Lockdown is riling black and white South Africans: could this be a reset moment?

- David Everatt

It is rare for a post-authoritarian society to get two chances to reconcile. This may be just that, for white South Africans in particular.

The South African government seems to have gone from an absence of data coupled to a firm but sensible strategy of lockdown to delay the pain of COVID-19, to a multitude of inputs and a seemingly cavalier attitude to the restrictions.

Statistics South Africa has submitted data on how the pandemic has devastated the country’s economy. Data from the Human Sciences Research Council points to overwhelming compliance with the restrictions by citizens, while regular updates by the National Institute for Communicable Diseases show the rates of infection continue to grow unabated.

Academics and NGOs have done the same, focusing primarily on the economy and poor people in particular. Many others have followed, with data or models or both.

In response, government developed a five-stage, evidence-informed strategy. This approach is meant to ease the lockdown, in place since 27 March, by assessing levels and sites of risk and adjusting accordingly. Government, and President Cyril Ramaphosa in particular, initially won global praise for their response to COVID-19 and apparent reliance on science to guide them. That was then.

Something has changed – the government or citizens?

Capriciousness

It is remarkable how quickly South Africans have lost the sense of camaraderie and support for a strong leader, and begun to complain rather about crypto-fascist authoritarianism. This was exacerbated by government as it introduced a “Stage 4” that was meant to be lighter than “Stage 5”.

It came with 73,000 more soldiers to help the police manage the new 8pm-5am curfew. So far, they have beaten up, threatened and intimidated innocent people, even killing a man. Citizens were permitted a “bonus” of three hours of exercise between 6am and 9am, making social distancing rather challenging.

On 1 May, when the relaxed restrictions kicked in, the roads were full of runners, walkers, shufflers, cyclists in their spandex, and dogs of every type. As he faced a sea of (mainly) white faces jogging on Cape Town’s Promenade, Police Minister Bheki Cele threatened:

I saw this thing of running, I think we will be making some form of recommendation to the National Command Council about it.

He added:

I saw … people running in clubs, walking with their dogs and they were even swimming – something that is [criminalised] in the regulations…

And in case anyone was in doubt about who had power, he added: “we can forget about Level 3” because such terrible behaviour meant citizens did not “deserve” it.

It is that final throw-away line that grates. This is not for citizens to “earn” or “deserve” because they behave well, it is meant to be a science-driven risk-based analysis that determines stages 1-5. But now it smacks of capriciousness, with more than a hint of pay-back.

South Africans – regardless of race or class – picked this up as they watched Cooperative Governance Minister Nkosazana Dlamini-Zuma announce the reversal of a promise of tobacco sales being allowed under “Stage 4”, made earlier by President Ramaphosa. Similar to Cele telling them whether they “deserve” stage 3 or not.

Virtually all research into racial attitudes in South Africa has shown racial differentiation growing. This was most easily shown in the 2019 elections. These differences seem increasingly to be replaced by a shared hostility towards an ANC government that appears to be making rules up as they feel like it, and whose own ministers clearly feel above COVID-19 – and above citizens.

Throwback to an inglorious past

Are citizens protected by evidence-based interventions, or are they being jerked around by mean-spirited politicians?

If the country steps back, is there not something worth learning now, particularly for white South Africans?

Think about it. You can’t go to work or school or to the park unless government says you can. Your freedom of movement is severely limited. You’re told when you’re allowed out, and you are supposed to have a permit akin to a dompas (dumb pass), to prove you’re legally out. (The dompas was the demeaning identity document all black people were required to carry during apartheid rule, which controlled their movements.)

And the troops and police are there to ensure you obey, or beat the hell out of you. Your behaviours are deemed foreign, not normal. You can only enter certain shops, and only after you are sanitised (because you may be dirty or a vector of disease) and you can’t buy alcohol or cigarettes. And other than a small handful, your work is not essential and government will decide for you if you can work or not.

White South Africans right now have a rather comfortable, tiny insight into what life under apartheid was like. It can be a powerful moment to empathise with what it was like to be black under apartheid – and this time, blacks and whites are all being treated the same.

They are all irritated by a government that seems bent on exercising power in small, nasty ways. That’s why this can be a great moment, because black and white South Africans really are all in this together, and they all increasingly dislike their government together.

If white people can stop acting as if they are individually and personally being attacked, and understand the shared nature of both unhappiness and anger, there is real potential for some (much delayed) healing.

As the global economy tanks, whites with retirement policies and shares and businesses are being hit in the pocket. Society and the economy, they are told, are never going back to normal – they have to reset in different, as yet unknown ways.

Can they?

Never waste a good crisis

If South Africa has to reset, can its people – consciously and together – treat this as the real “miracle” moment? A lot of good work has been done since apartheid, which advantaged the white minority to the detriment of the black majority, ended in 1994. Millions of people now have clean water, water-borne sewerage, electricity, tarred roads, street lights and the like. Quite a few more have tertiary education, and some have wealth.

According to most studies, reconciliation has not fared well. Racism, racial redress and patronage have made short work of the noble goals of the early 1990s.

We should see the last 26 years as South Africans’ infrastructural investment for the real “new South Africa” to be able to emerge.

If we assume that the society matters more than simply repeating “it’s the economy, stupid!”, now is the chance to be different, and to reset to a new social reality. Wealth has been destroyed by COVID-19, and it has laid bare the lines of inequality for all to see. So, talk of a wealth tax sounds rational, not punitive, in the post-COVID-19 context.

South Africans can come out of lockdown as a more empathetic and united people – even if united in irritation or anger at a capricious government that seems to regard evidence-based decision-making as meaning regulations chop and change according to ministerial whim.

Can they use this moment to look beyond “race” and see a shared humanity?

It is rare that any post-authoritarian society gets two chances to reconcile. This may be just that, for white South Africans in particular.The Conversation

David Everatt, Professor, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

What should South Africa’s coronavirus endgame look like? Here are some options

- Alex van den Heever, Imraan Valodia, Lucy Allais, Martin Veller and Willem Daniel Francois Venter

SA's response to the COVID-19 pandemic was one of 'intervene first and ask questions later'. Now is the time for government say what its strategic endgame is.

South Africa has aggressively intervened to contain the local SARS-CoV-2 viral epidemic. But it is far from clear which strategic outcome is being pursued. Is it following the lead of countries such as New Zealand or South Korea and trying to stop virus transmission altogether until a suitable vaccine becomes available? Or is it attempting to manage the infection rates so that extreme peaks in morbidity are prevented?

As the government’s strategy is not currently explicit, the intervention framework implemented so far appears consistent with a wide range of possible policy objectives. The rapid emergence of the pandemic defaulted policy to intervene first and ask questions later. But the dust is now settling, and the strategic endgame can and should be made transparent.

Any strategy requires a rational combination of what is known with what isn’t. What’s not known includes the possible outcomes of interventions, as well as contingencies that can materially influence the trajectory of the disease. Given the substantial uncertainties of disease elimination, South Africa should adopt at least a multi-year strategic perspective – that is the time until a vaccine or treatment is probable and has been implemented.

The strategy should, however, allow for the possibility that each month introduces more certainty about the success of public health interventions and the options for treatment and vaccines.

We discuss three possible approaches, and consider the efficacy of each.

What’s known, and what’s not known

The various options mapped out below take into account what is known, and what’s not known.

What’s known. First, the SARS-CoV-2 virus is highly infectious. In the absence of interventions it has an average reproduction rate (R or R0) every four days of roughly 2.5. Infections are also associated with levels of morbidity and mortality that make an active public health response necessary.

Second, no vaccine is available yet and no drug has been shown to prevent transmission of the virus.

Third, no virus-specific treatments exist to mitigate the current levels of morbidity.

Fourth, the complexity of the economic and social problems arising from general lockdowns means it is very difficult to rely on extended lockdowns without creating a new range of severe socio-economic problems.

Where does uncertainty lie?

First, the extent to which reliance can be placed on social distancing and lockdown strategies in South Africa’s high-density, poor and informal settlements is in question.

Second, South Africa appears unable to get testing to the levels necessary to successfully manage a health prevention strategy based on testing and contact tracing. This is true of a number of well-resourced countries too.

It is also unclear whether South Africa is able to ramp up testing, and associated isolation of those infected or their contacts, to the level needed to stay ahead of the epidemic during the course of 2020.

Third, it is unclear when a vaccine will become available. Even under ideal circumstances, it is likely that it will only be available for wider use in 2021. And even with the development of suitable vaccines, it may still take years to eliminate the virus.

Fourth, therapeutic options based on existing treatments, which could be available soon, are still speculative and unlikely to prove wholly successful.

Fifth, therapeutic options based on new technologies are unlikely to be available in South Africa until the latter part of 2021.

Strategic options

Option 1 is to target complete disease control within 2020, without waiting for a successful treatment or vaccine to be introduced. This would require that public health interventions achieve a sustained reproduction rate of the disease (R) below 1. This would require selective, targeted lockdowns, ongoing social distancing and high rates of population testing, tracing and quarantining.

Option 2 is to keep new infections relatively low, but accept that the epidemic will continue until a vaccine or some other treatment becomes available. This strategy would require keeping the R at around 1, by limiting daily, country-wide new infections to roughly 250 to 300. This approach is premised on the assumption that no public health approach, or other intervention, will be able to eliminate the epidemic in 2020, and also not completely in 2021. It assumes that a combination of treatment and vaccinations will eliminate the virus during the course of 2021.

Option 3 is to keep new infections sufficiently low that they prevent excessive morbidity at any point in time to avoid health services becoming overwhelmed, but sufficiently high as to achieve early herd immunity within, say, the next 18 months. While this approach assumes an average R of more than 1 for an initial period and roughly 1 thereafter, the daily levels of new infections would be higher than option 2, but should still be kept manageable using targeted public health interventions.

Process of elimination

Of the above, the third option – allowing infections to rise to achieve herd immunity – is ill-advised, at least for now. To achieve herd immunity over a period of just two years, assuming that only 60% of the population would need to have achieved immunity, would require roughly 51,000 new infections per day. At these levels it can be expected that more than 2,500 people will require hospitalisation each day and that approximately 500 will require intensive care, most of whom would die.

This option can also be rejected on rational grounds. If it is possible to maintain the R at about 1 over an extended period using public health interventions without undue economic hardship, it makes sense to manage a lower rather than a higher and more risky level of infections.

This leaves options 1 and 2. The choice comes down to what is achievable with South Africa’s public health and economic capacities and capabilities. Both options, however, must be compatible with the maintenance of a functioning economy.

A generalised lockdown is unlikely to succeed as a preventive option in the South African context. As a result much depends on whether more focused public health measures– such as testing and contact tracing, social distancing, employer health protocols, generalised requirements to wear masks and border management – are sufficient to hold R at 1 or below 1. If these interventions can’t be relied on, the outlook for South Africa would be bleak, as a runaway epidemic would be more, rather than less, probable. The de facto consequence would be option 3.

But it’s plausible that a strategy that is able to maintain a low level of daily new infections over a two-year period could hold out the opportunity for disease elimination if public health prevention improves over time.

For instance, while significant constraints exist to scale up testing in the short term, these can reasonably be expected to lift progressively over a 12-month period. Similarly, it is not unreasonable to expect the specificity and speed of contact tracing and quarantining to improve over time. It is also common sense for testing priority to be given to communities where transmission risks are highest – such as townships and informal settlements.

The direct costs of many of these interventions may appear large. But when compared to the indiscriminate impact of a general lockdown, the additional resources required pale into insignificance.

Conclusion

The current best option is for the government to pursue option 2 as a minimum strategic goal – keep new infections relatively low, but accept that the epidemic will continue until a vaccine or some other treatment becomes available to allow for societal immunity. With a continuous expansion of key public health interventions, such as testing, tracing and quarantining, this approach also offers some hope of achieving option 1 – to target complete disease control within 2020.

Keeping open the option of disease control through targeted public health measures within 2020 is plainly worthwhile, even if it is far from certain until treatment and vaccine options become more concrete.The Conversation

Alex van den Heever, Chair of Social Security Systems Administration and Management Studies, Adjunct Professor in the School of Governance, 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; Lucy Allais, Professor of Philosophy, University of the Witwatersrand; Martin Veller, Dean of the Faculty of Health Sciences, University of the Witwatersrand, and Willem Daniel Francois Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Choices in a fog of uncertainty: lessons for coronavirus from climate change

- Robert (Bob) Scholes, Albertus J. Smit, Francois Alwyn Engelbrecht, Guy Franklin Midgley, Jennifer Fitchett, Neville Sweijd, Pedro M.S. Monteiro and Pravesh Debba

The science to policy process that was developed to guide climate mitigation decisions can be applied to the response to the COVID-19 pandemic.

Governments around the world, driven by the threat of overburdened health systems and mass mortality resulting from the COVID-19 pandemic, are being forced to make decisions that have enormous, long-lasting consequences for lives and economies. They are doing so without sufficient assurance that the choices they make are the best ones.

The fog of uncertainty can be partly lifted by better use of information that’s emerging around the world. But it will never completely clear.

The most difficult choices are those that have to be made before you know how they will work out.

The challenge of making high-consequence decisions based on imperfect knowledge is not unprecedented. For example, tough policies to mitigate climate change must be adopted long before the world crosses catastrophic thresholds. To guide these decisions, countries rely on imperfect models of the climate system, along with divergent and values-based assumptions about how the future could unfold.

Scientists and policymakers, working together over a period of three decades through the Intergovernmental Panel on Climate Change, have worked out how to guide decisions in the face of uncertainty in such a way that there is broad agreement, and which minimises regrets even if the future does not work out exactly as projected. Their approach has allowed scientists to remain providers of evidence, and politicians to focus on value-based choices.

The Paris Agreement to mitigate climate change, signed by 197 countries, was the result of a well-functioning science-policy interaction.

This experience can be applied to the response to the COVID-19 pandemic, without having to reinvent the process.

The best practice guidelines involve making decisions based on the best available information at the time, and progressively improving them in the light of experience and emerging new information. Secondly, they involve using a “multi-model approach” and an ensemble of results, rather than placing all bets on a single prediction. And finally, they use collectively agreed scenarios to explore the full range of options and outcomes.

Three-pronged approach

Decisions about containing COVID-19 are inevitably a balancing act between reducing the immediate loss of lives on the one hand, and protecting livelihoods that could be damaged as a result of the actions taken on the other. The models used to support the decisions must be similarly balanced. There is no point in having precise projections about the course of the pandemic, but only a vague idea of the impact on the economy.

At present, these different streams of information are not well integrated.

For the case of using mathematical models to help guide COVID-19 policies, we make the following suggestions based on our collective experience with scientific assessments.

Use what information is available, then adapt: The novelty of the disease means you start from knowing very little and taking guidance from experiences with similar diseases in the past. You work towards improving modelled projections, using information from a range of sources – from science to public health to the economy.

Nimble and efficient channels of communication ensure that the pace of modelling matches the urgency of the problem.

The multi-model approach: Using several different models rather than one relies on the same logic that tells you not to put all your savings into a single asset. The most robust approach is to build a portfolio, which is collectively stronger than just one, particularly if they are based on fundamentally different assumptions.

Typically, different models have different purposes, and some are stronger in some respects than others. Some models are good at short-term projections while others are better in the long term. Including more detail is necessary for some purposes, but a less detailed model may be sufficient, and more reliable, for more general policies.

This does not mean you should not winnow out models that are simply wrong. But to do so you need a well-structured, evidence-based test. The statistician George Box wisely commented that “all models are wrong, but some are useful”.

For modelling COVID-19 we would similarly encourage a diversity of models.

Scenarios: Some things cannot be predicted accurately, because they depend on chaotic physical processes, or behaviours that defy simple representation, such as human choices. For these issues you use scenarios. Scenarios allow the models to be stress-tested, by asking questions such as: What is the range of possible outcomes? How does my decision play out in the worst case, as well as in my preferred case?

The scenarios must be shared between models, or you are unable to tease apart differences in the way models work from differences in model drivers.

The scenarios need to be plausible, but must span a wide range of possibilities if they are not to lead to confirmation bias – our tendency to choose the outcomes that support our prejudices. It is important to include measurable indicators, so that you later know which scenario is playing out.

For COVID-19 we recommend exploring the model predictions over a range of agreed scenarios. For example, one scenario can impose strict lockdown and maintain it over several months. Another can progressively relax the restrictions. And both can be compared to a reference scenario where no policy action is taken.

When many models, several scenarios and uncertain data are used together, the result will be a wide range of predictions. The differences need to be evaluated so it’s clearer which findings have the most supporting evidence.

Public trust is key

The balancing act of managing COVID-19 requires public trust, which is fostered by an open, clear and credible process of decision-making. The framework we propose is focused on providing the information needed to make good decisions, but should not assume the right to make the decisions. For that purpose, people elect political leaders to represent their rights and values.

This approach has been successfully applied elsewhere, for instance in the protection of the ozone layer, and mobilising action to halt biodiversity loss. In South Africa, it recently aided sensible decisions regarding fracking in the Karoo.The Conversation

Robert (Bob) Scholes, Acting Director of the Global Change Institute (GCI), University of the Witwatersrand, University of the Witwatersrand; Albertus J. Smit, Associate Professor, Marine Biology, University of the Western Cape; Francois Alwyn Engelbrecht, Professor of Climatology, University of the Witwatersrand; Guy Franklin Midgley, Professor in Botany, Zoology and Ecology, Stellenbosch University; Jennifer Fitchett, Associate Professor of Physical Geography, University of the Witwatersrand; Neville Sweijd, Director Alliance for Climate and Earth Systems Science (ACCESS), Applied Centre for Climate and Earth Systems Science; Pedro M.S. Monteiro, Head of Ocean Systems and Climate, Council for Scientific and Industrial Research, and Pravesh Debba, Impact Area Manager for Inclusive Smart Settlements and Regions, CSIR and Visiting Professor at the School of Statistics and Actuarial Sciences, Wits University, Council for Scientific and Industrial Research

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Wits Covid-19 Screening Tool

- Wits University

Information pertaining to the screening of staff and students entering University campuses and premises.

Government Directives pertaining to Covid-19 obligate employers to implement a Covid-19 Screening Tool to ensure that employee / student health condition is monitored.

In view hereof,

  • Staff / students must use the Covid-19 Screening Tool on a daily basis to monitor whether they are showing any Covid-19 symptoms. 
  • This must be done before staff / students leave their homes to come to Campus. 
  • Assuming staff / students have completed the forms to indicate that they do not display any of the symptoms – including having not been exposed to or in contact with any individuals who may have been diagnosed, been in self-isolation or in quarantine for the past 14 days, and do not suffer from any other risk factors; please drop the completed form in dedicated boxes at the entrances.

    Download the Covid-19 Screening Tool

    Further notes regarding the Covid-19 Screening Tool:

    • Please conduct daily self-screening before leaving home / residence and before coming onto Campus.​ Follow the flow diagram should symptoms be experienced.
    • If any symptoms mentioned in questions A1 to A10 are experienced then don’t attempt to enter the University. Consult your Healthcare Worker to determine whether further testing / self-quarantine will be necessary. If cleared by your Healthcare Worker only then may you enter the University. If you reside on Campus and experience Covid-19 symptoms then please remain in your room and seek advice telephonically from relevant CHRL staff and/or your Healthcare worker. ​​
    • If tested positive for Covid-19 (and, if you do not require hospitalisation) then self-isolate for 14 days. Follow your Healthcare Worker’s advice.​​
    • If you are not able to come to Campus due to experiencing Covid-19 type symptoms, or due to being tested for Covid-19 (or after being positively diagnosed) then urgently notify your Supervisor/ relevant Manager about your situation / absence. ​​
    • If you answered “YES” to any of the questions in Section B1, B2, C1 and C2 (but have none of the usual Covid-19 symptoms mentioned in sections A1 to A10, then this does not mean that you will be refused entry onto Campus (but a decision may be necessary as to whether this requires further intervention).​​
    • If “YES” is answered for the questions in sections A1 to A10 then this does not mean that you definitely have Covid-19. This screening tool is used merely as a pro-active precautionary indicator to establish whether further tests should be carried out in order to make a definite diagnosis. ​
    • If you reside on Campus then please follow the CHRL protocols on notification / quarantining should you experience Covid-19 symptoms. ​​
    • Nothing prevents a person that experiences any of the usual Covid-19 symptoms to immediately bring these to a Healthcare Workers attention at any time of day / night should these symptoms present themselves.
    • Service provider and contractor employees are expected to have a Screening process in place for their staff (preferably using the same standard of screening that Wits staff / students are using).
    • A flow diagram has also been developed and which explains the Covid-19 screening / testing / management process to be followed at Wits. This process flow must please be adhered to:

    Download the Covid-19 Screening Testing and Incident Management Flow Diagram

    Covid-19 Update (28) - Wellness services for students and staff

    - Wits University

    A reminder to all students and staff about Wits' mental health and wellbeing services that are available to you during the Covid-19 pandemic and lockdown.

    The majority of our staff and students have been home for 50 days now and given the many changes, it is expected that some individuals and families may be finding it difficult to deal with the disruption to normal life. We remain concerned about your well-being and want to remind you of a number of services available to staff and students during this period.

    Help for students

    The Wits Student Crisis Line is available 24/7/365 on 0800 111 331 to all Wits students who require counselling, including those feeling anxious or uncertain during the lockdown.

    Students who require personal, career or life coaching counselling services can email the Counselling and Careers Development Unit (CCDU) via info.ccdu@wits.ac.za between 08:00 and 16:30 on weekdays. A professional team member will respond with assistance. Zoom sessions and some group sessions are also available, depending on the need.

    The CCDU Lockdown Wellness Chronicles offers daily coping strategies that can be used by all. The site has daily prompts to help structure and regain control of life and also to prepare for normalcy. The May Motivation series is a useful resource to assist students. Visit the CCDU website for more information on various mental health and wellness topics.                                    

    The Campus Health and Wellness Centre is available to assist with primary healthcare and mental health enquires:

    • Primary healthcare enquiries – Call 0743077259 or 0824832251
    • Mental health enquiries – Call 0766093924

    A satellite Campus Health and Wellness Office is open on the Wits Education Campus from 08:30 to 12:00 on weekdays, in order to assist the final year medical students who have returned to campus.

    Help for staff and immediate family 

    The Wits Impil’enhle programme offers free services to staff and their immediate families who require counselling for stress, anxiety, abuse, trauma, parenting, relationship and marriage-related problems. They also offer legal and financial advice. This independent service is offered through Kaelo Lifestyle and is provided in all South African languages 24/7. Call 0861 635 766 OR dial *134*928 OR send a ‘Please call Me’ to 072 620 5699 OR Email asknelson@kaelo.co.za for assistance.

    Gender-based harm

    During this time of lockdown, we are aware that there are some people who will find themselves in spaces where they may not feel safe. The Gender Equity Office (GEO) can be reached via email on info.geo@wits.ac.za. Alternatively, call the national gender based violence command centre on 0800 428 428 or send a "Please Call Me" to *120*7867#. It is important to remember that should you require a restraining order, courts continue to operate for this purpose. The GEO is available to guide you through the process and prepare you for what to expect when you apply for the order. 

    Cyberbullying

    Cyberbullying involves the use of the internet or technological devices to send, post text or images intended to hurt, embarrass, discriminate, threaten, torment, humiliate or intimidate an individual or a group of people. Cyberbullying and harassment may become more common as the digital sphere expands and technology advances. For confidential reporting, consultation and support, contact the Transformation and Employment Equity Office via Cecilia.Smith@wits.ac.za or Advocate Mahlako Neo on neo.mahlako1@wits.ac.za. The Anti-Discrimination Policy can be accessed viawww.wits.ac.za/transformationoffice.

    Covid-19 resources

    Read more about the coronavirus at www.sacoronavirus.co.za or call the emergency hotline on 0800 029 999. The WhatsApp support line is 0600 123456. The website of the National Institute for Communicable Diseases also hosts a wealth of information on the coronavirus. Visit www.nicd.ac.za for daily updates and more information.

    Remember to always:

    • Wear a face mask in public areas,
    • Practice physical distancing,
    • Wash your hands for at least 20 seconds with soap and water (and dry it properly) or sanitise,
    • Sneeze/cough into a tissue or your elbow, and
    • Visit a healthcare professional if you have any COVID-19 symptoms

    Take care of your families, friends and loved ones during these difficult times. 

    Senior Executive Team

    15 May 2020

    What South Africa needs to forge a resilient social compact for Covid-19

    - Erin McCandless and Darlene Ajeet Miller

    Ramaphosa's call for a new social compact will fall on deaf ears unless there are some fundamental changes to the way in which the pandemic is being managed.

    South African President Cyril Ramaphosa has called for “a new social compact among all role players – business, labour, community and government – to restructure the economy and achieve inclusive growth”.

    In South Africa, ‘social compact’ has often been used narrowly to describe pacts between stakeholders on specific sectoral issues. A resilient social compact, as we use the concept, requires a dynamic agreement between the state and society on how to live together, and how to address issues of power and resources.

    For such an agreement to contribute to peace and societal well-being, it must be reflected in the mechanisms, policies and responses that uphold the agreement. This needs to be done in a way that’s flexible and responsive, especially in times of crisis.

    This approach recasts the concept of social compact (or social contract) as a tool for addressing issues of conflict, crisis and transition. Research across nine countries, including in South Africa, found that social cohesion is a key driver. Social cohesion builds on the concept of social solidarity, which lies in areas of trust and respect, belonging and identity, and participation.

    Its achievement also rests on progress by other drivers. These are inclusive political settlements addressing core issues dividing people, and institutions delivering fairly and effectively.

    To move in the direction of a resilient social compact, Ramaphosa’s call will fall on deaf ears unless there are some fundamental changes to the way in which the pandemic is being managed.

    Solidarity and cohesion

    The first is that there needs to be a critical focus on how vulnerable groups are affected differently.

    South Africa’s stark socio-economic inequalities – within and across racial groups – are core issues that continue to divide people. This is true economically as well as spatially, psychologically, socially and politically.

    Lockdown restrictions, therefore, affect people differently. In townships – apartheid-era residential areas that are predominantly black – loss of work means loss of livelihoods with grave challenges accessing food, health and education. Suburbanites – who are mostly white – on the other hand, have tended to be more preoccupied by loss of freedoms related to jogging, dog-walking, and accessing liquor and cigarettes.

    These differences demand, secondly, that greater attention be given to how policies are being implemented.

    Addressing these issues could ensure that social cohesion and social solidarity are nurtured through this crisis.

    People need to feel included and that they belong – and that policies and practices deliver on expectations and agreements. When this fails, and human rights are violated in the process, these bonds and relationships suffer. Trust in the state, its institutions and associated legitimacy needed for their functioning, falters.

    Human rights abuses by the security forces in the wake of the lockdown have included shootings, baton and gun beatings, teargassing, humiliation, abusive language, water bombing, invasion of private backyards, and even death. This has occurred especially in townships.

    The UN High Commissioner for Human Rights recently identified South Africa as among 15 countries where human rights violations associated with COVID-19 restrictions were most troubling.

    What’s missing

    In the current COVID-19 context we are seeing fissures that dangerously undermine the bonds and relationships between the state and citizens. These are common in fragile and transitional contexts.

    Many security forces members are following on the path Ramaphosa set with his peaceful messaging to guide them in defending citizens against the pandemic.

    But, some are abusing their power.

    These abuses echo the experiences of black South Africans under apartheid when obedience was secured with authoritarian rule and aggression.

    In addition, developing a national COVID-19 response has brought glaring inequalities to the fore – and the country’s persistent racial geographies.

    These too challenge the goal of achieving a resilient social compact.

    Resentment among some township residents has grown, and various forms of civil disobedience have resulted. Vuyo Zungula, leader of the African Transformation Movement, one of the smaller parties represented in parliament, observed on his Twitter page:

    Until I see Whites, Indians getting the same treatment for breaking the Lockdown rules I will view the SANDF and SAPS as the enemy of the people.

    Way forward

    If the lockdown is enforced through coercion rather than consent, and the dignity of citizens is not respected, a resilient social compact won’t ever be viewed as anything more than rhetoric.

    COVID-19 presents profound challenges for citizens and the state. Building trust and cooperation, between state and society, and between social and stakeholder groups in society, is paramount.

    What then is needed?

    First, there needs to be vigilant government commitment against coercion. Swift action must be taken against abuses by the security sector. And there needs to be effective communication with those affected by the abuse. This should accompany strong assurances of accountability and justice, and upscaled training of the military and the police in crisis response functions.

    Second, two-way communication channels that offer the means to build trust and legitimacy of government actions need to be established. These should focus on fostering innovative ways for citizens to access information and participate in crisis response strategies. This can occur through surveys, via radio and mobile applications, or radio call-in shows.

    Township and suburban residents must take part in the security and other crisis response measures. Widely accessible and consistent messaging is needed, such as the township education undertaken by the C-19 People’s Coalition. The alliance brings together social movements, trade unions, and community organisations working to provide an effective, just and equitable response to the pandemic.

    Its members distribute leaflets in Gauteng townships in local languages, as they demonstrate social distancing and the wearing of masks while they mobilise and strengthen networks of food production, distribution and consumption. These may well have benefits beyond the COVID-19 crisis.

    Finally, social solidarity is forged when each segment of society works together for the greater social good. Such efforts are widespread in South Africa and around the world. These stories need to be shared with a view to strengthening longer-term transformation efforts in the country.The Conversation

    Erin McCandless, Associate Professor, School of governance, University of the Witwatersrand and Darlene Ajeet Miller, Senior Lecturer, University of the Witwatersrand

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    South Africa’s COVID-19 strategy needs updating: here’s why and how

    - Imraan Valodia, Alex van den Heever, Lucy Allais,Martin Veller, Martin Veller and Willem Daniel Francois Venter

    South Africa should base its COVID-19 mitigation strategy on the premise that the pandemic will last for two years unless a vaccine is developed before then.

    Decision-making at the early stages of the SARS-CoV-2 pandemic (the coronavirus causing COVID-19) was constrained by a paucity of medical evidence and epidemiological data. Knowledge gained over the past two months can therefore inform the next phase of the strategy.

    In the context of the initial uncertainty, South Africa’s early lockdown was prudent. It allowed time to prepare the health care system, to ramp up wide-spread testing and to introduce other measures to reduce transmission rates. Extending the lockdown is no longer required. It is also no longer reducing transmission rates and has become unaffordable.

    Current evidence indicates that:

    • It is impossible to eliminate the virus and the spread will continue. Only a few countries have been able to minimise the rate of spread but they remain highly susceptible to repeated outbreaks.

    • The majority, approximately 70%, of people infected with SARS-CoV-2 are asymptomatic, or have a moderate, self-limiting illness (approximately 25%). The 5% who develop severe COVID-19, with the risk of dying, are usually older than 65 years (greater than 80%) or have underlying comorbidities (such as hypertension, diabetes and obesity).

    • Children under 18 years are generally spared from developing severe COVID-19 and contribute less than 1% of all COVID-19 deaths (none among the more than 30,000 COVID-19 deaths in Italy).

    • It is not likely that a vaccine will become available in the near future. Without this, control of the infection would require about 60% of the population to develop immunity. This will take time and while there is considerable uncertainty over the number of deaths that may occur from COVID-19 over the next two years. Current evidence suggests that it may be less than originally estimated.

    • An extended lockdown comes with substantial health costs. These include costs brought about by undermining public health initiatives such as immunising children against threatening diseases and in the impaired provision of health services to those living with comorbidities such as diabetes, tuberculosis (TB), HIV and hypertension. Indeed, there is evidence that currently the gains made over recent years in reducing the rates of, and deaths from TB are being reversed.

    • SARS-CoV-2 is highly infectious, with a reproduction rate every four days of roughly 2.5 at the onset of the outbreak. The reproduction rate measures the number of people to whom an infected person will pass on the virus. When South Africa introduced the lockdown, the reproduction rate was low relative to other countries. However, South Africa’s reproduction rate has remained above 1, even under a highly restrictive lockdown. Indications are it will remain above 1 at least for the foreseeable future.

    • The hard, extended lockdown has come at significant economic cost. While there is debate about the cost to date, with estimates from 5%-16% of GDP, economists agree that this has been significant.

    • The lockdown has also imposed social costs. For example, children are missing out on schooling. This is detrimental for their cognitive development and for many other reasons. Children are at risk of becoming malnourished due to missing out on school feeding schemes, as well as from the increasing number of families that are being pushed into poverty.

    South Africa needs to accept that it is not on a unique trajectory. The virus cannot be eliminated. The country’s strategy needs to move away from a hard lockdown. In our view, South Africa should focus on using interventions aimed at slowing the virus’ transmission rate.

    The success of these interventions depends on the buy-in and cooperation of citizens. The message to South Africa must be clear: It is not going to be spared deaths from COVID-19. But it is possible to prevent some of these through our own actions and by promoting strategic public health interventions.
    South Africa should plan to mitigate the effects of the pandemic using the above strategies for at least two years, or until a vaccine becomes available.

    Areas of uncertainty

    There are two important areas of additional uncertainty. The first is that it is too early to establish the effect of COVID-19 on people living with HIV. But emerging evidence appears to be reassuring. People living with HIV who are on antiretroviral treatment do not appear to be at an increased risk.

    Secondly, South Africa is not achieving the testing levels or reporting speeds required to contain the spread through diagnosis and contact-tracing. This gets harder as infection rates rise. Without this, it is unlikely that the country will stay ahead of the epidemic.

    South Africa’s strategic thinking should therefore be informed by the following:

    • The need to minimise infection in vulnerable, high-risk groups and, where possible, to minimise deaths from COVID-19. This requires clear communication on the actual threat of the virus, preventative strategies, and slowing the spread of the virus to levels that spare the healthcare system and the economy while preventing the economic effects themselves from causing death.

    • It is not possible to contain the spread through lockdowns, because of the economic cost and the fact that it is not possible to keep the reproduction rate at consistently low levels easing lockdown.

    It is therefore vital that the country develops strategies to control the virus and simultaneously manage the health, social and economic implications without resorting to further lockdowns.

    Economic strategy

    We suggest that South Africa move rapidly to stage 2 lockdown and that a risk-assessed framework be adapted. We propose that such a framework permit all economic activity, except where there is a clear and material threat to public health. The other exception are activities that pose a high risk of transmission over a short period of time, for example mass gatherings or transmission hotspots.

    The framework should specify, by exception, economic activity not allowed on public health grounds. This would see the reopening of critical areas of the economy coupled with current behavioural and societal mechanisms to slow viral spread.

    Within this framework, we also suggest that:

    • Health of workers should be a high priority. Precautions with respect to the protection of healthcare workers and protocols in healthcare settings require careful attention.

    • Regulations should specify employer responsibilities to ensure that the opening up of the economy does not result in flareups of infections.

    • Retail opening hours be extended to reduce density and exposure to the virus, with early pensioner-only hours.

    • The frequency of public transport services be increased to enable movement subject to the adoption of health protocols. These protocols can be enhanced as necessary.

    • The hours of work for accessing public services be extended to make it possible for the population to access services in ways consistent with health protocols.

    • For now, international travel for leisure should not be allowed.

    The health risks associated with this economic strategy should be premised on effective strategies to mitigate the rapid rate of transmission of the virus. This is best achieved by:

    • Reinforcing physical distance measures in settings where people have no option but to gather, and paying attention to ventilation. In the case of busses and taxis, windows should be opened to prevent prolonged contact with potentially contaminated air.

    • Reinforcing evidence-based public health measures like hand washing. This should include providing sanitation to all communities.

    • The continued use of face masks for all outside of the home. Reusable masks must be made available to all communities free of charge.

    This list is not exhaustive but sets parameters which can guide an adaptation to level 2.

    The ability of the country to avert the possible full impact of the virus will only succeed if all citizens of South Africa cooperate willingly with measures aimed at slowing the rate of transmission. If that does not happen, the full might of this virus will manifest itself sooner rather than later, irrespective of the level of official lockdown.The Conversation

    Imraan Valodia, Dean of the Faculty of Commerce, Law and Management, and Head of the Southern Centre for Inequality Studies, 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; Lucy Allais, Professor of Philosophy, University of the Witwatersrand; Martin Veller, Dean of the Faculty of Health Sciences, University of the Witwatersrand; Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, and Willem Daniel Francois Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, University of the Witwatersrand

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Why more must be done to fight bogus COVID-19 cure claims

    - Chimaraoke Izugbara and Mary O. Obiyan

    Authorities around the world can do more to ensure that correct information and messages on the pandemic reach everybody.

    Fake and bogus cure claims are a longstanding, but neglected public health problem. Throughout recorded history, plagues have inspired anxiety and desperation. Time and again, this public nervousness has proved a fertile ground for false cures and claimants to thrive. In this sense, recent claims of COVID-19 cures and antidotes are no exception.

    During the Spanish flu, cure claims generated a false sense of safety that drove hundreds to defy closures and isolation. In the US, scores of bogus remedies alleging to cure the flu were sold under upbeat labels that undermined preventive action. One ad boasted:

    When Vick’s VapoRub is applied over the throat and chest, the medicated vapors loosen the phlegm, open the air passages and stimulate the mucus membrane to throw off the germs.

    Fake and bogus cures caused the death of many as HIV swept around the world. In Nigeria, for instance, as early as the 1990s, Jeremiah Abalaka, a surgeon with fringe training in immunology, startled the world with his HIV cure claim. Many of the HIV patients who flocked to his private clinic reportedly died, including dozens of soldiers referred for treatment by the Nigerian government.

    More recently, during both the Ebola and SARS epidemics, fake cure claims also circulated freely, with lethal consequences. For example, salt solution, snake venom, vitamin C, Nano Silver and some herbs were all touted as cures for Ebola. At least two people died in Nigeria and about 20 more were hospitalised after drinking excessive amounts of salt solution to prevent Ebola infection.

    Sadly, history is repeating itself in the context of COVID-19. False claims range from US president Donald Trump’s touting of anti-malaria drug hydroxychloroquine as a miracle cure to Madagascar’s herbal “cure” promoted by President Andry Rajoelina.

    In Ghana, a Pentecostal pastor launched and sold “Coronavirus Oil”, telling a packed church that it was effective against COVID-19. An American pastor also recently directed viewers to buy Optivida Silver Solution to prevent COVID-19. Its promoter had falsely claimed that the product was government-approved and has the ability to kill every pathogen it has ever been tested on, including SARS and HIV.

    With growing global anxiety, many people are easy targets for cure scams and hucksters. Victims of fake cure claims are often among the world’s poorest and most vulnerable. Fighting these cure claims is integral to containing the COVID-19 pandemic.

    Authorities across the world are working hard to ensure that correct information and messages on the pandemic reach everybody. But there is room to do more.

    Why we must act now

    Cure claims are dangerous. They delay treatment-seeking and promote reckless behaviour that may result in deaths. At least 300 Iranians have died from methanol poisoning after consuming alcohol to prevent COVID-19. Hours after Trump declared hydroxychloroquine as a miracle cure for COVID-19, people overdosed on it in Africa and Asia. In Arizona, a man died after reportedly treating himself with a COVID-19 home therapy derived from the same anti-malarial drug that the US president touted as a wonder drug.

    Health literacy – the ability of patients to read, comprehend and act on medical instructions – remains weak in many contexts. Several millions of health-seekers around the world rely on informal or inexpert sources for their health information needs. Hard-to-reach and vulnerable groups and communities must be targeted through bespoke health promotion strategies.

    Online and traditional media offer immense potential to intensify public health education. They must maintain vigilance on COVID-19 cure scams and claimants as they emerge in diverse forms and places. However, merely identifying bogus COVID-19 cure claims or alerting the public about them is no longer enough.

    Targeted seizure and destruction of unproven cures can deliver important results. In 2015, a global crackdown by Interpol seized nearly 21 million fake and illegal drugs, including fake cancer “cures”.

    Governments must also implement community health outreach programmes that communicate clearly and accurately. Such programmes should have fit-for-purpose feedback systems to enable lay persons in multiple contexts to raise concerns, ask questions and swiftly receive answers. One size will not fit all at this time. Part of the success recorded in Nigeria during the Ebola outbreak has been attributed to the use of different media, including government-sponsored TV and radio messages, town-criers, social media campaigns, and experts to communicate health information to its citizens.

    Countries and national health bodies must integrate traditional healers, faith leaders and community principals in their COVID-19 response strategies. Several studies have documented proven strategies for effectively engaging lay and faith healers to offer correct support and information on epidemics. This is the time to bring these strategies to scale.

    Robust mechanisms for holding scam COVID-19 cure claimants and hucksters accountable are also urgently needed. Currently, few countries have such mechanisms. But a good precedent exists in Australia, where a “healing church” that touted a bleach-based solution as a COVID-19 cure has been fined more than $150,000. Politicians and other thought leaders must also realise that their utterances and actions during this pandemic will have far-reaching health, social and economic consequences.The Conversation

    Chimaraoke Izugbara, Director, Global Health, Youth and Development, International Center for Research on Women (ICRW), USA & Visiting Professor, University of the Witwatersrand and Mary O. Obiyan, Senior Lecturer, Department of Demography and Social Statistics, Obafemi Awolowo University. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Why arguments against quantitative easing hold no water

    - Chris Malikane

    The Reserve Bank should be allowed to buy more government bonds and securities to support the liquidity of the banking system.

    Some analysts, including myself, have argued that the SA Reserve Bank should have long started the local version of quantitative easing (QE), which involves the central bank buying long-term securities on a large scale.

    In addition, and contrary to the Bank’s initial position, I have argued that the law allows it to directly finance the fiscal deficit, and it could refinance government debt to open fiscal space for an effective response, not just to Covid-19 but also to the underlying structural economic crisis.

    I estimate that the limit imposed by the SA Reserve Bank Act implies that the Bank’s balance sheet could absorb at least R239bn worth of direct bond purchases from the government. This excludes loans and other advances the Bank could extend to development finance institutions and municipalities.

    The limits in the act do not provide sufficient flexibility and space for the Bank to play its developmental role given the scale of the structural historical problems, which have not been adequately addressed for far too long. The finance minister should by now have tabled amendments to the act to lift those limits, with new provisions that would permit the Bank to broaden the types of securities it may acquire in response to the crisis.    

    There are, however, those who oppose these proposals. The first view is that QE is strictly applied when economies face deflation, which is an absolute fall in prices, and when short-term interest rates are at 0%. The argument is that in deflation people delay buying goods and services in anticipation of prices dropping. This and other forces, such as debt deflation, reinforce a fall in demand and drive the economy into a severe contraction. Because the short-term interest rate is impotent at 0%, the use of QE aims to raise inflation, to make people anticipate a rise in prices in future and buy goods and services now.

    The second view holds that outright financing of fiscal deficits and refinancing of public debt by the Bank would undermine the central bank’s “hard-won central independence”, which would weaken its ability to meet its monetary policy mandate. The argument is also that money creation to finance deficits would cause inflation to breach the Bank’s target, in much the same way as QE.          

    The argument that direct financing of the government undermines central bank independence is not necessarily correct. First, whether central independence is undermined depends on how the interface between the central bank balance sheet and that of the government is designed, particularly the need for transparency, accountability and the specification of limits in the use of such financing mechanisms.

    Second, if the monetary policy mandate of the central bank — the inflation or long-term interest rate target — provides an explicit overarching device to co-ordinate fiscal and monetary policies, the ability of the central bank to achieve its monetary mandate will not be jeopardised. In fact, it may be enhanced. Third, in this arrangement the Bank remains independent to choose whatever instrument it deems fit to pursue its mandate.  

    In a number of cases central banks that directly finance their governments exhibit a higher degree of independence than the Reserve Bank. The Bank of Thailand directly subscribed to a variety of government debt instruments, yet it scores substantially higher than the Reserve Bank when it comes to independence. The same is true for the Bank of Korea, which lends directly to its government. The central banks of Uganda, Nigeria and Malawi all score better than the Bank on independence, and directly purchase bonds and make advances to their governments. This is also the case with the Central Bank of Cuba, which exhibits more independence than SA’s central bank.

    The argument that direct money financing of the government necessarily undermines “the hard-won independence” of the Bank is therefore not correct. It all depends on the institutional design, transparency and accountability in the interface between the Treasury and the central bank. The proposals for the Bank to adopt unconventional measures do not tamper with the requirements for transparency and accountability.  

    The second view maintains that short-term interest rates, those that are charged for lending for less than one year, should be 0% before QE can be applied. I have argued elsewhere that this view is erroneous for an emerging market. To have a stable exchange rate the short-term interest rate in an emerging market should equal the interest rate of an advanced economy plus a sovereign risk premium.

    When the advanced economy hits a 0% lower bound, the emerging-market interest rate will equal the sovereign risk premium, which is not 0%. Therefore, while the advanced economy embarks on QE at a 0% interest rate, the emerging market does so at some positive rate equal to the sovereign risk premium. It is wrong to expect SA to hit 0% interest before QE can be pursued. By extension it is also incorrect to say the currency will automatically depreciate if QE is implemented. It depends on the specific aims and design of the QE.

    A related argument against the QE proposal is that it is strictly for economies on the verge of a deflation. This is also not correct. When an advanced economy hits its inflation target, say 2%, the emerging market hits its own target of say 4.5%. Now if the advanced economy hits 0% inflation, the emerging market reaches 2.5% inflation. Therefore an inflation rate that is on, or below, the target and an interest rate that is at the sovereign risk premium are sufficient conditions for an emerging market to embark on QE. This is where SA is now.

    To expect the emerging-market inflation rate to be on the verge of 0% before embarking on QE is to allow the unemployment rate to soar to high levels because demand would have to fall significantly to pull inflation down to zero, before aggressive measures to counter the downturn are implemented. Such a haemorrhage of the real economy would be made worse if inflation expectations are anchored, as they should be, at the target.        

    The Bank should not be shy to acquire more government bonds and other securities to support the liquidity of the banking system, even if the short-term interest rate is above 0%. The R11bn purchases of government bonds is a step in the correct direction, but it is sadly inadequate.

    Because the banking system is increasingly facing defaults and high risk aversion, the Bank should be legally empowered to broaden the types of securities it could purchase from the entire financial system, to effectively secure financial stability and drive progressive structural change. The Bank should also explore more channels of credit transmission to the real sector, beyond the conventional banking channel, such as direct lending to development financial institutions, securitised commercial loans, acquisition of government-guaranteed securities and direct lending to government. All this should be done in a transparent and accountable manner, in much the same way as the budget process.

    In short, a new financial architecture needs to be established that is informed by a vision and mission to address the historical and structural fault lines of SA society, beyond the pandemic.

    Chris Malikane is Associate Professor in the School of Economics and Finance at Wits University. This article was first published in Business Day.

    A new, fairer economy is possible, but that would mean sacrifice

    - Imraan Valodia

    That Covid-19, the lockdown and whatever will come after will have had a lasting and devastating impact on our economy seems indisputable.

    Since it was first reported in Wuhan, China in December 2019, the SARS-CoV-2 virus and the resultant disease, Covid-19, has evolved from being a distant perceived threat to having the most devastating impact on the world economy of any single event since the Great Depression.

    This has occurred in a matter of less than 6 months. Having declared a state of national disaster on 15 March 2020, President Ramaphosa announced on 23 March that South Africa would commence a three-week national lockdown starting at midnight on 26 March 2020.

    The lockdown was then extended for a period of 2 weeks, and continues for the foreseeable future, albeit now in terms of the South African government’s risk-assessed phased approach.

    The economic, health, social and political consequences of the pandemic have wreaked havoc on our lives and left us all permanently scarred.

    The pandemic has exposed the deeply unequal world that we live in, and uncovered how vulnerable the economic situations of millions of our citizens really are.

    It is ironic that it is not the working of the economy, but rather the shutting down of the economy, that has most starkly exposed our unequal world.

    Those at the top own the most of everything

    Two pieces of research on income and wealth, conducted by my colleagues Gabriel Espi and Aroop Chatterjee in the Southern Centre for Inequality Studies, highlight the extent of South Africa’s inequality.

    If we divide South African households into five groups (quintiles), we can create a picture of income inequality and how different income groups have been able to live through the challenges of a lockdown.

     

    On average, South African households in the poorest income quintile have a total monthly income of just R2600, which has to support, on average, 5 members of the breadwinner’s household.

    About 18 million South Africans live in these households.

    In contrast, the highest income quintile has an average income of R38 000, which has to support two household members. Some 7 million South Africans live in these households.

    The data on the distribution of wealth is even worse.

    The poorest 50% of South Africans have an average net wealth of negative R16 000.

    That means their assets are less than their liabilities: they are deeply in debt.

    By contrast, the richest 10% of South Africans have an average net wealth of R2.8 million per person. The top 1% of holders of wealth in South Africa have an average net wealth of R17.8 million per person.

    The ability of these households to withstand the economic effects of a sustained lockdown is very different indeed.

    For low-income households, closing off the taps that allow them to earn their meagre income has meant being plunged immediately into hunger and even deeper poverty.

    With this income and wealth picture in mind, it is not at all surprising to see the shocking food queues that we have seen over the last five weeks.

    Low-skilled and informal occupations are by far the hardest hit

    Let us consider the world of work, in which the inequalities go much deeper. Andrew Kerr and Amy Thornton from the University of Cape Town have done some very interesting research  that aims to examine who, notwithstanding the lockdown, is able to work and who is not.

    They estimate that just over two million South Africans, who make up 13.8% of those who had employment pre-lockdown, are able to continue working from home for the same income they were earning before the lockdown.

    It is hardly surprising these are mainly professionals and those with high levels of skill. For most low-skill occupations, outside of those who are essential workers, the lockdown has meant a dramatic fall in income.

    That has affected 10.5 million workers - approximately 63% of the workforce.

    Some of these workers are facing the prospect of long-term unemployment as large businesses consider shutting down permanently.

    The effect of the lockdown has been particularly severe on one group of workers: the approximately 5 million workers who earn their livelihoods in the informal economy.

    For this group, who rely on a functioning economy to earn a small amount of income from selling vegetables at a bus rank, preparing food for sale at the train station, or collecting waste for recycling, the lockdown has meant immediate poverty and hunger.

    As my colleague at Wits University, Melanie Samson has shown, waste pickers, while clearly part of essential services, remain unseen by policymakers because they form part of the informal economy.

    Formal sector waste services are deemed to be essential services and allowed to operate, but those who perform exactly the same services in the informal economy are not.

    The double standard could not be more stark.

    Until government relaxed the lockdown rules and allowed some informal trade to happen and announced a special Covid-19 grant for the unemployed and those working in the informal economy, the lockdown was placing informal workers in an impossible moral dilemma: abide by the lockdown regulations and starve, or break the rules and expose yourself and others to the risk of infection.

    My colleagues at the African Centre for Migration and Society at Wits University have highlighted the fact that the percentage of foreign born migrant workers in the informal economy is twice as high as that of South Africans.

    For most of these migrants, the lockdown means neither an income from informal work, nor a Covid-19 grant.

    Gender Inequality

    The gender inequalities in our society have also been starkly exposed. Besides the gender inequalities in employment, the lockdown has revealed the deeply unequal gender relations within households.

    Ours is unfortunately a society with significant levels of gender-based violence. For many of our women and children, the lockdown has meant a dramatic increase in gender-based violence.

    The Foundation for Human Rights reports that, during the first week of the lockdown, SAPS received more than 2333 complaints of gender-based violence - a 37% increase on the weekly average for 2019.

    One of the most significant but unseen gender inequalities in our economy is the unequal value that society places on care work. Care work is undervalued mainly because the work is done largely by women.

    This inequality is seen starkly in a comment by Matt Hancock, the UK Health Secretary (the equivalent of our Minister of Health). Responding to a question on the numbers of health workers that have died in the UK as a result of Covid-19, Hancock replied: “We’re seen very sadly four doctors die so far, and some nurses”.

    Quite disgusting! While our Health Minister is doing a better job than Matt Hancock, our gender data on the unequal burden of care is not dissimilar to that in the UK.

    According to our time use survey in 2010, women in South Africa spend 5.8 times more time doing unpaid care work than men do. It would be interesting to see how much more unequal this burden is during a lockdown.

    Effects on the economy

    That Covid-19, the lockdown and whatever will come after will have had a lasting and devastating impact on our economy seems indisputable.

    Might it also provide the impetus for a new economy – one that is more equitable, more resilient and more sustainable?

    President Ramaphosa has raised the idea of a new social compact to get us onto such a path.

    As a hopeless optimistic, I do think that it is possible to gain consensus on such a social compact, and rebuild our economy as on that is more equal.

    However, a key ingredient for a social compact is getting those who have a lot to give up some of their short term interests, in the long term interest of the entire society.

    How does one convince people to give something up in an economy that is likely to contract by as much as 10 percent?

    Professor Imraan Valodia is Dean of the Faculty of Commerce, Law and Management and Head of the Southern Centre for Inequality Studies at the University of the Witwatersrand. This article was first published on News24.

    Wits' Covid-19 Standard Operating Procedures

    - Wits University

    The country remains in a level four lockdown, which means that only employees who render essential services are allowed to be on our campuses.

    This may change in the coming weeks if restrictions are relaxed.

    As and when employees are allowed to return to work, it will become imperative for all executives, managers, deans and heads of school to ensure that all employees, service providers, contractors and visitors comply with the Standard Operating Procedures. These documents elaborate on the processes to be followed regarding access to the University’s campuses, as well as the screening and testing procedures that need to be followed. These documents must be read in conjunction with the Human Resources Plan circulated two weeks ago.

    The Screening Form will have to completed every day, before anyone can access the University’s campuses. The Form will be made available on the Wits website, and where possible should be downloaded and completed before employees, service providers, contractors or visitors arrive on campus. Where this is not possible, people will have to fill out a screening form at the University’s gates. A mobile application is being developed to eventually replace the hard copy forms.

    All employees must abide by all the regulations stipulated in the documents above whilst on the University’s premises, with effect from today, 18 May 2020.

    Should you have any questions pertaining to access, please direct them to Gary.Kruser@wits.ac.za. All issues pertaining to Occupational Health and Safety, should be directed to Jonathan.Devilliers@wits.ac.za.

    Thank you

    Zeblon Vilakazi

    Vice-Principal and DVC: Research and Postgraduate Affairs

    18 May 2020

    GeneXpert testing platform for TB repurposed to accelerate testing for Covid-19

    - Wits University

    Efforts to test for Covid-19 in SA have been boosted through repurposing the Cepheid GeneXpert® Systems, originally designed to test for tuberculosis (TB).

    The first batch of GeneXpert machines began testing for Covid-19 ahead of Freedom Day on 26 April 2020.

    The GeneXpert testing platform for TB has been repurposed to test for Covid19

    The combined efforts of joint staff in the Division of Haematology and Molecular Medicine at Wits University and the National Health Laboratory Service (NHLS), along with the National Department of Health (NDoH) has enabled the National Priority Programme (NPP) division to now also support Covid-19 testing in record time.

    The NPP division enables the NDoH to provide increased access to patient testing and treatment – now also for Covid-19. Professor Wendy Stevens, Head of Haematology and Molecular Medicine in the School of Pathology at Wits leads the NPP division, which aims to provide affordable, accessible HIV and TB diagnostic services that yield accurate, reliable, relevant and timely results.

    These services and results align with NDoH strategy and are based on current scientific knowledge and international norms. Through efficiently leveraging existing resources, including the GeneXpert platform, the NPP division can now also respond to the global Covid-19 pandemic.

    There is no doubt that the GeneXpert System will make a massive difference in testing capacity, provided that there is constant access to reagents and the appropriate human resources support. The GeneXpert System is simple to run, with the bigger machines accepting up to 80 cartridges at a time.

    It is forecasted that if all the Covid-19 testing sites are operational on a 24-hour basis, up to 15 000 additional tests can be conducted daily from these machines alone. The data collected from the testing sites will provide valuable insight into the spread of the virus and hopefully contribute to a greater understanding of it in the South African context.

    Xpert diagnostics for Covid-19

    The GeneXpert platform has been used extensively in South Africa to test for TB for almost a decade. The initial rollout took 18 months to complete. Now, with the Covid-19 pandemic, the NHLS has utilized its existing TB footprint and condensed the escalation of testing into just one month.

    The NHLS has been responsible for the implementation and programmatic monitoring of TB through GeneXpert since 2011. Developed by American-based company Cepheid, these systems are distributed to 166 laboratories in South Africa, with more than 325 machines ranging in size and capacity, the smallest no bigger than a desktop computer. More than 17 million TB tests have been conducted to date – 1.7 million positive cases and more than 100 000 drug-resistant cases have been detected.

    Thanks to the GeneXpert’s ability to test an array of assays (including HIV), GeneXpert instruments are now being used to test for the presence of Covid-19. Cepheid released their Xpert® Xpress SARS-CoV-2 cartridge on 21 March 2020, following emergency Federal Drug Administration approval, to support the scale-up of testing. Training material has been distributed to all users.

    To detect Covid-19, the machines are loaded with the test cartridges containing a combination of a patient’s specimen (e.g., pharyngeal swab) and chemical reagents, thereby enabling detection of certain genetic material. Once a cartridge is loaded, it produces a result within 45 minutes. 

    Xpert project management

    Puleng Marokane is the GeneXpert programme manager

    With experience gained in managing the GeneXpert Programme for TB testing since its inception, Ms Puleng Marokane, the GeneXpert Project Manager within the NPP division of the NHLS, has been tasked with ensuring the smooth rollout of Covid-19 testing nationwide.

    Marokane explained that successful implementation of the system was only possible if all the parameters were in place. The system would have to be loaded with Covid-19-specific software, and cartridges validated to ensure they could produce the requisite results. Although laboratory technicians have used GeneXpert Systems before, it was important that they adapted to the new Covid-19 interface.

    Online training in this regard focused mainly on the new cartridge, processing and result interpretation, whilst emphasising Good Clinical Laboratory Practice. This was guided by a standard operating procedure (SOP) developed by the NPP and used across all test sites.

    “This was not an easy job [in lockdown]. We had to rely on everybody’s experience with GeneXpert to ensure they could load the software themselves. Our task then was to try to cover all nine provinces. We were hoping to implement testing in a phased manner, but because this is an emergency, it is not always possible,” said Marokane.

    Once technicians had familiarized themselves with the system, they were able to begin the cartridge verification process. A limited number of reagents were ordered centrally and were sent through to specific sites. Verification panels were developed by SmartSpot®, a manufacturing company co-founded by Professor Stevens and Professor Lesley Scott in the School of Pathology at Wits, to aid with diagnostic testing. 

    Covid-19 sample verification was kept to a minimum due to a shortage of reagents – all that was required was to confirm the system could produce a positive or negative result. To date, eight of the testing sites have passed the verification process and have gone live for testing.

    Testing and training in challenging times

    Marokane and her team have worked tirelessly to ensure operational stability of the system. However, a project of this scope is not without challenges. South Africa’s national lockdown impedes the shipment of reagents, the vital component required to meet the kind of daily testing numbers the health ministry is hoping to achieve. At the time of writing, an additional 10 000 reagents were received from Cepheid. But with South African borders being closed indefinitely, access remains an issue.

    Some staff members have expressed concern about their personal safety during the testing process. The NPP, through the NHLS, is working closely with safety departments: virtual training is being rolled out for NHLS staff; SOP material has been made available to advise laboratories on processing the test method, as well as sample disposal; and the appropriate Personal Protective Equipment (PPE) has been provided in line with government regulations.

    “All that is left to do at this stage is to monitor the implementation processes. We want to ensure users are comfortable using the tests,” added Marokane.

    Covid-19 Update (29) - Students to receive an additional 15GB of data for next 15 days

    - Wits University

    The four telecommunications companies agree to extend the provision of data to students for another 15 days.

    Wits University has negotiated with the four telecommunications companies to extend the provision of data to students for another 15 days. This means that students whose numbers are registered on the self-service portal will automatically receive an additional 15GB of data (5GB daytime and 10GB night express) from 21 May 2020 until 5 June 2020 in order to continue with the academic programme online.

    The University is in the process of establishing a long-term solution for staff and students from 6 June 2020 onwards.

    Please direct any data-related queries to DataHelp@wits.ac.za

    We wish you all the best with your studies.

    SENIOR EXECUTIVE TEAM

    20 MAY 2020

    Economic policy remains hotly contested in South Africa: this detailed history shows why

    - Edward Webster

    Book sheds new light on the evolution of the economic policy of the African National Congress, South Africa's governing party.

    Economic inequality in post-apartheid South Africa has deepened. This is not what was expected. Firstly, the African National Congress (ANC) won an overwhelming victory in the 1994 elections and promised to significantly reduce inequality in the world’s most unequal country. Secondly, the country’s constitution, adopted in May 1996, foregrounds the promotion of social and economic rights.

    This paradoxical outcome has led to a ferocious political-economic debate on the nature of South Africa’s transition to democracy.

    On the one hand, there are those who argue that in the 1994 settlement the leaders of the liberation movement sold out their socialist commitments to the white minority, in particular, international and local capital. This conserved the pillars of the apartheid economy, the minerals-energy complex.

    On the other hand, there are those who argue that the ANC had no alternative to the Washington consensus approach to the economy in the 1990s. They say it was always a party of a mixed economy, the right to trade freely and the growth of a black business class.

    Among the exponents of this view are Thabo Mbeki, the key figure in shaping ANC economic policy as deputy president from 1994 to 1999, and Trevor Manuel, finance minister at the time.

    Simply put, the Mbeki camp maintains that a fundamental continuity exists in the economic and social policies developed after 1994. Critics say there has been a policy reversal in post-apartheid South Africa.

    A new book, Shadow of Liberation, by Vishnu Padayachee and Robert Van Niekerk, respectively Distinguished Professor of Development Economics and Professor of Public Governance at the University of the Witwatersrand, challenges both approaches. It revisits how economic and social policies were made from the late 1980s to the mid-1990s. The authors draw on 35 in-depth interviews with participants in the policy process. This pool of original data is complemented by a rich archive of primary and secondary sources. Together, these data sets reveal a fascinating story about who shaped these policies and how.

    The book is the first attempt to comprehensively document and interpret the origins and evolution of the ANC’s economic and social polices.

    Evolution of ANC economic policy

    The authors argue that the ANC lacked economic expertise – and spurned what little it had. In particular, it rejected the evidence-based analysis and recommendations of the MacroEconomic Research Group, which it had commissioned. They argue that it was less a case of the ANC “selling out” and more one of being outmanoeuvred. Policy makers were, Padayachee and Van Niekerk conclude (p. 135),

    Intellectually seduced in comfortable surroundings and eventually outmanoeuvred by the well-resourced apartheid state and by international and local pro-market friendly actors.

    The story of the evolution of the ANC’s economic policy is a complex one. The authors take us on a long journey that begins in the 1940s. The rest of the journey is spread over nine chapters. Chapter 2 shows how the party’s economic and social roots lie in social democratic policies. These ideals can be found in the bill of rights in African Claims, developed in 1943.

    African Claims was a document with a recognisably social democratic impetus. It argued for state intervention to secure social rights to health, education and welfare for all. This was to be based on universal political and social citizenship. These aspirations can also be traced to what the authors call the “Keynesian, social democratic welfare state, based on the social rights of citizenship” in the Freedom Charter adopted in 1955 (p. 22).

    The next chapter connects the past to the dawn of democracy and the formation of the ANC’s economic planning department. The authors argue this consisted of a small group – Trevor Manuel, Alec Erwin, Maria Ramos, Neil Morrison, Moss Ngoasheng, Leslie Maasdorp – who came to believe that there

    was no alternative to neo-liberal globalisation (p. 67).

    The pace quickens in chapters 4, 5 and 6 – the empirical heart of the book. The authors show how the ANC distanced itself from the post-Keynesian MacroEconomic Research Group in December 1993, and then abruptly dropped the popular “growth through redistribution” Reconstruction and Development Programme in April 1996.

    At the centre of the book is a powerful critique, not only of the policy outcomes, but also of the way in which the policies were made. Yet the critiques sometimes feel incomplete.

    There is a substantial body of literature on the “politics of economic reform” that could have been drawn on to deepen Padayachee and Van Niekerk’s argument that widespread consultation and negotiation is vital for successful economic reform. In fairness, the refusal to negotiate the Growth, Employment and Redistribution macroeconomic strategy for South Africa in the National Economic Development and Labour Council is rightly criticised and the authors show admirable awareness of the issue.

    The late post-Keynesian American economist Hyman Minsky’s famous observation, made over 30 years ago and rightly quoted by the authors, makes the point:

    Economic issues must become a serious public matter and the subject of debate if new directions are to be undertaken. Meaningful reforms cannot be put over by an advisory and administrative elite that is itself the architect of the existing situation (quoted on p. xi of the book under review).

    Tragically, it is precisely what unfolded in South Africa in the 1990s.

    Speaking to the present

    Although the book examines events nearly three decades ago, it speaks to the present where the demand for rapid economic reform has become widespread.

    The lesson I draw from the book is that economic reform cannot be undertaken by a small group of people. Instead, policies must be formulated and implemented through negotiation and consultation of a social compact beyond the state and parliament to include unions, employers and other interest groups.

    What I argued in 1998 remains true today:

    Labour retains the power to block the imposition of economic reform – both at the national and workplace level. Any attempt to impose neo-liberal solutions unilaterally is likely to take the country down the path of ungovernability and civil war – it will ensure rather than avert chaos. If, at the same time, socialist solutions seem unfeasible, this conclusion points towards a class compromise between capital and the labouring poor: a Southern version of social democracy.

    The insights in Shadow of Liberation complement this claim, while developing new interpretations based on evidence from face-to-face interviews with the key actors as well as new archival material. It is a necessary read for a new generation of policymakers as they confront the challenge of economic reform. Above all, this book is a major contribution to the growing body of literature on the appropriate policies required to reduce inequality in the global South.

    This is an edited version of a longer article published in the June issue of the African Review of Economics and Finance.The Conversation

    Edward Webster, Distinguished Reserach Professor, Southern Centre for Inequality Studies, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Support for Professor Glenda Gray

    - Wits University

    Statement of Support for Professor Glenda Gray and the Principle of Academic Freedom of Speech.

    Professor Glenda Gray, Full Professor in the Faculty of Health Sciences, has pioneered advances in preventing mother-to-child transmission of HIV, which has saved thousands of lives. She is an alumna of Wits Medical School and established the Wits Perinatal HIV Research Unit at Chris Hani Baragwanath Hospital in 1996. She has been awareded South Africa's highest honor, the Order of Mapungubwe (Silver); and in 2017 TIME Magazine named Professor Gray among the top 100 most influential people in the world.

    She is an NRF A-rated scientist, CEO and President of the South African Medical Research Council (SAMRC) and involved in HIV vaccine research.

    Professor Glenda Gray

    Statement of Support for Professor Glenda Gray and the Principle of Academic Freedom of Speech:

    “As scientists, academics and policy experts, we are committed to being part of the complex policy response and debate on dealing with the epidemic of SARS-CoV-2 (the cause of COVID-19) in South Africa. We recognize that it is impossible to have perfected the response to the epidemic, but course correction should be rapid and not defensive. With that in mind, we condemn the specific threat made against Professor Glenda Gray for expressing her opinion in public, which is totally out of step with the public pronouncements made by the President, welcoming criticism. We uphold the right to academic freedom of speech, and call on the South African government to engage openly with alternate views, and for all of us to urgently work towards constructive solutions regarding policy, in the interests of the country"

    Current signatures (alphabetic order): (note, this list was assembled on Saturday evening, and finalised at 6.45 pm; additional names may be added)

    • The Wits Senate Academic Freedom Committee (SAFC):
      • Associate Professor S Laryea (Chairperson)
      • Professor M Byrne (Senate representative)
      • Professor J Dugard (Senate Representative) 
      • Dr B Johnson (Acting Director: Transformation Office)
      • Professor E Sideras-Haddad (Senate Representative)
      • Mr A MyIchreest (Legal Office Representative) 
      • Professor R Osman (DVC: Academic and Vice-Principal)
      • Dr T Augustine (Academic Staff Member)
      • Adjunct Professor F Cachalia (Academic Staff Member)

     

    • Professor Cathi Albertyn, School of Law, University of the Witwatersrand
    • Professor Lucy Allais, Professor of Philosophy, University of the Witwatersrand, Henry Alison chair of the History of Philosophy, UCS
    • Professor Linda-Gail Bekker, Director, Desmond Tutu HIV Foundation, University of Cape Town
    • Dr Duanne Blaauw, School of Public Health, University of the Witwatersrand
    • Professor Keith Breckenridge, WISER, University of the Witwatersrand
    • Professor Catherine Burns, Associate Professor of Medical History; Adler Museum of Medicine; Faculty of Health Sciences, University of the Witwatersrand
    • Professor Nithaya Chetty, Dean, Faculty of Science, University of the Witwatersrand
    • Professor Usuf Chikte, Emeritus Professor, Department of Global Health, Stellenbosch University
    • Professor Jason Cohen, Deputy Dean, Faculty of Commerce, Law and Management, University of the Witwatersrand
    • Dr Francesca Conradie, Clinical HIV Research Unit, University of Witwatersrand
    • Dr Aslam Dasoo, Progressive Health Forum
    • Prof Joel Dave, Head of Division of Endocrinology, University of Cape Town
    • Professor Ames Dhai, Professor of Bioethics, University of Witwatersrand
    • Professor David Everatt, Wits School of Government, University of the Witwatersrand
    • Dr Dean Gopalan, President Critical Care Society of South Africa
    • Professor Adam Habib, Vice Chancellor, University of the Witwatersrand
    • Professor Shireen Hassim, WISER, University of the Witwatersrand
    • Professor Ian Jandrell, Dean, Faculty of Engineering the the Built Environment, University of the Witwatersrand
    • Professor Bavesh Kana, Personal Professor, Wits University
    • Professor Kathy Kahn, School of Public Health, University of the Witwatersrand
    • Professor Uma Kollamparambil, Head, School of Economics and Finance, University of the Witwatersrand
    • Professor Naomi Levitt, Emeritus Professor of Endocrinolgy, University of Cape Town
    • Professor Gary Maartens, Head of Clinical Pharmacology, University of Cape Town
    • Professor Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand
    • Dr Gloria Maimela, Director: Health Programmes, Wits Reproductive Health and HIV Institute, University of the Witwatersrand
    • Dr Moeketsi Mathe, private practice, lecturer, University of Witwatersrand
    • Professor Marc Mendelson, Head of Division of Infectious Diseases & HIV Medicine, University of Cape Town
    • Prof James McIntyre, School of Public Health & Family Medicine, University of Cape Town
    • Professor Shaheen Mehtar, Emeritus Professor, Stellenbosch University
    • Professor Mike Morris, Economics, University of Cape Town
    • Dr Jeremy Nel, Department of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand
    • Professor Ntobeko Ntusi, Head of Medicine, University of Cape Town
    • Dr Regina Osih, Senior Technical Expert, Aurum Institute
    • Prof Peter Raubenheimer Department of Medicine, University of Cape Town
    • Dr Haroun Rhemtula, Head of Clinical Unit and Head of Obstetrics, Department of Obstetrics and Gynaecology, CMJAH and University of the Witwatersrand
    • Professor Guy Richards, Emeritus Professor, University of the Witwatersrand
    • Mr Fana Sibanyoni, Chief Operations Officer, University of the Witwatersrand
    • Professor Mark Sonderup, Division of Hepatology, University of Cape Town
    • Professor Jantjie Taljaard, Head of Divison of Infectious Diseases, University of Stellenbosch
    • Professor Steven Tollman, School of Public Health, University of the Witwatersrand
    • Prof Imraan Valodia, Dean, Faculty of Commerce, Law and Management, University of the Witwatersrand
    • Professor Alex Van Den Heever, Chair in the field of Social Security at the Wits School of Governance
    • Professor Martin Veller, Dean, Faculty of Health Sciences, University of Witwatersrand
    • Professor Francois Venter, Ezintsha, sub-division of Wits Reproductive Health and HIV Institute, University of the Witwatersrand
    • Prof Zeblon Vilakazi, DVC Research, University of the Witwatersrand
    • Professor Jimmy Volmink, Dean Faculty of Health Sciences, Stellenbosch university
    • Professor Sean Wasserman, Infectious Diseases. Groote Schuur Hospital, University of Cape Town
    • Prof Nicola Wearne, Division of Nephrology, University of Cape Town
    • Professor Edward Webster, Southern Centre for Inequality Studies, University of the Witwatersrand
    • Professor Robin Wood, Director, Desmond Tutu HIV Centre, University of Cape Town
    • Dr Adrienne Wulfsohn, Emergency and Disaster Medicine, KZN

    Correspondence to Professor Francois Venter, fventer@wrhi.ac.zaventer.francois@gmail.com 

    Covid-19 Update (30) - Wits Prepares for the return of some students

    - Wits University

    Final year students and other identified groups of students expected to return to campus from 8 June 2020.

    Dear Colleagues and Students

    We have spent almost two months in lockdown and we understand that the restrictions may be taking a toll on some students and staff members. If you do need help, please make use of the University’s health and wellness services available to staff and students.

    On another note, President Cyril Ramaphosa announced last night that the entire country would be moving to level 3 restrictions. He said that all higher education institutions should have remote teaching and learning plans in place to ensure that all students had an equitable chance of completing the 2020 academic year. He added that all students who could study or work from home should do so. Finally, he confirmed that final year students and other groups of students would be allowed to return to public universities from June 2020, provided that all the requisite preparations were in place and that no more than one third of the total University community returned.

    The University has developed a schedule for the planned return of students and staff at level three and subsequent levels. Senior executives and managers will refine the plan and will advise on Friday, which student groups should return to campus from 8 June 2020.

    The next two weeks will be used to ensure that our campuses are prepared for the return of students and staff, and that all the requisite screening, cleaning, sanitising and personal protection equipment is in place before members of the community return to campus. Further details will follow later this week.

    In the interim, keep learning and working from home.

    Take care and keep well.

    SENIOR EXECUTIVE TEAM

    25 MAY 2020

    Dubious remedies will not decolonise Africa

    - William Gumede

    So-called African solutions that are often uncritically accepted as ‘good’ do nothing for the continent

    Many African governments, leaders and intellectuals’ misguided seeking refuge in quick fixes and conspiracy theories to deal with intractable problems have undermined development, good health and peace since end of official colonialism at the end of the Second World War.

    It now undermines the fight against Covid-19 in Africa. The Covid-19 pandemic has now reached more than 100 000 confirmed cases in Africa, with more than 3100 confirmed deaths. While reporting statistics in Africa is often unreliable, it nevertheless appears that in Africa Covid-19 appears to be rising slower than elsewhere, taking 52 days to reach 10 000 confirmed Covid-19 cases, it took 11 days to increase from 30 000 to 50 000 cases, according to the World Health Organisation.

    Some African leaders and intellectuals say Covid-19 is a Western or Chinese conspiracy, aimed to entrench their pharmaceutical or imperial interests in Africa.

    Often diseases, development problems and violence are blamed mostly on outsiders – which leads to no or little decisive action to tackle diseases, development problems and violence; or the wrong solutions are embarked on. This is not to say that colonialism did not bring diseases, development problems and violence to Africa; or that former colonial powers do not meddle in the domestic affairs of African countries to the harm of the continent’s peoples.

    Under the rubric of fighting decolonization, every African problem or solution to a problem is wrongly often positioned as either Western-originated, and therefore to be rejected; or African-originated and therefore to be embraced. Scientific and evidence-based solutions are then rejected as supposedly Western colonialism. Yet, science and evidence-based solutions are universal, meaning they are not restricted to Western countries alone, neither are they unAfrican.

    At the same time dubious solutions are often embraced solely because they originated from within Africa. Many so-called misguided African solutions are therefore uncritically accepted as part of decolonization. Other ancient societies which suffered from colonialism or imperialism, just like Africa, such as China, Japan or Singapore, do not take the Africa approach to decolonization. Such countries take the best of their own and Western cultures and forge new solutions out of these; or they adapt appropriate solutions from outside for their own circumstances.

    Madagascar’s President Andry Rajoelina has claimed to have discovered a cure for Covid-19. He has pushing what he calls Covid-Organics, an herbal drink, put together by the Malagasy Institute of Applied Research, which he says can cure Covid-19. The Madagascan government has given the drink to school children.  

    Rajoelina has provided no information about any clinical trials, tests or results of the efficacy of the drug beyond saying “all trials and tests have been conducted and its effectiveness in reducing and elimination of symptoms has been proven in the treatment of Covid-19 patients in Madagascar”. The Malagasy Institute of Applied Research look at the treatment of disease by African traditional practices, plants and animals.

    Equatorial Guinea, Liberia and Tanzania have enthusiastically accepted batches of the herbal drink. Many African countries, leaders and intellectuals appear to have embraced the Madagascar drug as an indigenous “African solution”, as part of “decolonization”. Many have dismissed questions over the science of the drug as supposedly Western government, pharmaceutical and business interests against African “solutions”.

    Rajoelina in an interview stated: “If it was a European country that had actually discovered this remedy, would there be so much doubt? I don't think so”. Stéphane Ralandison, Dean of the Toamasina School of Medicine in Madagascar has warned that the underlying research methods behind the Covid-Organics were “not fully scientific”. The World Health Organisation has said that: “Africans deserve to use medicines tested to the same standards as people in the rest of the world.”

    Across Africa, in countries such as Uganda, the Democratic Republic of Congo (DRC) and Cameroon, other so-called traditional African potions are being touted as a cure-all for Covid-19. In the Democratic Republic of Congo one traditional leader has secured a following with his alleged cure of inhaling steam from a concoction of mango bark, ginger, papaya leaves and unknown plant. There have been deaths reported in the DRC as a direct result of people using such African potions as cures for Covid-19.

    Uganda arrested Lazarus Kungu, an herbalist who claimed to have invented his own traditional plant-based remedy for Covid-19 for endangering public health. Tanzanian President John Magufuli has called for prayer in churches and mosques as a solution to tackle Covid-19.

    The African Union has been predictably be quiet – its usual default position on contentious issues where it should actually take decisive leadership - on Madagascar’s and other untested African Covid-19 remedies and conspiracies.

    During the explosion of the HIV/Aids virus, many African leaders, governments and intellectuals also blamed Western conspiracies for its spread on the continent. This delayed tackling the disease causing needless loss in lives. Then South African President Thabo Mbeki questioned the science used to treat the disease. The late South African Health Minister Manto Tshabalala Msimang preached the African potato, garlic and beetroot as remedies for HIV/Aids.

    To deal with Covid-19, African countries must follow, what their peers in Asia, such as China, South Korea, Singapore and Taiwan has done, by making evidence-based policies guide their strategies to tackle the virus. These countries have done so without conspiracy theories, blaming outsiders or sought untested dubious “local” solutions – and they have been very successful as a result. Former colonial powers now look at lessons from these countries in how they have tackled Covid-19. Now, there is successful decolonisation in practice. 

    William Gumede is Associate Professor, School of Governance, University of the Witwatersrand; and author of South Africa in BRICS (Tafelberg)

    Long-term Data Access for 2020 - Wits partners with Vodacom

    - Wits University

    New initiative provides students with data to access selected URLs through the Wits network.

    Staff and students who provided valid Vodacom numbers to the University are receiving 10Gb daytime and 20Gb night-owl data-bundles per month for use on selected URLs accessed through the Wits network. This will continue on a rolling month-to-month basis. To use the data, staff and students must have provided the University with a valid Vodacom mobile number and installed the CISCO AnyConnect Mobile Client VPN app on their device.

    Any queries or requests for assistance for existing staff and students should be directed to DataHelp@wits.ac.za.

    Covid-19 Update (31) - The phased return of students and staff to campuses

    - Wits University

    Information regarding the staggered approach adopted for a phased return to ensure wellbeing and safety of students and staff.

    The phased, coordinated and safe return of students and staff to the University from 8 June 2020 was deliberated on this week, following the announcement that South Africa would move to level 3 of the COVID-19 lockdown from June, which will allow for some groups of students and staff to return to campuses across the country.

    The wellbeing and safety of our students and staff is paramount and it will take our collective effort, courage and determination to keep the coronavirus at bay. After consultation with the Deans, academics and student leaders, it was agreed that a staggered approach will be adopted with the first cohort of students returning from the 8th of June 2020, followed by a second cohort in mid-July.

    The following student groups will return from the 8th of June 2020. The exact dates and schedules for each cohort will be communicated by faculties:

    Faculty of Commerce, Law and Management

    Certain courses in the Faculty’s executive education programme in the Wits Business School and Wits School of Governance will be offered on campus.

     

    The Faculty will reintegrate a percentage of the student body in Phase 2 from July onwards, as and when appropriate. Further details will be communicated in due course.

    Faculty of Engineering and the Built Environment

    PhD and MSc students who require access to laboratories will return.

     

    Selected graduating classes and progressing students (including third year students who need access to laboratories) will return.

    Faculty of Health Sciences

     

     

     

     

     

     

     

     

    Clinical students and students in their final year of study (MBBCh, GEMP and students on the Mandela-Castro programme) are already on campus.

     

    Pre-final year students with a high clinical load will return.

     

    Undergraduate students with clinical training needs and postgraduate students with laboratory-based research will return.

    Faculty of Humanities

    The Faculty will reintegrate a percentage of the student body as and when appropriate in Phase 2 from July onwards.

    Faculty of Science

    PhD and Research Masters Students will return.

     

    Honours students who require access to laboratories will return.

     

    A very careful selection of 3rd year students will return.

     

    Residence students who do not live in an environment conducive to learning and who find it extremely difficult to study online

    Students in this category will be brought back to residences incrementally, to enable them to continue with their studies online from their respective residences. As per regulations, not more than one third of Wits’ residences may be occupied at any given time. This means that the number of students who are able to return to residences are limited. The Dean of Students will communicate the process to be followed for the phased return of students in this category early next week.  

     

    Details of student groups that will return from July onwards will be communicated in the coming weeks. Please do not return to campus unless you have been given permission to return. 

    Level 3 lockdown: Implications for staff members

    The phased reopening of our campuses will necessitate the return of some academic, professional and support staff to our campuses. A comprehensive workplace plan has been developed by the Senior Director: Human Resources, which includes guidelines for the preparation of the workplace before employees arrive, the responsibilities of managers, health and safety officers and employees before returning to work, whilst in the workplace, and processes to follow if issues arise.

    The SET has also agreed to the following principles:

    • All academic, professional, administrative and support staff who can work from home, should continue to do so, and should only come onto campus if necessary;
    • Staff members who are required to be at work should report for duty (line managers will make this request to staff members);
    • Staff members over the age of 60 or those living with co-morbidities (see below) should stay at home;
    • All staff who are unable to work during this period, should, where possible, be redeployed to areas where they could make a contribution.     
    • Staff members who have co-morbidities (like cancer, diabetes, asthma or other respiratory illnesses) should voluntarily declare these illnesses to their line manager or provide a valid doctor’s letter that indicates specifically why they cannot report for work. Where line managers believe that it is necessary, a second opinion may be obtained from selected healthcare practitioners based at the Wits Donald Gordon Medical Centre. 

    Line managers should work with health and safety officers, Services and HR to ensure that the following measures are in place:

    • Physical distancing of staff and students;
    • The adequate provision of sanitisers and/or soap and water;
    • The regular cleaning of venues and work spaces;
    • The provision of cloth masks (two per student and staff member) and other personal protective equipment for specialised areas; and
    • Protocols to prevent the spread of infection.

    It is the responsibility of every staff member to ensure that the self-screening form (paper or online or via the app) is completed in full every morning. The paper-based screening form is being converted into a mobile application to reduce congestion at entry points. Details about the app will follow early next week.

    Conclusion

    Students and colleagues, we are living through a difficult period, but it is time for us to put our shoulder to the wheel and to move forward, in the interests of the broader Wits community. This is a true test of our Ubuntu - our personal actions, behaviours and choices impacts on those around us, and it is up to each and every one of us to act responsibly for the sake of our collective humanity.

    Keep well and safe.

    SENIOR EXECUTIVE TEAM

    29 MAY 2020

    The world is flat: Covid-19 becomes the driving force for 4IR

    - Barry Dwolatzky and Mark Harris

    The most profound change is the accelerated of way in which digital transformation and the Fourth Industrial Revolution have moved at warp speed.

    In February 2020 the Presidential Commission on the 4th Industrial Revolution (4IR) finalised its recommendations. As it did so an unexpected and terrifying tsunami was gathering on the horizon. On 26 March South Africa went into a national lockdown in response to the Covid-19 pandemic.

    It is still far too early to understand the ramifications of the pandemic on the country, our economy and institutions. However, one immediate and obvious consequence has been the rapid adoption of digital technology. This is driven by necessity as the world has been catapulted into rapid digital transformation.

    Many people are discussing the “new normal” that will emerge beyond the current coronavirus emergency. There seems to be a consensus that we won’t simply return to our old ways of working, at least until a vaccine is available, but possibly forever. New standards for health and safety are emerging that will prioritise social and physical distancing. These standards will permanently influence the nature of the “workplace” and how work is done. What will the “new normal” look like? Has 4IR suddenly arrived?

    Digital transformation inhibitors

    Over recent years many digital transformation initiatives have failed, both in South Africa and internationally. In an article in Forbes magazine published on 30 September 2019, Blake Morgan wrote that 70% of corporate digital transformations fail.

    While each failed transformation initiative can be attributed to specific reasons, a common theme in almost all failed digital transformation projects is a lack of buy-in. Either executive support for the proposed initiative is insufficient or change management is unsuccessful. People have a natural propensity to resist change, and digital transformation usually involves a profound and significant change in how people are expected, or required, to behave.

    In South Africa, the challenge of creating a new digital world is compounded by other inhibitors to the digital transformation such as poor connectivity, lack of digital literacy and a low level of access to suitable technology, such as smartphones. 

    Some examples of digital transformation in SA in response to Covid-19

    Detailed case studies of how specific organisations and sectors in South Africa are responding to the pandemic are still to be written. We have, however, been collecting some of our own observations and those of others. We have used these to inform the comments that follow.

    The sudden decision by the government to impose a general lockdown gave companies and institutions only three days to move to a work-from-home (WFH) policy. Different sectors dealt with this enormous challenge in different ways, some coping better than others

    The health sector: Perhaps the most important example of digital adoption in the health sector has been the rapid adoption of basic tele-medicine methods. Health practitioners, including GPs, psychologists, biokineticists and pharmacists have started using tools such as WhatsApp, Zoom and various apps to engage with patients and clients. There has also been innovative use of data visualisation tools such as Google’s Data Studio to aggregate and present Covid-19 data in the form of dashboards.

    Education: Although the issue of e-learning and distance education has been discussed in South Africa for decades, the sudden arrival of the lockdown caught most institutions completely unprepared. It is in this sector that the deep chasm of the digital divide has become most visible. Issues of connectivity (both the cost and availability of network connection) and access to technology and computer literacy have become critical factors. We have, however, seen rapid adoption of e-learning and distance education tools and methods.

    Justice: Who would have imagined a few months ago that advocates would be arguing cases on Zoom to judges while they all sat in their studies at home? This is now happening in “virtual courtrooms” around South Africa. One of the professions most reluctant to embrace digital transformation before the lockdown has been transformed in the space of a few weeks.

    We could list other sectors. Driven by necessity, individuals and institutions are willingly adopting digital technology in order to survive and continue operations. And – most importantly – the technology adopted has been existing applications that are readily available. This digital transformation has been achieved at a very low cost using technology that is free, some of it open source, and all of it easy to use.

    Digital transformation in South Africa beyond the pandemic

    It is our belief that the pandemic has removed some of the significant inhibitors to digital transformation in South Africa. These are:

    Executive buy-in: With the arrival of Covid-19, executives who in the past were lukewarm to digital adoption now have evidence that digital technology actually works within the context of their organisation, and that it supports effective and better ways of working.

    Policies and regulation: Both government and business are having to rewrite a variety of policies and regulations to accommodate the need for rapid change to cope with the changes we are experiencing.

    Buy-in from staff and other stakeholders: Before the pandemic, many people working in organisations and people interacting with organisations might have been resistant to using digital technology. The pandemic has blown away many of these doubts and opened up people’s minds to different ways of working and interacting.

    Concerns about cost and new technologies: A common preconception has been that digital transformation is expensive and requires the development of new customised digital solutions with a large price-tag. Many organisations have made effective use of available, low-cost (or free) solutions, most of it on the Cloud.

    Concerns about skills: Another preconception is that digital transformation requires lengthy and expensive training of existing staff, or recruitment of new staff. During the Covid-19 crisis many people have rapidly and easily taken to working in a digital world.

    Connectivity and access: While some short-term solutions have been found during the lockdown period, a great deal will need to be done in the future to remove the digital divide. Government, companies and other institutions have all come to realise the importance of having the entire population well connected. 

    Redefining a ‘job’

    In the old style of working, a “job” is defined as supervised attendance at the workplace. Being employed means having a “job”, which means that one is paid to spend a certain number of hours each month at a place of work. This is usually understood as a specific physical space in an office provided by the employer. Measurements of an employee’s performance are usually relative to time spent at the workplace and managers track delivery through inspection. We might, for example, measure productivity as the output produced per time spent at the workplace.

    WFH fundamentally changes the definition of a job. In the future, jobs will be deconstructed into a set of activities or tasks. In thinking about a “job” we will no longer see it as belonging to an individual. The tasks within a job might be done by different individuals, or might even be automated and done by robots. While there will still be tasks that require physical presence, this will likely be the focus of moves to drive automation. We’ll discuss this in more detail later.

    A redefinition of the notion of a job brings into focus the issue of how work is measured and how it is managed. There will be a requirement for new tools and processes. These tools will be designed to give management oversight of tasks. The output of tasks will need to be monitored, measured and coordinated.

    Human resource models will have to be re-examined

    Contractual relationships that currently bind an individual having a job to a specific organisation will be replaced by tools that measure task outputs. Instead of me saying, “I have an employment contract with Company X that defines my job at Company X”, I will say: “I spend my day doing tasks of a certain type. I get rewarded for completing these tasks. Some of the tasks I do are for Company X.” This trend emerged several years ago under the definition of the “Gig Economy”, which is defined as an arrangement where organisations and independent workers engage via a digital platform in short-term work arrangements. The changes brought about by the Covid-19 pandemic will see this trend accelerate rapidly and will bring a larger variety of tasks into this mode of working.

    Management philosophies will be dramatically impacted by new human capital data

    Many of the changes brought about by remote working and a redefinition of the notions of “a job” and a “workplace” will increase the importance of data to manage the organisation. We are destined to see a transition from human-to-machine interaction to far more machine-to-machine (M2M) activity. This type of communication results in the generation and use of large amounts of data. Although this is not new, it will become far more pervasive.

    Given the importance of data, all organisations will need to develop very clear strategies on the collection, storage, use and management of data. This is called “data governance” and it will become a central requirement in our new way of working.

    Automation will become widespread

    We have touched on automation in relation to redefining jobs and sequences of tasks, some of which might be automated, or performed by robots. Social distancing and the WFH will result in society adapting to working more interactively with chatbots, robots and other forms of automation. An important prerequisite for wide-scale automation is the availability of data. This seems set to become a reality, based partly on the increased use of M2M communication and the Internet of Things (IoT).

    Covid-19  flattens the world

    In his 2005 book “The World is Flat” Thomas L Friedman writes about small companies accessing advanced skill sets from around the world. If this is used correctly it will be one of the most powerful tools a company can have. It will allow small companies to compete globally and gain access to advanced skill sets (especially in areas such as engineering design) at a reduced cost for a temporary period of time. This allows small local companies to produce globally competitive products without the long-term expenses and risk of employing a large team. This can only be accomplished if done correctly.

    In the post-Covid-19 “new-normal”, businesses that reject outsourcing will simply not scale at the same speed as the ones that do. For the first time, a piece of work done by an individual in South Africa vs someone outside of our country will only be differentiated by quality, speed and cost. While this might not be creating local employment, it does put South Africa in the position to start exporting technology globally, which will have a significant impact on the local economy. 

    Reflections on 4IR

    While South Africa’s Presidential Commission on 4IR submitted its recommendations to government early this year, these will need to be rewritten in the light of Covid-19.

    One of the key principles at the heart of the commission, and much of the discussion that has taken place around 4IR, is “technological determinism”, ie, technology drives change. The response to Covid-19 implies that rather than technological determinism we are seeing the opposite driver for change, namely “social determinism”. At the same time, core concepts such as the notion of “jobs” and “workplaces” are being redefined.

    It has become critical that the Presidential Commission on 4IR should re-examine its recommendation from the perspective of social determinism and in the light of redefining some core concepts. While a new 4IR strategy will be required for the post-Covid-19 South Africa, it will need to take account of the many changes currently happening outside of any strategic framework.

    Professor Barry Dwolatzky is Emeritus Professor at the University of the Witwatersrand and director of the Joburg Centre for Software Engineering. Mark Harris is CEO of Altron Nexus. This article first appeared in Daily Maverick/Business Maverick.

    Stop random Covid-19 testing and sort out the backlog

    - Marc Mendelson, Shabir Madhi, Jeremy Nel and Francois Venter

    The testing backlog and proposed testing strategies outside hospital settings are threatening patient management and compromising health care workers’ safety.

    The Covid-19 pandemic has created a national crisis in South Africa, requiring a State of Disaster to be enforced. As frontline clinicians and public health specialists at the forefront of this crisis, we signal an urgent need for a course correction of our testing strategy to focus it on saving lives and the integrity of the country’s health system. Acceleration of change must occur, and unnecessary testing for reasons outside of these goals must be stopped.

    A medical test should only ever be performed if it will change management of an individual patient or inform a public health response. Early in South Africa’s SARS-CoV-2 epidemic, which has now resulted in 29,240 cases of Covid-19 (as of 29 May), testing for the virus served two main purposes – to triage patients and to trigger the contact tracing, quarantine and isolation cascade.

    Recently, different ministries have announced generalised testing of employees returning to work (e.g. in the mines), and screening and testing of sportsmen before non-contact sporting events are allowed to restart under Level 3 restrictions. Unfortunately, these “regulations” are seemingly oblivious to realities of the national crisis facing South Africa’s capabilities to undertake Covid-19 testing.

    The testing crisis in South Africa is due to internal planning issues by private and public laboratories, and a consequence of global shortage of testing kits. The number of testing kits available in South Africa within the National Health Laboratory Services (NHLS) is reportedly running dangerously low, and risk being exhausted within a matter of weeks if indiscriminate testing is not halted immediately.

    Furthermore, the turnaround time (TAT) of getting results from the time of sampling is already exceeding 24 hours. Dr Kamy Chetty, CEO of the NHLS, indicated during the minister of health’s press conference on 29 May that a backlog of over 80,000 tests had built up nationwide. This is despite the valiant efforts of NHLS laboratory staff on the frontline. This translates into a TAT for a test of up to two weeks. In many instances, this renders testing a futile exercise, since by the time suspected cases tested in the community receive their results, they are less likely (if at all) to be infectious than when they presented for testing, and would have in the interim inadvertently continued spreading the virus. Consequently, a more pragmatic strategy would be the adoption of apps or web-based platforms that are widely and freely available, and that are able to screen for symptoms of Covid-19 and provide advice to the user. The same strategy was implemented in high-resource settings such as the UK at the time of the peak of the outbreak, when they too faced constraints with PCR testing.

    The focus of the limited resources for Covid-19 testing available in South Africa – which is unlikely to change over the next few months – needs to be unconditionally reserved for where needs are the greatest, and that’s in our healthcare facilities.

    In the hospital setting, the delayed TAT is impairing decision-making on the triage of patients and consequently negatively affecting the management of seriously ill Covid-19 and non-Covid patients and patient flow within the hospital. Consequently, more dedicated wards for suspected cases awaiting tests need to be opened.

    Compounding this is the shortage of adequate personal protective equipment (PPE) for healthcare workers (HCWs), with higher levels of PPE (e.g. N95 respirators) being reserved for when managing suspected and confirmed Covid-19 cases and doing aerosol-generating procedures such as intubation. Consequently, not knowing the Covid-19 status of hospitalised patients within the shortest possible time likewise risks jeopardising the wellbeing of HCWs in these facilities.

    Also, missing from rationality in the regulations for Covid-19 testing of returning employees or in the sporting environment, is the apparent failure to understand that for such a strategy to be of any use, it would require repeat testing every three to four days, as the risk for acquisition of the virus continues within and outside of workplaces as the outbreak continues its upward trajectory across the country.

    This is compounded by the majority (50-80%) of individuals who are infected by SARS-CoV-2 being completely asymptomatic; hence, subsequent testing cannot be reserved for individuals with clinical symptoms of Covid-19 illness. Rather, the only pragmatic strategy available to workplaces and the return of sporting events is one that focuses on ensuring rigorous enforcement and adherence to non-pharmaceutical interventions; i.e. physical distancing, rigorous attention to hand hygiene, use of cloth masks in public, and a ban on mass gatherings (including within the social areas of workplaces).

    The focus of the limited resources for Covid-19 testing available in South Africa – which is unlikely to change over the next few months – needs to be unconditionally reserved for where needs are the greatest, and that’s in our healthcare facilities.

    We, and others, have repeatedly highlighted this in publications (The Conversation, SAMJ), within the advisory system of government and in public interviews. Despite the department of health taking steps to rectify this, acceleration of change is needed, and other government departments must retract regulations that will not significantly mitigate the risk of people becoming infected, but will only increase demand for testing and worsen the current testing crisis. Here is what needs to happen:

    1. The backlog of tests must be dealt with. For the reasons outlined above, we see little point in testing any of the backlogged samples that were taken more than 48 hours previously. The backlog is such that rapid identification and separation of the mountain of tests is going to be a challenge. Realistically, those tested within 48 hours would get their result back between day 3-5, which may still influence management. As the laboratory test detects the virus’ genetic code, which begins to degrade in the days after the sample is taken, the heightened chance of a false negative result is too great, impairing interpretation. Hence, any test taken more than 48 hours previously – that is from a non-hospitalised person or any test from a hospitalised patient that is unable to be tested immediately – should be discarded. The person who was sampled, and the HCW who took the sample, should be informed with a clearly defined procedure to follow for different scenarios that the person may find themselves in at this new time point. Furthermore, we believe that all tests from the community screening programme (if identifiable) should be discarded, irrespective of sampling time, if from the country’s high prevalence areas where the ability to impact on contact tracing cascade has been lost.
    2. The ‘tap’ regulating the flow of tests to the laboratory must be tightened, and indeed, turned off for certain testing indications. A prioritisation process for determining which persons will benefit from a test at this surge and mitigation stage of the epidemic (and the position we find ourselves in here and now as a country) must be accelerated, and focus on testing only those persons for whom it will change clinical management or protect the integrity of the health service. The process is already nearing completion, but rapid publication and communication to the public is now vital, so that everyone understands the reasons behind the new strategy of our public health response. Testing must focus squarely on hospitalised patients for the reasons given above, and on HCWs to ensure continued running of the health service in South Africa. Linking prioritisation groups to the realistic number of tests that can be performed each day allows us to optimise the testing strategy. Substitution of testing with already formulated screening apps or similar platforms that can impart advice and instruction, should be rapidly rolled out.
    3. Regulations from government ministries outside the department of health that will not impact on mitigating the epidemic or have no scientific rationale, must be rescinded immediately. These include:
    4. Department of Labour – the Minister of Employment and Labour is planning to amend workplace regulations to compel employers to test employees and place them in quarantine if close contacts are infected.  These tests would give a snapshot at one moment in time, but are meaningless as a once-off test, as explained above.
      The current department of labour regulations also state that employees that have been diagnosed with Covid-19 can only return to work once they have tested negative. This is not consistent with national guidelines or advice from the Ministerial Advisory Committee on Covid-19. The only workers for which a recommendation of testing is made to facilitate early return to work are HCWs who have a high-risk exposure to a confirmed Covid-19 patient, but who are asymptomatic themselves. This does not apply to any other worker.
    5. Department of Sport, Arts and Culture. It is pointless to require that athletes and staff of clubs must undergo Covid-19 testing and quarantine pending results of the tests before resumption of activities during Level 3 lockdown. As for employees forced to be tested by the department of labour, these ‘snapshot’ tests will not significantly contribute to mitigating viral transmission or meaningfully address virus acquisition, and will detract from the critical focus of our testing strategy.

    Our focus at this stage of the epidemic in South Africa demands that our sole attention must be on saving lives and the integrity of our health service through its workers. This can only be achieved through accelerated course correction of the testing platform, and elimination of unnecessary and wasteful testing countrywide.

    Marc Mendelson is Professor of Infectious Diseases and Head of the Division of Infectious Diseases & HIV Medicine at Groote Schuur Hospital, University of Cape Town (UCT). Shabir A. Madhi is Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand. Jeremy Nel is Head of Division of Infectious Diseases, Helen Joseph Hospital, University of the Witwatersrand Francois Venter is Professor of Medicine, Ezintsha, University of the Witwatersrand. This article was first published in Daily Maverick/Maverick Citizen.

    Almost 16-million people allowed back to work

    - David Francis, Kamal Ramburuth-Hurt and Imraan Valodia

    New level 3 regulations mark an important strategic shift in the government’s approach to the coronavirus pandemic.

    During the Covid-19 pandemic and response an important question from both a health and economic policy perspective is how many people are able to return to work as the lockdown is eased (and tightened). Policymakers will need to consider the likely implications for the spread of the virus.

    In a recent working paper we estimated how many people would return to work, either at the workplace or at home, at the different levels of the lockdown, according to the five-level plan unveiled on April 26. Using a static analysis derived from industry subsectors matched to the five-level plan, we estimated that under level 5 of the original lockdown framework 40% of total employment was permitted, or 6.6-million workers. This rose to 55% (9.2-million) under level 4; 71% (11.8-million) under level 3; 94% (15.6-million) under level 2 and 100% under level 1. These figures are all benchmarked against employment levels in the fourth quarter of 2019, before any curbing of economic activity.

    In the final regulations for level 3, which were published on May 28, there have been significant changes to the framework. The “new” level 3 allows all economic activity to resume, except for a small set of exceptions including restaurants, theatres, personal services and leisure air travel. This has significantly increased the number of people who are permitted to work under level 3.

    According to the original strategy we calculated that 11.8-million workers would be permitted to return to work at level 3 of the lockdown. Under the new regulations an additional 3.97-million people will be permitted to return to work. The total number of those permitted to work under the new level 3 is about 15.8-million, slightly more than would have been permitted under the original level 2 regulations, and close to the total level of employment at the end of 2019, which was 16.6-million.

    We estimate that the shift from level 4 to the new level 3 means the total number of people able to work increases from 9.2-million to 15.8-million. That means 95% of the employed workforce is permitted to return to work.

    Some subsectors, such as in mining, were permitted to operate fully under the old framework and the changes will have little effect. But there are a few sectors where there has been a substantial increase in the number of workers permitted. One of these is the private households sector, a category that includes domestic workers. About 1-million more workers will be permitted to work under the revised level 3 regulations. Another large sector is manufacturing: under the previous level 3 a large portion of the sector was only permitted to operate at 50% capacity, but it is now permitted to operate fully. This permits about 300,000 more people to return to work.

    This marks an important strategic shift in the government’s approach. The initial approach was to restrict all activity and then allow a set of special emergency sectors to operate. The new approach is the opposite: allow everything, except for a small set of restrictions. The new regulations are likely to be easier to regulate, are more transparent, and will result in better coherence between the health and economic strategies government is following.

    The significance of this change is reflected in the large number of additional workers who are now permitted to return to work. The total change in permitted employment between level 4 and the new level 3 is 6.6-million people. Of course, in this analysis we are assuming that all workers who had jobs before the lockdown will have jobs to return to. Estimates of job losses run into the millions. It will take time to understand how many have been lost, where these losses have occurred, and whether they are permanent. We are also assuming that all of those who are able to work and have a job to return to will in fact return. This may well not be the case.

    We expect a lot of statistical noise about this as we try to understand the full impact of the lockdown on unemployment and on how many workers may not be able to return to work because of concerns about comorbidities, Covid-19 infections and other perceived health risks. It also remains to be seen whether workers can be accommodated in a manner that is in line with best-practice health protocols.

    David Francis is the Deputy Director, and Kamal Ramburuth-Hurt a researcher, at the Southern Centre for Inequality Studies at Wits University. Professor Imraan Valodia is Dean of the University’s Faculty of Commerce, Law and Management. This article was first published in Business Day.

    Sub-Saharan Africa needs to plug local knowledge gap to up its anti-COVID-19 game

    - Alex Ezeh and Sharon Fonn

    Africa needs to be better prepared to deal with future pandemics; starting with a re-assessment of how countries invest in – and support – local research.

    Africa remains one of the regions least affected by COVID-19, although evidence suggests it is an evolving and growing pandemic. It is now present in all African countries and territories.

    From the start, the responses across many African countries have mirrored those of other countries where the pandemic has been more prevalent. These measures generally include the promotion of social distancing and personal hygiene, lockdown orders, and management of more severe cases in hospitals. Other responses, such as contact tracing, testing, and isolation of suspected cases, have been used less widely.

    The implementation of lockdowns has created major challenges for governments and citizens alike. Local realities – such as urban slums – make the spread of the virus more likely and social distancing almost impossible. Lockdowns in these settings pose very high economic risks for the residents.

    Given local conditions in many of Africa’s urban areas – including high density slums and informal settlements – lockdown strategies are proving to be unworkable.

    Part of the disconnect between the current responses and the current realities of many Africans stems from the limited engagement between policy decision-makers and African institutions generating contextual knowledge. Some examples are the lack of an adequate notice period before lockdowns and the limited consideration given to the situation of slum residents.

    The gaps in our current knowledge of the course of COVID-19 in Africa make things even more difficult.

    We don’t know what accounts for the very low numbers of cases in most countries. Is it a reflection of very low testing capacity? Or rather, of Africa’s very young demographic profile? Or is it simply that we are in the early phase of the pandemic?

    Each of these possible explanations will demand different policy responses.

    Now more than ever, African governments need their scientists and their scientific institutions to provide insights and guidance. They are turning to these local institutions for help in managing their responses to the pandemic. Unfortunately, many years of neglect and limited investment have created capacity gaps. Where capacity does exist, it is being used, though it remains inadequate. The extent of this is being documented by a network of academics across the continent.

    African scientists are not able to deliver what Africa needs because governments have starved their institutions of crucial funds for many years. The result is that governments are importing wholesale what is being done elsewhere.

    What’s missing

    Africa’s experiences in managing other recent and ongoing epidemics could be an advantage in responding to COVID-19. These epidemics include cholera, measles and viral haemorrhagic diseases like Ebola virus disease, yellow fever, dengue, Lassa fever, and Rift Valley fever. The potential is there, but strong research institutions and systems are needed to activate this advantage to inform timely local, national and global responses to the COVID-19 pandemic. These, unfortunately, remain underdeveloped. The use being made of the resources that do exist only underlines the need for the science and research systems in Africa to be strengthened.

    For example, there has been a glaring lack of ongoing rigorous studies of the pandemic on the continent. Of the 2,032 clinical trials related to COVID-19 registered by 14 May this year, only 35 included study sites in Africa. Of these, 23 were in Egypt and only 12 included a site in a sub-Saharan African country. Seven of the 12 were internationally led multi-country studies. The remaining five were in Nigeria and South Africa.

    Additionally, the 12 clinical trials involving a country in sub-Saharan Africa are extremely limited as most are looking at hydroxychloroquine, while another is looking at traditional medicine.

    This pattern positions Africa to remain a consumer of knowledge and solutions produced elsewhere.

    And, during this period of a global pandemic with critical shortages of life-saving resources, Africa is losing because it lacks the capacity to produce what it needs and what others may need.

    What needs to be done

    What key actions need to be taken?

    The first lesson for Africa is that it cannot continue to depend on international and multinational agencies to determine the path it takes to development. We must reverse the limited investments in local and regional research institutions and universities. Countries must do more to attract their best minds, many of whom have been forced, over the years, to leave Africa.

    As we look towards a post-COVID-19 world, investments in strengthening local and regional knowledge-based institutions will be key to enhancing the continent’s global relevance and competitiveness.

    And we need to understand where we currently are in the course of the pandemic. This requires clarifying the drivers of current low levels of reported infections and deaths. Achieving this will require coordinated serological antibody surveys across countries with different epidemiological profiles of the pandemic. These surveys would be a game changer.

    At the moment countries are only doing antigen tests. These tests are positive if a person is currently sick with the virus. Once the person is better, the test will again be negative. Antibodies, however, last longer in people who have contracted a virus and will be positive in asymptomatic people as well (it is not yet known for how long). An antibody survey would involve selecting a sample of people who are representative of the entire population and testing them. This will show how widespread the infection has been in a given population.

    Such antibody surveys will show who has had the virus – and therefore has built antibodies (some kind of immunity) to it. This will be key to formulating appropriate context specific responses to the pandemic. And it would help us understand where a country’s responses to the pandemic have been appropriate.

    These surveys could show us, for example, if the lockdown policies have been beneficial, or if there have been very widespread infections but with mild morbidity and very low mortality, perhaps due to the continent’s young age profile. This would mean the quarantines and lockdowns have come at a high price with less than anticipated benefits.

    Combining such surveys with community studies that include verbal autopsies – interviewing people who were close to the person who died, and from this deciding the cause of death – could show if the lockdown is leading to increased mortality within communities that are not being captured in our accounting of COVID-19-related deaths.

    Understanding the extent of the spread of COVID-19 within urban and rural Africa can also help with the adaptation of policy responses to a specific setting. This is urgently needed as many countries are in the middle of their rainy season when most villagers cultivate their farms. Disruptions in farming activities, coupled with the effects of climate change-related floods and an ongoing locust epidemic in East Africa, could spell an uncertain future for hundreds of millions of people as they begin to face massive food insecurity.

    Evidence from such studies can help countries calibrate their national responses to the pandemic.

    In the long term, we must be better prepared to deal with future pandemics, and that preparation needs to start with a re-assessment of how we invest in and support local research and service delivery institutions across Africa.

    This article draws on contributions to Drexel University’s Webinar on “The Global Impact of Pandemics”; the African Development Bank’s Global Community of Practice Webinar on “Enhancing Resilience in African Economies: Macro-Economic Policy Responses to COVID-19 Pandemic in Africa”; and the Think-20 Engagement Group and Global Solutions Summit Panel on “The Social and Economic Implications of Covid-19 Pandemic and Beyond: Risks and Opportunities for the Global South”.The Conversation

    Alex Ezeh, Dornsife Professor of Global Health, Drexel University and Sharon Fonn, Professsor of Public Health; Co-Director Consortium for Advanced Research Training in Africa; Panel Member, Private Healthcare Market Inquiry, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The false ideas surrounding the coronavirus

    - Lisa Claire du Toit and Neelaveni Padayachee

    Pasha 66 - The Conversation Africa's podcast series focus on "Coronavirus conspiracy theories and myths".

    The coronavirus was made in a laboratory in Wuhan, China.” “COVID-19 is not real and comes from 5G network towers.” “Drinking warm water with lemon juice will kill the coronavirus.” “The flu vaccination will mean I won’t get COVID-19.” These are all conspiracy theories and myths shared on social media platforms. And it’s time they were addressed.

    In today’s episode of Pasha, Neelaveni Padayachee, a lecturer in the Department of Pharmacy and Pharmacology, and Lisa Claire du Toit, an associate professor, both at the University of the Witwatersrand, talk about false ideas surrounding the coronavirus.

    LISTEN TO THE PODCAST: Pasha 66: Coronavirus conspiracy theories and myths

     


    Wits thanks SA Post Office for delivering laptops to students

    - Wits University

    SA Post Office enables online learning through the delivery of almost 5 000 laptops to Wits students across the country.

    The Speed Services Courier Unit of the South African Post Office (SAPO) delivered almost 5 000 laptops to the homes of disadvantaged Wits students across South Africa – including in rural areas, thereby allowing these students to continue with their studies online.

    The University suspended contact teaching due to the national COVID-19 lockdown and commenced with emergency remote teaching and learning on 20 April 2020. In its transition to online learning, Wits established a Mobile Computing Bank that granted qualifying students access to a mobile device for online learning purposes. A partnership with the SAPO ensured that students who needed mobile devices could continue learning during the lockdown. SAPO successfully delivered these devices to the homes of students.

    SAPO Acting CEO, Ivumile Nongogo hailed the sterling service of the SAPO staff who ensured the seamless delivery of mobile devices to Wits students.

    “I want to commend our drivers and other employees for their dedication during this time when regular transport connections were not available. This is another example of the role that the Post Office plays in making South Africa’s infrastructure work and bringing services to the people,” he said.

    Professor Adam Habib, Wits Vice-Chancellor and Principal expressed his deep gratitude towards the SAPO.

    “All devices were delivered promptly by SAPO employees to students at various locations across the country (including many rural areas), thus enabling the students to participate in the University’s online academic programme. This project is an exemplar of how public institutions can work together efficiently to achieve a common good that benefits society,” he said. “We are appreciative of the SAPO and its efficient delivery of services that has positively impacted on the lives of thousands of students.”

    This mutually beneficial relationship has benefitted students, Wits and the SAPO and we look forward to partnering on similar projects in the future.

    Covid-19 (Update 32) - Wits Screening APP goes live

    -

    Self-screening form on the app is for staff members with permits to be on campus, and students who have been invited to return to campus only.

    The Wits Screening App (LogBox Patient Application) is now live and can be downloaded from the App Store or the Google Play Store.

    Staff members with permits to be on campus, and students who have been invited to return to campus must COMPLETE THE SELF-SCREENING FORM ON THE APP EVERY DAY, BEFOREentering campus.

    Download the Logbox Patient Application from the App Store or the Google Play Store.

    Follow the initial instructions in the Covid-19 WITS SCREENING APP BROCHURE to set up the app.

    Fill in the screening form every day.

    You will receive a notice on your mobile phone that either clears you for entry or denies you entry to campus.

    Show your clearance note to the security officers before entering campus.

    For those staff members and students without smartphones or computers, hard copies of the screening form can be filled in and/or dropped off in boxes at the gates.

    For more information on the Wits Covid-19 Screening Process, visit: http://www.wits.ac.za/covid19/covid19-screening-tool/

    Thank you

    SENIOR EXECUTIVE TEAM

    8 JUNE 2020 

    It’s time to talk about coronavirus symptoms

    - Tom Boyles

    Pasha 66 - The Conversation Africa's podcast series focus on questions arising from the symptoms of people who have contracted the coronavirus.

    COVID-19 is proving a hard medical nut to crack. Why are some people asymptomatic? Why do some people have different symptoms? Why are children hardly symptomatic and why do older people seem to be hit the hardest?

    In today’s episode of Pasha Tom Boyles, an infectious diseases specialist at the University of the Witwatersrand, answers these, and other questions.

    LISTEN TO THE PODCAST


    What sets good and bad leaders apart in the coronavirus era

    - Lawrence Hamilton

    It is no accident that those leaders who have responded worst to this crisis have been the main sources of countless conspiracy theories and misinformation.

    Crises bring out the best and worst of politicians and populations. Folly, fear and fortitude are on display everywhere. In the main, democracies have fared better than non-democracies in handling the coronavirus pandemic.

    But the record is very varied indeed. What explains this? What can be done about it?

    Among democratic regimes, at the one extreme we have seen denialism, the denigration of scientific advice and an obsession with putting the economy before lives. This is especially evident in the United States and Brazil. At the other we have witnessed the organised, prudent, empathetic responses of countries such as South Korea, New Zealand, and Finland. South African president Cyril Ramaphosa initially did very well, but some subsequent decisions might damage his good record.

    These two extremes of leadership style were evident even before COVID-19.

    The USA and Brazilian responses to the pandemic, led by President Donald Trump and President Jair Bolsonaro, have been characterised by secretive, narcissistic, paranoid, hubristic and impulsive decision-making. These actions have endangered the lives and livelihoods of their residents, over which they have a duty of care.

    The data bears this out well. Despite having arrived on their shores relatively late, the pandemic has ripped through their populations, with no sign of abating. They lead in infections and deaths.

    At the other extreme, a common denominator has been a firm attempt by political leaders to “follow the science” and control the spread of the virus and fake news from the outset. A combination of transparency, prudence, empathy, timing and courage has produced excellent results in South Korea, New Zealand and Finland.

    South Africa’s response has been lauded, though it is beginning to attract criticism for heavy-handed policing and some inexplicable decisions.

    Democracy and leadership

    What becomes clear is that in these fast-moving and life-defining times in democracies a great deal depends on the quality of the elected leadership. Democracies that happen to have leaders who simultaneously engage empathetically with those they govern and are informed by good science are best able to deal with the crisis.

    They gather clear-eyed knowledge of their countries’ particular circumstances, and display courage and timing in making critical and sometimes unpopular decisions. They are able to overcome many of the challenges that the pandemic throws up.

    Democracy helps, but it is not the deciding factor. What matters most is what kind of leader is in place, where his or her priorities lie: the well-being of the populace or the interests of a small group.

    Four of the top five performing countries in terms of lives saved and control of the spread of the virus have women leaders: New Zealand’s Jacinda Ardern, Finland’s Sanna Marin, Germany’s Angela Merkel and Taiwan’s Tsai Ing-wen. These women display empathy and firm focus on the well-being of their populations.

    Politicians judge best when they listen to their populations and learn from the science. That is why democracy is uniquely placed to engender good judgements, as the Indian economist Amartya Sen argued with regard to famines, and I have argued elsewhere.

    Yet, it would be mistaken to think that democracy guarantees good judgement. If the purveyors of conspiracy theories and exemplars of prejudice are also your democratic leaders, democracy itself cannot resolve things. It only gives citizens the power to remove those leaders at the next election.

    Bread, circuses and crises

    In the current crisis, Ramaphosa has done a much better job than Trump and Bolsonaro.

    Ramaphosa got off to a great start. He acted firmly, quickly, with clear justification and impressive results. South Africans have just emerged from one of the most severe lockdowns imposed anywhere in the world. This kept the infection rate nearly as low as that of South Korea, though it is now shooting up.

    During this period, however, there have been at least two problematic decisions that undermine public trust and thus how people may behave.

    The first is the decision to ban the sale of tobacco. Even if we could distinguish sharply between basic needs and other needs – something I dispute – the idea that addiction to smoking falls into the latter category, and that, along with the fact that COVID-19 is a respiratory disease, justifies the ban, is misguided. For an addict, the need for a cigarette may often trump even the need for vital nutrition.

    The second is the decision to allow religious gatherings to resume under lockdown level 3. Having spent so long restricting gatherings, to now allow larger gatherings seems like folly. It is well known – cases abound from South Africa to South Korea – that, like funerals, large religious gatherings are super-spreading events.

    Along with the ban on tobacco products and the incorrect assumption that the state could directly meet the basic nutritional needs of the population via the delivery of food parcels, the response to the religious lobby is reminiscent of Juvenal’s comment under imperial Rome some two thousand years ago that all the people really want is “bread and circuses”. This is not what people want or need. They require the power to express their actual needs and interests and the democratic means to ensure that government responds to these.

    Ramaphosa’s good leadership has been undermined by a paternalistic attitude to people’s needs and seeming deference to South Africa’s powerful religious lobby.

    Lessons to be learnt

    Two things can be learnt from the varied responses to the coronavirus crisis.

    First, we must use it to find a roadmap for how we can properly make the health and well-being of a state’s population the raison d’être of its government. The first thing to identify is that health is not the “absence of disease” but the status we each have when our ever-changing needs are optimally satisfied. For this, we need a politics that allows us to express and assess our needs, and determine who is best placed to represent us in responding to these needs, all in non-dominating conditions.

    Second, given that it is no accident that those leaders who have responded worst to this crisis have also been the main sources of countless conspiracy theories and misinformation, we must learn to keep oligarchs away from political power. Under representative democracy, bar outright revolution, we do not have the power to affect the everyday decisions of our representatives, but we can keep those with exclusive social and economic interests out of positions of political power.The Conversation

    Lawrence Hamilton, SARChI/Newton Research Professor in Political Theory, Wits and Cambridge, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Climate change, biodiversity loss and other global ills share root causes

    - Mary Scholes and Robert (Bob) Scholes

    By identifying the roots of global ills there's an opportunity for coordinated action as countries lay new pathways for a post-Covid world.

    The modern world seems to lurch from one crisis to another. What if that is because the crises have shared underlying causes, and therefore tackling them as if they were independent events is doomed to fail?

    The issues of climate change and biodiversity are deeply intertwined. The United Nations Framework Convention on Climate Change and the Convention on Biological Diversity, the international treaties charged with solving two of the biggest problems of the 21st century, were both due to hold make-or-break meetings in 2020. COVID-19 – yet another crisis with strong connections to the other two – has forced the meetings to be postponed. The only positive result is that the delay provides an opportunity to better coordinate actions, in order to lead to better outcomes.

    To mark World Environment Day on 5 June, the Commonwealth Academies released a statement on climate change, biodiversity and sustainable energy. The statement stressed the grave risks to people and nature of allowing the global climate to warm at its current rate and draws attention to the accelerating rate of biodiversity loss. It proposes that a rapid transition to predominantly renewable energy sources can help alleviate both issues. The statement calls for urgent leadership.

    This article explains the logic behind that statement, linking three apparently different issues. By identifying the connections we reveal the opportunities for coordinated action and the pitfalls of continuing to pursue independent agendas.

    Rapid species extinction

    The world is in the throes of a “sixth extinction crisis” – an accelerating loss of species at a rate far more rapid than the evolution of new species. Such a loss was last seen sixty million years ago, when Earth collided with an asteroid. The result is the unravelling of the ecosystems which we depend on for our well-being.

    For the past few centuries, the main cause of declining biological diversity has been habitat loss – the relentless replacement of natural ecosystems by croplands, cities and managed forest, to meet human demands for food, timber and raw materials. That process continues.

    Apart from driving our co-inhabitants of the planet to extinction, land use change is the most important cause of climate change after the burning of fossil fuels. Human encroachment on nature is also the root cause of the emergence of novel zoonotic diseases such as COVID-19. So if we could stop deforestation, we would help solve three problems at the same time.

    Climate change

    But as we move into the middle part of the 21st century, the biggest future threat to plants and animals is climate change. Despite the undertaking by most of the countries of the world in Paris in 2015 to stabilise the global climate at safe levels by mid-century, the climate continues to warm at an accelerating rate.

    As a result the climate comfort zones of millions of species are moving faster than they can keep up. Our main strategy thus far for conserving biodiversity – the creation of protected areas – is increasingly irrelevant. The single most important thing we can do to save nature (and ourselves) in the 21st century is to cap global warming at no more than 1.5℃. In other words, the fate of nature is being decided by the outcome of climate negotiations, not biodiversity discussions.

    There are also examples where an action taken to address one of the crises makes things worse for another. For instance, there is great enthusiasm for planting forests to soak up carbon dioxide. Many of the targeted areas – which need to be huge to make a useful difference – are not places that formerly supported forests.

    As South Africa learned the hard way, when we afforest ancient, species-rich grasslands with monocultures of alien trees, the rivers dry up and biodiversity is lost. There are potentially similar problems with simply replacing fossil fuels with bio energy crops. The vast areas required will either displace food crops or further encroach on natural habitats.

    Energy generation

    Renewable energy – particularly solar and wind power – offer far more sustainable futures. They are not without impacts on biodiversity, but the magnitude of those impacts is much less than the effects of climate change, driven by fossil fuels and land use change.

    The remarkable worldwide reduction in atmospheric pollutants and the resurgence of nature while travel and economic activity were suspended under COVID-19 restrictions give us a glimpse of what we have lost and what we stand to gain.

    Those effects will be short-lived, but they do show that when the world perceives a problem to be urgent and critically important, it can very quickly take actions previously said to be completely impossible. That is the lesson we need to apply to the much more life-threatening, and just as urgent, challenges of climate change and biodiversity loss.The Conversation

    Mary Scholes, Professor and holder of a Research Chair in Applied Systems Analysis, University of the Witwatersrand and Robert (Bob) Scholes, Acting Director of the Global Change Institute (GCI), University of the Witwatersrand, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Covid-19 update (33) - Secure gateway enables teaching and learning

    - Wits University

    Students and staff members who have not already done so, must complete the student survey or staff survey before 8pm on Thursday, 11 June 2020.

    Wits University has partnered with Vodacom to implement a secure gateway, which enables staff and students to access teaching and learning resources.

    This solution will provide staff and students with 10GB daytime and 20GB night-owl data bundles per month for use on selected URLs that can accessed through the Wits network for teaching and learning purposes. This is available on Vodacom SIM cards only.

    A comprehensive set of Frequently Asked Questions can be downloaded, which explains how you can access the data: www.wits.ac.za/mywits/data-access/. You will have to download the CISCO VPN app and have a R5 Vodacom sim card to access the solution (the R5 will be refunded through airtime).

    Students and staff members who have not already done so, must complete the student survey or staff survey before 8pm on Thursday, 11 June 2020 in order to inform the University of their Vodacom number or to advise if they do not want to receive the data.

    Please direct all queries to DataHelp@wits.ac.za – the ICT team will respond within 24 hours.

    Thank you.

    SENIOR EXECUTIVE TEAM

    10 JUNE 2020

    South Africa needs a new governance model post-Covid-19

    - William Gumede

    South Africa’s governance model, the way the country is run, is broken.

    Without a new governance model, South Africa will be unable to overcome the Covid-19 health, social and economic crises; and the country is likely to plunge into economic chaos, social breakdown and rolling violent unrest. To save South Africa from such a frightening fate, a new governance model is urgently needed.

    Here’s 10 pillars that should be the foundations of a new post-Covid-19 governance model for South Africa.

    Evidence-based policy must be a key pillar of the management strategy model of the country. This will make government policy more logical, credible and palatable, to wider constituencies. Over the past few years, government policy-making has often either been based on ideology, wishful thinking or being corrupted. 

    Merit must be principle of government operations. The talents of all South Africans, no matter their colour, ethnicity or political affiliation must be used to rebuild the economy.

    Merit-based appointments to government positions and to structures that oversee Covid-19 economic restructuring are crucial. Crony, cadre and pork-barrel appointments to government structures has wreaked destruction since 1994, undermining public service delivery, wasting scarce public funds and destroying government’s credibility. Government contracts must be awarded based on merit, fairness and value for money.

    Commonsense must drive government decisions, actions and policies. Many government policies, decisions and actions over the past years have made little rational sense. This definitely have to change.

    There has to be greater accountability from elected and public representatives. There has to be consequences for wrongdoing. People must be hold accountable for wrongdoing. The culture impunity must come to an end.

    Accountability strengthens the credibility of government, and importantly motivate citizens to willingly comply with government directives. If citizens perceive there a lack of accountability among elected and public representatives accountability, citizens readily defy government injunctions.

    There has to be partnerships between the public, private sector, civil society and communities to reconstruct the post-Covid-19 economy. The private sector and civil society are not the enemies of government to be in mortal combat with as many ANC leaders may misguidedly belief.

    It is also a fallacy to think as many ANC members or others do, that the state can go it alone. The state simply lacks the capacity, resources and ideas to execute economic policies on its own. Partnerships not only bring goodwill, they bring skills, resources and wider-buying for policies, decisions and delivery.

    Government must govern honestly. Without honesty, there can be no trust, the glue of effective partnerships, citizen compliance and willingness to behave public-spiritedly. This includes government communicating honestly to citizens, beyond the traditional faceless press statements, doublespeak and gobblygook, is crucial rally citizens behind government initiatives.

    Entrepreneurship has to be heart of post-Covid-19 economy reconstruction. Entrepreneurs create new industries, new jobs and new wealth. They increase the size of economies. They fuel economic growth. They inspire a virtual cycle of others trying their hand at starting new businesses, new developments and new initiatives too. In South Africa, entrepreneurship will have to be promoted across society - within the state, private sector, civil society and communities.

    Corruption has to be tackled with greater seriousness. No successful posti-Covid—19 reconstruction is remotely possible with the government seen to tackling corruption, especially corrupt by untouchable politically connected ANC cadres, political capitalists and tenderpreneurs. Corruption that is not dealt destroys the credibility of government, trust and encourages corruption across society.

    The rule of law is fundamental. The rule of law must apply to everyone equally. The rule of law cannot just be applied to ordinary citizens. The politically-connected cannot be exempted from the law as has been the case since the end of apartheid. Neither should there be untouchables, which appear to be above the law, such as minibus taxi drivers and bosses, gangsters and building hijackers.

    The poor, vulnerable and marginalised must always be cared for, without this principle, there will be no post-Covid-19 economic reconstruction possible. The, country will go up in flames on the back of their.  The Covid-19 crisis offers a fresh opportunity to fix South Africa’s broken governance model. Without fixing the broken governance model a new equitable, inclusive and peaceful society is not possible.

    William Gumede is Associate Professor, School of Governance, University of the Witwatersrand; and author of Restless Nation: Making Sense of Troubled Times (Tafelberg)

    This is an edited extract from the Academic Review Paper, “Priority Setting for Interventions in Pre-and Post-Pandemic Management: The Case of Covid-19, analysing Government’s Covid-19 response. The report was done in partnership with the South African Technology Network (SATN) and National Scientists and Organisations.

    Does alcohol have an undisclosed African heritage?

    - Neil Rusch

    Until now the search for early evidence of alcohol has fixated on residue analysis.

    Alcohol is the most widely used psychoactive substance in the world. But where was the first alcoholic beverage brewed and consumed?

    The answer isn’t clear because traces of alcohol don’t preserve well in the archaeological record. Containers like skin bags and wooden vessels that were likely used to hold alcohol don’t survive indefinitely. This poses a problem because residue analysis relies on the preservation of containers and implements.

    The earliest evidence of alcohol comes from starch granules, either wheat or barley, transformed by fermentation. These were found in Raqefet Cave in Israel and are dated to 13,000 years ago. Chemical traces of alcohol have been detected in containers from Neolithic China. These were used in the seventh millennium B.C.E for the storage and dispensing of a fermented drink made of rice, honey and fruit. Early evidence of wine has been found in Northern Iran and dated to the mid-sixth millennium B.C.E.

    Where does the African continent fit into the story of alcohol? Until now the search for early evidence of alcohol has fixated on residue analysis. But I tried a different route – I looked at the role of honey, because honey and bee-related products were being used and consumed 40,000 years ago by people living in southern Africa.

    First, I conducted a fermentation experiment in which alcohol is produced by combining honey, water and moerwortel (Glia prolifera).

    The procedure and combination of ingredients follows an indigenous method, as was conveyed to the botanist Carl Thunberg by indigenous Khoe-San informants in the 18th century. Results of this experiment are contextualised using ethnohistorical and early traveller testimonies that suggest widespread use of honey-alcohol combined with plant material for psychotropic and medicinal purposes. This included kanna (Sceletium tortuosum), which produced a ‘spiked’ honey drink known as khadi.

    Controlled fermentation may have emerged as early as the Middle Stone Age (which started about 280,000 years ago and ended between 50,000 and 25,000 years ago) together with manifestations of complex behaviour and mental processing that was cognisant and capable of using a suite of complementary botanical, technical and chemical methods for various applications. These included making arrow poison and the synthesis of compound materials for the manufacture of mastics, adhesives and pigment.

    The results of this study have been published in Southern Africa Humanities.

    From this research I conclude that honey was the most likely catalyst that allowed controlled fermentation to commence at a very early date in Africa, with the weight of probability pointing to southern Africa.

    The background

    In my research, I’ve also provided an explanatory framework that encompasses a Middle Stone Age and deep-time perspective. This helps to explain the related themes of honey bees in southern San mythology, pictorial expression and fermentation practices.

    Fragments of knowledge about honey fermentation are retained in ethnohistoric accounts and among communities that continue to use honey to make alcohol, to this day. The association between alcohol, honey and bees has pre-historical antecedents. We see this in the form of rock paintings that feature bee-related themes. Mythology, widespread among the San of southern Africa, considers bees, wax and honey to have magical qualities.

    The cognitive requirements necessary to support an understanding of chemical and technical processes (such as fermentation) are manifested in the last 100,000 years in the Middle Stone Age in southern Africa. These processes include bow hunting, about 60,000 years ago; the use of ochre compound, interpreted as paint, around 100,000 years ago, and arrow poison, 24,000 years ago. Arrow poison was possibly used even earlier.

    Intentionally controlled fermentation fits comfortably within these techno-behaviours but leaves no archaeological trace.

    What we do have, though, is a parcel of beeswax. This tells us that honey and bee products were being used and consumed 40,000 years ago in southern Africa by people living at Border Cave, near the present Eswatini (Swaziland) border.

    The Border Cave beeswax is an important biomarker: (1) it is the oldest known example of the use of beeswax anywhere; (2) it makes explicit the connection between honey, bees and plant poison.

    Ingredients for an indigenous fermentation experiment, combining honey and plant adjuncts. (a) kanna; (b) moerwortel; (c) ground kanna and chopped moerwortel. Photographs © Neil Rusch
    Moerwortel root, stem and leaves. Photograph © Neil Rusch

    From this information it is reasonable to infer that controlled fermentation arose on the African continent alongside bow hunting and the use of poison tipped arrows, some time between 60,000 and 24,000 years ago.

    Within this time bracket, what is certain is that at 40,000 years ago early people were using and consuming bee products.

    Does this mean that fermentation of honey-alcohol was attempted 40,000 years ago? We cannot know for sure. All we can say is that the conditions were highly conducive.

    Ongoing questions

    Honey is the most likely catalyst that allowed controlled fermentation to commence at a very early date in Africa, with the weight of probability pointing to southern Africa, given current evidence. And chemical analysis of the Border Cave beeswax provides added incentive for continuing investigation.The Conversation

    Neil Rusch, Research Associate, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    So you think investing in fever screening can curb the spread of COVID-19? Think again

    - Andrea Fuller and Duncan Mitchell

    Detecting fever requires measuring core body temperature. Screening measures the body's surface temperature.

    As lockdowns are lifted, procedures are being put in place to reduce the spread of COVID-19. Along with physical distancing, hand sanitisation and wearing of masks, fever screening is increasingly being set up as a requirement before entry is allowed into hospitals, shops, workplaces and schools. But there are physiological and clinical reasons why fever screening simply won’t work.

    Andrea Fuller and Duncan Mitchell explain why fever screening is unlikely to reduce the spread of the virus. Their arguments are based on an understanding of the physiology of fever, body temperature measurement, and fever prevalence in people who transmit COVID-19.

    What happens to your body when you have a fever?

    Fever is a temporary elevation of body core temperature. It is part of a defensive response to infection by a virus.

    When you develop a fever, you feel cold, heat generation in your body increases (achieved by shivering) and heat loss decreases (achieved by seeking warmth, covering up and reducing the flow of warm blood to the skin). When a fever breaks, either naturally or because you have taken an antipyretic like paracetamol, you feel warm. Your reactions include increasing the flow of warm blood to the skin and sweating, which helps to bring the body’s core temperature back to normal.

    What are the limitations to infrared thermometers or thermal cameras detecting fevers?

    Detecting fever requires measuring body core temperature. To do that accurately, you need to put a thermometer into the body core. Temperature in the rectum and the mouth get close to body core temperature.

    Needing to measure body core temperature raises the first problem with fever screening. Thermal cameras and infrared thermometers measure heat radiating from a surface – in other words surface temperature. They don’t measure body core temperature.

    Measuring surface temperature has contributed usefully to healthcare and to biology. For example, infrared cameras have shown whether skin grafts are receiving blood. On the biology front they have shown that toucans dump body heat through their bills.

    But the forehead skin or inner eye temperatures that infrared thermometers or thermal cameras usually measure in fever screening are not body core temperatures.

    Human surface temperature is heavily influenced by environmental conditions. In cool environments, surface temperatures can be much lower than body core temperature. And doing exercise, or being exposed to the sun, can raise the temperature on our foreheads above body core temperature. Thermal cameras screen for high skin temperature. They can and do find high face temperatures that have nothing to do with infections. Those “false positives” waste time and money in unnecessary follow-up.

    Another problem is that skin temperature does not rise during the developing phase of a fever. It falls, because warm blood is kept away from the skin. So your skin temperature changes in the opposite direction to your body core temperature.

    Thermal cameras would declare you safe, because your skin temperature is low, but you could be in the most infectious phase of the fever. No surface temperature is a reliable indicator of fever.

    Could better fever screening detect COVID-19?

    Even if infrared thermometers could detect fever reliably, they could not detect COVID-19 reliably. Nor could any other thermometer. Patients with COVID-19 are not guaranteed to have a fever.

    Recent research indicates that many people who test positive for COVID-19, and especially children, never have any detectable sign of illness, including fever.

    Even people who later do show symptoms will not have a fever during COVID-19’s incubation phase, which can last nearly two weeks. During this period, when they are asymptomatic, they can spread the virus. The finding that infected people without symptoms shed virus is the Achilles’ heel of controlling the current pandemic.

    To add to the problem, not all patients with symptoms will have a fever, at least on the basis of once-off measurement. Only 31% of patients presenting at New York State hospitals with COVID-19 had fevers.

    So, in addition to not measuring body core temperature well, infrared thermometers are being used to find a high temperature that many people exposed to COVID-19 won’t have.

    Has fever screening ever helped to prevent the spread of viruses?

    Thermal cameras were introduced at airports at the outbreak of the 2002/3 Severe Acute Respiratory Syndrome (SARS) pandemic. They were widespread in airports during the 2009 Influenza A (H1N1) pandemic. But for medical and technological reasons they have failed to prevent the import of any virus causing respiratory disease. They have failed even in combination with other interventions like follow-up contact and health declaration questionnaires. For example, 930 people who presented as potentially infected candidates were picked out by thermal screening from over 9 million passengers entering Japan in 2009/2010. But not one case of H1N1 influenza was diagnosed.

    The data from Ebola shows the same pattern. Not one case of Ebola virus infection was picked up in 166,242 airport passengers screened when entering and leaving Sierra Leone in the 2014/2016 outbreak.

    In the case of COVID-19, CNN has reported that no cases were detected among the more than 30,000 passengers screened with thermal cameras at US airports by mid-February 2020 .

    Some scientists have been forthright about the dubious value of fever screening, arguing that border screening for infectious diseases should not be continued.

    Is there any place for fever screening?

    Perhaps, there may be benefits.

    Some people with viral infections who know they are sick attempt to conceal their illness. Travellers wanting to fly home are prone to do so. Others take antipyretic drugs, hoping to avoid triggering thermal cameras.

    Though there still is no scientific evidence, researchers have suggested that the prospect of being caught by fever screening is a deterrent to such dishonesty.

    But we do not believe that the potential benefit outweighs the negatives. Apart from fever screening being unreliable, infrared thermometry poses a risk to thermometer operators who are required to come up close to potentially infected persons. Successfully passing a fever screen can create a false sense of security. And the thermal cameras used for mass screening are costly. So are the personnel required for any fever screening.The Conversation

    Andrea Fuller, Professor, School of Physiology; Director, Brain Function Research Group, University of the Witwatersrand and Duncan Mitchell, Adjunct Professor in the School of Human Sciences, University of Western Australia, and Honorary Professorial Research Fellow, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Society is not ready to safely reopen schools and education centres

    - C-19 People’s Coalition

    Government is steaming ahead with the reopening of schools. This is an overly hasty, ill-considered step for a number of reasons.

    The government plans for reopening schools are underway. But Covid-19 infections and deaths are rapidly increasing. Testing is still severely delayed, and effective tracking and tracing isn’t yet in place. In response to this, the government seems inclined to narrow the criteria for who gets tested even while pushing to reopen schools. 

    But we need all these public health measures to identify infection clusters and learn how reopening schools affects viral spread so we can respond appropriately. Announcing reopening dates before schools have all safety measures in place and before we are able to track and trace the pandemic is arbitrary, and premature. Any decision to reopen must follow the evidence of health and safety at schools and the societal state of spread/containment of the virus.

    Some loud voices insist that children are at lower risk of suffering Covid-19 symptoms so schools must reopen immediately. But the evidence on how children transmit the virus is not yet clear in South Africa or internationally. We do not know how much children can infect adults, especially those who are elderly or at high risk. It is irresponsible to insist on using partial and conflicting evidence to make unqualified claims about the safety of opening schools.

    Given this context, society is not yet ready to safely reopen ordinary schools, special schools, special care centres and early childhood development centres. The risks of school infections are especially high because: 

    1. Many schools lack sufficient water, toilets, soap, masks, textbooks and classrooms (and once these are supplied, schools need time to establish safe routines);
    2. Budget cuts mean there are not enough teachers for physical distancing in schools;
    3. Many teachers are at high risk because of their age and illness profiles, and there are insufficient measures in place to protect them; and
    4. Learner transport is unsafe and too crowded.

    Opening justly, not just opening

    Our education system is unequal and unjust. The short-term plan must use this time of school closure to prepare and strengthen education, and contribute to the goals of a longer-term plan so that we have a unified education system that serves all our children justly, freely and equally. We have an unusual opportunity to address long-standing injustices. We should not waste it.

    We must all think creatively, together, about how to educate each other in this time of crisis and how to use this time to bend schooling towards free, equal education for all. Education is wider than schooling: education is about learning to live together critically in the world as it is, struggling towards the better world we must build. This social learning must lie at the heart of our struggle against Covid-19, the social crisis it has intensified, and the unjust, unequal education system.

    Who decides?

    Schools and education centres are social resources and human communities for the public good. Millions of learners and caregivers, and hundreds of thousands of teachers and early childhood development (ECD) practitioners, are involved in education. The minister and education bureaucracy can’t unilaterally announce when it is safe to reopen. People themselves, in local school communities, must be integral to deciding democratically whether and when they are ready to reopen schools, in context, equitably and safely across society. People’s involvement must extend beyond “consulting” school governing bodies (SGBs). 

    In line with democratic principles, we demand that the national and provincial education departments make policymaking transparent and open to real public engagement:

    1. Education departments must make public which experts they are drawing on, what research they are using to inform their decision-making and the minutes of all meetings;
    2. They must recognise and seek out the invaluable contextual knowledge that teachers, support staff, learners and caregivers have: they are experts who know their own contexts best;
    3. They must invite the public to participate directly in developing policy – not just inform them via National Education Collaboration Trust (NECT) representatives;
    4. They must invite the public to guide budget priorities and monitor contractual deliverables and spending;
    5. They must empower local school communities, including SGBs, parents, students, principals, teachers, civic bodies in local communities such as churches, welfare providers, sports and recreation clubs, and religious structures, to decide on whether schools should be reopened or not; and
    6. If schools decide to open, they, in collaboration with local communities must be provided optimal sanitary resources by the provincial education departments and districts to secure safe, and healthy conditions of learning. School communities should be empowered to secure deep cleaning, sanitisation, safe distancing, and the delivery of water, food and health security.   

    Importantly, the national Department of Basic Education must develop clear roles and responsibilities, and hold provinces to account for failing to comply with its directives. This will reduce the petty power struggles and bickering over responsibilities which have made our schools a battleground for party politics, spreading confusion, and undermining coherent and realistic policymaking.

    Prepare infrastructure and support teachers

    Poor infrastructure and insufficient support for teachers are central obstacles to responding effectively to Covid-19. So the Department of Basic Education should work hand-in-hand with the public to pursue the following concrete measures, with all effort, immediately:

    1. Ring-fence a portion of Covid-19 funds for preparing and strengthening the education system;
    2. Work with the Department of Public Works to build and rehabilitate school infrastructure, and encourage the employment of local community members; and
    3. Support and work with teachers to:
    4. Identify teachers at risk and work with them to identify how they can safely participate in education: for example, by collectively developing open-access textbooks, storybooks, and learning aids
    5. Identify young and unemployed teachers and integrate them into the education system on equal terms with public sector teachers
    6. Identify all teachers employed by SGBs as their jobs are at risk: they must be formally employed by the state on equal terms with public sector teachers
    7. Identify teachers who are teaching out of phase and out of subject, and work with them to reallocate them appropriately
    8. Work with teachers to develop more creative physical distancing solutions, where schools decide with their learners and teachers how best to use their space and time equitably. 
    9.   Work with teachers to build a realistic school calendar and timetable for learning that is structured around the pandemic instead of an artificially imposed “academic year”.

    Support schools to serve communities

    Communities have real, serious needs for nutrition and childcare, because the economy is forcing caregivers to risk their lives and return to work for others’ profits and to earn just enough to eat. We must address these needs by understanding and using schools as community resources while they are closed for formal teaching and learning. When teaching resumes, schools will have stronger relationships with their community and continue to build on these programmes.

    To this end, the Department of Basic Education must work together with the Department of Social Development to recognise and strengthen the social role of schools in communities:

    1. Use schools as nutrition centres for both children and adults: children need to eat to learn, but all people need nutrition to learn and live;
    2. Use schools to distribute public health awareness literature;
    3. Use schools to identify at-risk families and provide psychosocial support through social workers;
    4. Use schools as spaces where other state support programmes can be supported and housed, such as SASSA grant disbursement; and
    5. Use schools as tracking and testing spaces for specific areas surrounding the school.

    Support schools for social learning

    Government’s obsession with “saving” the academic year is unrealistic and unjust. 

    It is unrealistic because the government’s regulation that only 50% of learners can be at school at any time means that learners (outside of Grade 12) will be out of school half the time. Schools that reopen may need to reclose; many teachers and learners will spend time at home, in quarantine or isolating. Given this, it will be impossible to “complete” the CAPS curriculum on its own terms. 

    It is unjust because the curriculum has already been failing us, as struggles for free, decolonised education have articulated. The curriculum should define what people and communities believe is important for everyone to know and be able to do, and identify human knowledge and skills which should be accessible to all.

    Moreover, education should enable and enrich life, learning, and life-making, together for all. It is not just about ensuring that the minority of learners who matriculate have a certificate for an inequitable and unjust job market. 

    The government’s insistence on “saving the curriculum academic year” prioritises saving face over supporting everyone to learn. Dropping the folly of trying to save the academic year will give the school system the flexibility to respond to the pandemic when, for example, infections increase exponentially, or when schools respond to the psychosocial, food and health needs of learners. 

    Together, we can build a just and emancipatory popular education using social learning. To do this, national and provincial education departments must work together with schools, families and communities to support learning. 

    First, learning happens at home and in the community as much as it happens in school. Education departments must support this learning through:

    1.   Asking caregivers how they cope during holidays and sharing this to guide childcare practice and policy;
    2. Rolling out public mobile libraries to support reading at home;
    3. Rolling out public toy libraries to support playing at home; and
    4. Implementing realistic and practical distance learning initiatives accessible to all. Instead of the government’s unrealistic and inequitable emphasis on 4IR and online learning, we must use public and community radio and television for distance learning. Here, we can learn from what other countries are doing and have done. This should be complemented with the delivery of printed materials through schools.

    Second, national and provincial education departments must pay special attention to children who have been unjustly excluded from the education system:

    1.   Hundreds of thousands of children with disabilities who are excluded from formal schooling;
    2. Millions of children who are pushed out of schooling for socio-economic reasons and then blamed as “drop-outs”; and
    3. One million undocumented children who were excluded until this year from accessing basic education.

    Education departments must publicly acknowledge that the education system has failed these children, and openly ask for the public’s help to fundamentally transform the education system to ensure equitable and truly inclusive participation for all.

    Strengthen education financing and governance

    Over the medium term, the national Department of Basic Education must recognise that three issues are the key drivers of inequality and injustice in education: financing, school choice and decentralisation.

    Financing

    The national Department of Basic Education has a duty to:

    1. Pressure Treasury to protect and increase the education budget over the next three years to reduce teacher-student ratios. The education budget must not be cut after years of decreasing real spending per learner. Education funding must be increased significantly to build a just, free, equal schooling system. And this must not be used as an excuse to cut funding for ECD and post-school education, or other social spending;
    2. Pressure Treasury to prioritise education over non-social spending, such as the Security Cluster. Buying military-grade weapons for the police, who routinely kill people, is violently unjust when children don’t have toilets at school;
    3. Revise the equitable share formula to allocate budget equitably and progressively across provinces, redressing long-standing inequities: the current formula, which only considers the number of learners in each province, doesn’t consider that education is more expensive to provide in the poorest provinces because larger distances and lower population densities increase costs;
    4. To pressure other organs of state, such as SARS, to crack down on illicit financial outflows and tax evasion in order to improve public finances; and
    5. To pressure other organs of state to revise tax laws to incorporate a wealth tax and strengthen a progressive income tax which better targets the upper bracket of earners.

    We demand that government recognise that school spending is an investment in our people and our future, a public good, not a “cost” to be reduced no matter the consequences.

    School choice

    The national Department of Basic Education has a duty to:

    1.   Publicly acknowledge that policy enabled the creation of no-fee public schools, fee-paying public schools and private schools. This allows the middle class and rich to opt out of true public schooling and capture a disproportionate share of education spending. It must work with the public to develop a plan to reintegrate these schools back into a tuition-free public sector, in the same way that the Department of Health is working with the public to develop a National Health Insurance scheme to create a unified people’s health service. In the interim, it must place an absolute cap on school fees in public and private schools; and
    2. Publicly consider how the policy of allowing teachers and learners to choose which schools to attend has fostered race and class segregation. The department must work with the public to demarketise schooling and implement the recommendations of the Hunter Report, which it ignored during the transition to democracy.

    Decentralisation

    The national Department of Basic Education has a duty to:

    1.   Publicly recognise that the creation of provinces was a key concession in the Codesa negotiations. The provinces have strong spatial and institutional overlaps with apartheid bureaucracies. This means that the anti-democratic ethos of apartheid institutions has manifested itself in many provinces – through white enclaves and ethnic provinces;
    2. These provinces have a high level of autonomy over budgets and the hiring and firing of staff. It is difficult for either the national government or the public to hold them accountable. While recognising the entrenched political power of the provinces, the department must work with the public to address this fundamental driver of inequality; and
    3. District and circuit structures need to be reorientated to serve schools by supporting teachers and learners, instead of imposing unrealistic plans on schools and pressuring them to comply.

    Covid-19 has shown us how violently unequal our schools are. During the democratic transition, we had an opportunity to create a unified education system that serves all our children justly, freely and equally. We squandered that opportunity. Covid-19 has given us a precious second chance. For the sake of our children and those who have yet to come, we dare not squander it again.

    Issued by the C19 People’s Coalition and its Education Working Group.

     

    Signatories:

    Adam Haupt – Centre for Film & Media Studies, UCT; Ally Cassiem, CALT, UJ; Anna James – ELRC, Rhodes University; Asanda Benya – Department of Sociology, UCT; Ashley Visagie – Bottomup; Aslam Fataar – Stellenbosch University; Azeem Badroodien – School of Education, UCT; Ben Verghese – UWC; Bonga Nzuza – Concerned Citizen; Britt Baatjes – Educationalist; Bruce Damons – Centre for the Community School, Nelson Mandela University; Carolyn McKinney – bua-lit Language and Literacy Collective; Clint Le Bruyns – Theology & Development Programme, UKZN, Underground Academy for Lifelong Learning; Dylan Valley – Centre for Film and Media Studies, UCT; Enver Motala – Centre for Education Rights and Transformation, University of Johannesburg; Fadia Gamieldien – Division of Occupational Therapy and CPMH, UCT; Fairuz Mullagee – UWC; Fathima Peerbhay -University of Western Cape; Fatima Gabru – Educator; Ganief Davids – Trustee Hidayatul Islam Primary School; Heila Lotz-Sisitka – Environmental Learning Research Centre, Rhodes University; Helene Rousseau – Bottomup; Ivor Baatjes – CIPSET, Nelson Mandela University; Jabu Bam – Centre for the Community School, Nelson Mandela University; Jane Keen – South African Education Project; Jane Quin – Education and Development, UKZN-P; Jon Fish Hodgson; Josh Miller – University of Cambridge; Kaathima Ebrahim; Kate Angier – School of Education, UCT; Kelly Gillespie – Department of Anthropology, UWC; Kharnita Mohamed – Department of Anthropology, UCT; Koni Benson – Department of History, University of the Western Cape; Kristen Abrahams – Division of Communication Sciences and Disorders, UCT; Leigh-Ann Naidoo – School of Education, UCT; Liz Blaiklock – concerned citizen; Lubna Nadvi – School of Social Sciences, UKZN; Lyndal Pottier – School of Education, UCT; Marcus Solomon – Children’s Resource Centre; Mejury Mushanguri – South African Education Project; Mellisa Francke – Division of Occupational Therapy, UCT; Mocke J van Veuren – University of the Witwatersrand (Film & TV); Moeneer Gamieldien – College of Cape Town; Mohamed Shahid Mathee – Religion Studies, UJ; Morné Steyn – Centre for Theatre, Dance and Performance Studies, UCT; Nadeema Musthan – Centre for the Community School, Nelson Mandela University; Najwa Norodien-Fataar – Cape Peninsula University of Technology; Nandi Msezane – Pan African Home Education Foundation; Natasha Vally – Department of Sociology, UCT; Nimi Hoffmann – Centre for International Education, University of Sussex; Polo Moji – Department of English Literature, UCT; Post School Education Alliance for Social Pedagogy; Pumeza Mahobe – South African Education Project; Rasigan Maharajh – Institute for Economic Research on Innovation, Tshwane University of Technology; Reza Khota – UWC; Robin Notshulwana – Nelson Mandela University; Roshan Galvaan – Division of Occupational Therapy, UCT; Rubina Setlhare – Educational Psychologist, UJ; Ruchi Chaturvedi – Department of Sociology, UCT; Saajidha Sader – School of Education, University of Kwazulu-Natal; Sadick Desai – eduACTION Community Education SA; Salim Vally – Centre for Education Rights and Transformation, University of Johannesburg; Sandra Jordaan – Department of Integrative Biomedical Sciences, UCT; Sara Black – Centre for Education Rights and Transformation, University of Johannesburg; Sarah Godsell – Social and Economic Sciences, Wits University; Sebolelo Mokapela – Department of Xhosa, UWC; Sinethemba Zungu – University of KwaZulu-Natal; Suren Pillay – UWC; Susan Gredley – University of the Western Cape; Susie Taylor-Alston – South African Education Project; Vanessa Japtha – Western Cape Forum for Intellectual Disability; Vanessa Pillay – Educator; and Xolisa Guzula – bua-lit Language and Literacy Collective.

     

    Covid-19: The full economic impact will only be known later

    - David Francis, Imraan Valodia and Kamal Ramburuth-Hurt

    South Africa needs to focus urgently on how COVID-19 will reshape its labour market.

    The full economic damage caused by COVID-19 and the lockdowns is uncertain. It will take several months, indeed years, to have a better understanding of where the damage has occurred and how severe it is. While the magnitudes are uncertain, it is already clear that we will see a sharp decline in incomes, rising unemployment, and widespread business closures.

    South Africa, in particular, needs to keep a close eye on all aspects of the labour market so that policy responses can support those most in need. Recent work has highlighted the enormous impact of the COVID-19 pandemic and the lockdown on the lives of working people.

    A focus on the labour market is particularly important given South Africa’s already high unemployment, and the inequality which is generated by the labour market. We highlight four areas of the labour market which will require scrutiny in the coming months: the informal economy; turbulence and job churn; increasing capital intensity; and gender and work.

    Informal sector as a shock absorber?

    Before the pandemic, South Africa had about 5 million people working in the informal economy. The orthodox view in development economics on the effect of economic crises is that informal employment acts as a shock absorber for the formal economy. When someone loses a formal job, they take up informal work. The argument is that there are no barriers to entry to informal work, so workers will simply move into this part of the economy and undertake some informal activity.

    In South Africa, the evidence is that this is largely not the case. This is due to the very low absorption rate of labour of both the formal and informal sectors. Different to other developing countries, South Africa has both very high unemployment and relatively low informal employment. About 34% of workers in South Africa are informally employed, while the global average is more than 60%.

    There is good reason to believe that the informal economy, rather than being a shock absorber, could well have proportionately larger employment losses in South Africa. For example, following the 2008 crisis, Professor Mike Rogan from Rhodes University found that both the formal and informal sectors contracted – the formal sector by 4%, the informal by 7%. This suggests that the informal economy does not necessarily absorb those who lose their formal jobs.

    In the current crisis, this is exacerbated by the design of the lockdown and physical distancing protocols. These have had a particularly severe impact on the informal economy. Any economic policy responses must therefore take the informal economy into account, and provide support where possible.

    Churn and capital intensification

    The second area South Africa needs to focus on is which kind of jobs will be lost, who will be most affected, and where opportunities exist to create new employment. This requires looking deeper than the headline unemployment figures and into the nature of job changes. The economic shock from the pandemic and the lockdown will cause a reconfiguration in the labour market. Many people will lose jobs, but many will find new ones, too. This has been a common dynamic in labour markets since the industrial revolution. But the new jobs might pay less, or be more precarious, or more dangerous.

    Given the structural nature of the shock, the changes to the labour market will not be random, and may affect certain groups more than others. Low to medium skilled workers are more likely to be employed in lower paying, more precarious forms of work. And there’s a concern that the sectors hardest hit will be those that employ a large proportion of women. Evidence from other countries suggests that, unlike in previous recessions where men lose proportionately more jobs, the current crisis is affecting women disproportionately.

    The third important labour market issue to consider is capital intensity in the economy. In the production of goods and services, firms use a combination of labour, machinery and equipment (capital), land and entrepreneurship; the factors of production. The proportion of labour versus capital that firms in an economy use matters for job creation and unemployment. South Africa has seen a general trend toward capital intensive production. The country is likely to see an acceleration of this due to physical distancing requirements in offices and factories that will make automation more attractive for firms.

    Physical capital, technology and labour can be combined in different proportions by a firm to increase or maintain the same amount of production. But in a country like South Africa, with very high unemployment, increasing capital intensity will further increase unemployment, and undermine the prospects of labour-intensive growth. This change will not be instantaneous. It’s more likely to unfold over the next months and years.

    An increasing capital-to-labour ratio in production is an important consideration for two reasons. The first is its effect on unemployment. Secondly, a shift towards capital intensity will increase existing inequalities. One way this will occur is through the rising portion of value that is generated by capital that will be claimed by the relatively small number of owners of capital. This is a common driver of long-term inequality that persists if it is not countered by redistributive policies.

    The fourth aspect is gender and work. Women in the South African labour market continue to suffer higher unemployment, lower wages, and more precarious working conditions. Indeed, women earn less than men, in general, even when they do the same job. In addition to the fact that evidence is pointing to the crisis affecting women disproportionately in the labour market, there is also uncertainty about how the lockdown has affected the distribution of unpaid work in the household – a burden which falls disproportionately and unfairly on women. It is critical that the country’s policy interventions are developed with these gender considerations in mind.

    Need for new social compact

    If the solidarity and social commitment to ending divisions in South African society is to be taken seriously beyond the pandemic, the manner in which these labour market trends will affect inequality must be considered. There is no natural mechanism or economic law that reduces inequality. Reducing it relies on policies of redistribution. This can happen either directly through structural changes leading to employment growth, higher wages or fiscally through taxation and expenditure. All of these require development policies that ensure the benefits of growth accrue disproportionately to low-income groups.

    Given the conditions the world finds itself in, an increase in employment or wages is unlikely. In the case of South Africa, the country is also in a highly constrained fiscal position, which limits its ability to pursue redistributive policies.

    In the medium to long term, South Africa will need a new social compact that ensures that the economic damage from COVID-19 is not borne disproportionately by the poor. Such a compact will have to address policies that raise the incomes of the poor – through the labour market and fiscal measures. South Africa needs to start an urgent conversation not only about the costs of COVID-19 but also about how the economy is likely to transform and who will benefit from that transformation.The Conversation

    David Francis, Deputy Director at the Southern Centre for Inequality Studies, University of the Witwatersrand and Imraan Valodia, Dean of the Faculty of Commerce, Law and Management, and Head of the Southern Centre for Inequality Studies, University of the. Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    SA needs to block transmission routes to get Covid-19 under control

    - Alex van den Heever, Imraan Valodia, Lucy Allais, Martin Veller, Shabir Madhi and Willem Daniel Francois Venter

    Testing and tracing has not been at a level needed to suppress the spread and must now focus on containing opportunities for super-spreading and transmissions.

    As the lockdown is relaxed, South Africa’s focus should now be on how best to suppress the spread of the SARS-CoV-2 virus using other strategies. Policy should be informed by understanding the spread of the virus both in terms of the main mechanism of transmission (respiratory particles) as well as in terms of the connections that result in spread between communities. Crucially, not all spreaders are equal, and understanding this is important for policy.

    South Africa introduced a lockdown early. It couldn’t afford, or adequately implement, a lockdown for long enough and effectively enough to contain the virus. Unfortunately, the country has also not been able to implement testing and tracing at a level needed to suppress the spread.

    Nevertheless, the strategy did buy some time to prepare hospitals and the healthcare system. But if the country can’t contain the spread through lockdown or testing and tracing, this certainly does not mean that it should give up. Importantly, whether or not there is a lockdown, as long as people are conducting some economic activity, working in healthcare and other essential areas, and using transport to do so, there are routes of spread.

    This means that, independent of lockdowns, the government needs to pay attention to limiting spread in these routes.

    In this article we examine a way to think about successfully suppressing the epidemic with the tools that South Africa has available, by examining the main areas of transmission risk.

    Features of SARS-CoV-2 transmission

    Respiratory viruses spread rapidly as transmission occurs largely through the air. The reproduction rate (or R0) represents the average number of people an infected person will infect over a period of time. Importantly, the R0 figure is a crude average which in fact reflects a wide distribution of spreaders of the virus.

    It turns out that much of the average is made up of a few super-spreading events and a majority of weak spreaders. Super-spreading can be tied to one-off events, such as a religious gathering, or a recurring high-risk setting – such as a call centre with many workers in an enclosed open plan setting. In the case of influenza, schools and universities are associated with super-spreading due to the frequent grouping of people into enclosed classrooms and canteens.

    The importance of super-spreading events can be seen in the finding, in a still to be peer-reviewed article, that roughly 80% of COVID-19 infections are attributable to 20% of infected people. More interesting is a finding that roughly 70% of people with COVID-19 did not infect anyone else.

    Understanding the importance of super-spreaders informs the potential effectiveness of physical distancing interventions – even in the absence of testing and tracing.

    Social spaces that connect households

    Given the way it spreads, the risk of exposure depends on:

    In terms of transmission between groups it is worth differentiating between three levels of connection.

    • First there is the household level. Infected people within a household will tend to infect other family members living in close proximity.

    • Second, there are the social spaces that connect households within a community. A community refers to multiple households in close proximity to each other – such as in a district or town. Local shops, stores, local schools and restaurants create opportunities for transmission to occur between households within a community.

    • Third, there are the spaces that connect communities. These include places of employment, forms of bulk transport, major shopping centres, places of education, places of worship, theatres, healthcare providers, funeral gatherings, sports events, and any area where people from multiple communities are in close proximity.

    The infectious disease spread between households and communities depends on two factors: first, the way in which the disease is transmitted between people; and second, the dynamics that connect people to each other. More distance naturally translates into no, or slower, transmission.

    The distance is narrowed by social spaces that connect households and communities. Social spaces between households are responsible for transmission within a community. Social spaces between communities transmit an infectious disease between distant communities.

    In theory, a strong generalised lockdown successfully implemented early enough could close both social spaces, restricting the further spread of the epidemic to that within the households. If these household members did not have contact with others, the disease would become extinct.

    Where a generalised lockdown successfully closed the third-level social space, but left the second open, the spread would be affected by the number of communities with at least one household infected. In this scenario, the outbreak spreads through the connections between households within a community. However, the outbreaks would be quite localised. Communities with no infected households prior to the lockdown would not experience any outbreak.

    Containment without preventive testing and tracing

    Community-based testing and tracing can contain community-level outbreaks of COVID-19 relatively quickly – but only if the infection levels are relatively low and testing and tracing capabilities are highly responsive. This option has been taken off the table, given South Africa’s level of spread combined with insufficient rapid testing.

    This means that the country’s strategy should focus on intensive management of the two levels of social space that connect households.

    First, this means closing or heavily controlling the social spaces that provide opportunities for super-spreading and that are not essential for the economy and society. These include all large gatherings, such as funerals and church gatherings, particularly where these gatherings occur indoors in spaces with poor air circulation.

    Second, it means the following general requirements for all spaces that are essential for the maintenance of the economy and society:

    • Masks to be worn by everyone.

    • Require physical distancing wherever possible. Staff who can work from home should be required to do so.

    • Introduce outside air into closed settings. Whenever people from different households are in a vehicle, open windows if possible.

    • Upgrade filters in air conditioning systems and only use air conditioning systems which extract rather than re-circulate air. Air flow from air conditioning systems and fans may also need to be modified.

    • Regularly clean high-contact surfaces.

    • Require that employers provide good quality protective equipment for staff in regular contact with clients.

    • Provide for on-site symptom screening for staff. Self-screening should also be enabled before coming to work. This should include a requirement to stay at home if any person in the household has symptoms and clear messaging about which symptoms these are.

    • Access to hand-washing facilities must be made available.

    • Where cases are detected at any social space, testing and contact-tracing can ensue (where resources allow), with the possibility of a temporary short-term closure where required to understand the outbreak.

    This strategy requires clear, accurate public information messaging, co-operation from employers and employees, and buy-in from society.

    Conclusion

    These measures are unlikely to eliminate spread, but will contain opportunities for super-spreading and transmissions between communities and households.

    South Africa has clearly struggled to manage the social spaces within and between high-density communities using a lockdown approach. Redirecting efforts to managing the high-risk social spaces between communities and households may go a long way towards lowering the maximum infection peaks and reducing the risk to society.

    If infection levels decline sufficiently, current capabilities for testing and tracing could be sufficient for their strategic redirection toward prevention – particularly if all testing capabilities in government, universities and the private sector were mobilised as part of a single strategy.The Conversation

    Alex van den Heever, Chair of Social Security Systems Administration and Management Studies, Adjunct Professor in the School of Governance, 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; Lucy Allais, Professor of Philosophy, University of the Witwatersrand; Martin Veller, Dean of the Faculty of Health Sciences, University of the Witwatersrand; Shabir Madhi, Professor of Vaccinology and Director of the MRC Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, and Willem Daniel Francois Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, University of the Witwatersrand

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The first Covid-19 vaccine trial in South Africa begins

    - Wits University

    The first participants in South Africa's first clinical trial for a vaccine against Covid-19 will be vaccinated this week.

    The South African Ox1Cov-19 Vaccine VIDA-Trial partners' logos

    The first clinical trial in South Africa and on the continent for a Covid-19 vaccine was announced today, 23 June 2020, at a virtual press conference hosted by the University of the Witwatersrand, Johannesburg (Wits).

    To watch the full Zoom recording of the press conference, click here and enter the password: 5n?p3Z*?

    The South African Ox1Cov-19 Vaccine VIDA-Trial aims to find a vaccine that will prevent infection by SARS-CoV-2, the virus that causes Covid-19.

    In South Africa, at least 80,000 people have already been diagnosed with Covid-19 and more than 1,674 have died from Covid-19 since March, when the President declared a state of disaster and national lockdown.

    By 17 June 2020, South Africa (population: 59 million) contributed to 30% of all diagnosed Covid-19 cases and 23% of all Covid-19 deaths on the African continent (population: 1.34 billion). These statistics emphasise the urgent need for prevention of Covid-19 on the continent. 

    Shabir Madhi, Professor of Vaccinology at Wits University and Director of the South Africa Medical Research Council (SAMRC) Vaccines and Infectious Diseases Analytics Research Unit (VIDA), leads the South African Ox1Cov-19 Vaccine VIDA-Trial.

    Wits University is collaborating with the University of Oxford and the Oxford Jenner Institute on the South African trial.

    Professor Shabir Madhi, Professor of Vaccinology at Wits University and Director of the South Africa Medical Research Council (SAMRC) Vaccines and Infectious Diseases Analytics Research Unit (VIDA), leads the South African Ox1Cov-19 Vaccine VIDA-Trial. ©WITS UNIVERSITY

    “This is a landmark moment for South Africa and Africa at this stage of the Covid-19 pandemic. As we enter winter in South Africa and pressure increases on public hospitals, now more than ever we need a vaccine to prevent infection by Covid-19,” said Madhi at the launch of the South African Ox1Cov-19 Vaccine VIDA-Trial, which is being run at multiple sites in South Africa.

    “We began screening participants for the South African Oxford 1 Covid-19 vaccine trial last week and the first participants will be vaccinated this week,” says Madhi, who is also the National Research Foundation/Department of Science and Innovation SARChI (South African Research Chairs Initiative) Chair in Vaccine Preventable Diseases, based at the University of the Witwatersrand.

    Professor Zeblon Vilakazi, Vice Principal and Deputy Vice Chancellor: Research and Postgraduate Affairs at the Wits University, who facilitated the virtual press conference, said: “Wits University identified vaccinology as a key institutional flagship project in 2016. Vaccines are amongst the most powerful tools to mitigate life-threatening diseases. Without a vaccine against Covid-19, there will likely be ongoing contagion, causing severe illness and death. Wits is committed to developing a vaccine to save lives in collaboration with the University of Oxford.”

    Prior to launch, the South African study was subject to rigorous review and has been approved by the South African Health Products Regulatory Authority (SAHPRA) and the Human Research Ethics Committee of the University of the Witwatersrand.

    Furthermore, after eliciting and considering public comment, the Department of Agriculture, Forestry and Fisheries (DAFF) approved import of the investigational vaccine for use in the trial.

    South African participation in international trials

    The vaccine is already being evaluated in a large clinical trial in the UK where more than 4,000 participants have already been enrolled. In addition to the South African study, similar and related studies are about to start in Brazil. An even larger study of the same vaccine of up to 30,000 participants is planned in the USA.

    Professor Helen Rees, Chair of SAHPRA and Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI).

    “It is essential that vaccine studies are performed in southern hemisphere countries, including in the African region, concurrently with studies in northern hemisphere countries,” says Professor Helen Rees, Chair of SAHPRA and Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI). 

    “This allows evaluation of the efficacy and safety of candidate vaccines to be assessed in a global context, failing which the introduction of many life-saving vaccines into public immunization programmes for low-middle income countries frequently lags behind those in high-income countries.”

    Rees also co-directs the Wits African Leadership in Vaccinology Excellence (ALIVE) flagship programme and is engaged in global discussions with Gavi, the Vaccine Alliance and the World Health Organization to ensure equitable access for all countries, including those in Africa, should a successful vaccine be developed.

    About the South African vaccine on trial

    The technical name of the vaccine is ChAdOx1 nCoV-19, as it is made from a virus called ChAdOx1, which is a weakened and non-replicating version of a common cold virus (adenovirus). The vaccine has been engineered to express the SARS-CoV-2 spike protein.

    The vaccine was developed at the Oxford Jenner Institute and is currently on trial in the UK, where over 4,000 participants are already enrolled into the clinical trial and enrolment of an additional 10, 000 participants is planned. 

    The vaccine being used in the South African trial is the same as that being used in the UK and Brazil.

    The vaccine was made by adding genetic material – called spike glycoprotein – that is expressed on the surface of SARS-CoV-2 to the ChAdOx1 virus.

    This spike glycoprotein is usually found on the surface of the novel coronavirus and is what gives the coronavirus its distinct spiky appearance.

    These spikes play an essential role in laying a path for infection by the coronavirus. The virus that causes Covid-19 uses this spike protein to bind to ACE2 receptors on human cells.

    ACE2 is a protein on the surface of many cell types. It is an enzyme that generates small proteins that then go on to regulate functions in the cell. In this way, the virus gains entry to the cells in the human body and causes Covid-19 infection. 

    Researchers have shown that antibodies produced against sections of the spike protein after natural infection are able to neutralize (kill) the virus when tested in the laboratory.

    By vaccinating volunteers with ChAdOx1 nCoV-19, scientists hope to make the human body recognise and develop an immune response (i.e., develop antibodies) to the spike glycoprotein that will help stop the SARS-CoV-2 virus from entering human cells and causing Covid-19.

    Local application of a global response

    In addition to the more than 4,000 people already vaccinated in the UK with the ChAdOx1 nCoV-19 vaccine, other vaccines made from the ChAdOx1 virus have also been given to more than 320 people to date. These vaccines have been shown to be safe and well-tolerated, although they can cause temporary side effects, such as a temperature, headache or a sore arm.

    There are currently over 100 candidate Covid vaccines in development around the world and many of South Africa’s best vaccine research institutions will soon be involved in a range of vaccine studies evaluating other types of potential Covid vaccines.

    Professor Glenda Gray, President and CEO of the South African Medical Research Council.

    “As the world rallies to find health solutions, a South African endeavour for the development of an effective Covid-19 vaccine is testament to our commitment of supporting healthcare innovation to save lives,” says Professor Glenda Gray, President and CEO of the South African Medical Research Council.

    Dr Sandile Buthelezi, the Director General of Health in the National Department of Health, said: “The National Department of Health is excited at the launch of this vaccine trial, which will go a long way to cement South Africa's leadership in the scientific space. With Covid-19 infections increasing every day, the development of the vaccine will be the last solution in the long term, and we are fully behind the team leading this trial.” 

    Distance, Dose, Dispersion: Experts’ guide on Covid-19 risks in South Africa and how to manage them

    - Lucy Allais, Shaheen Mehtar, Francois Venter, David Francis, Shabir Madhi, Alex van den Heever, Imraan Valodia and Martin Veller

    Understand the three things that can make the most difference to easing the lockdown and reopening South Africa with the least risk.

    Our lives have been turned upside down by the coronavirus pandemic and by the lockdown, and further confused by shifting information. You might be wondering about the role of masks, whether to wipe down your groceries, and if the lifting of lockdown means we can all relax now. You might have concerns about how you can safely travel to work, what steps to take as you reopen your business, whether to attend a religious gathering, or what to tell your grandmother about how to stay safe.

    It has become clear that some countries in Asia and Europe rapidly contained their epidemics through simple and relatively easy behaviour changes, rather than relying on changes in immunity or prolonged lockdown strategies. Our aim here is to share some basic essentials about how to minimise risk. Nothing is risk-free (for example, we take risks getting into cars, buses or taxis). But we can manage risks, which requires understanding how they intersect and amplify each other. It turns out that with this new coronavirus, open windows, masks and physical distancing are more important than obsessive hand sanitising and temperature taking.

    Understand that we may be in for a long haul, adjusting our lives for at least the next few years. Some of these changes may be permanent (and may be things we should have done anyway, for TB and seasonal ‘flu). We need to enable businesses to survive, our institutions to open as safely as possible, while we live our lives as naturally social animals.

    We cannot be saved by government policy alone – the things we can all do are what will save South African lives. And those things are pretty simple.

    Our Summary:

    • Do everything possible Outdoors;
    • Open Windows;
    • wear Masks;
    • keep at least one metre Distance (two metres is better) from people,
    • Avoid Crowded spaces,
    • be Quick.

    What causes the problem?

    The way the virus spreads is that when we cough, sneeze, talk, sing or simply breathe, we spray very small drops of moisture into the air; these are respiratory particles. If someone is infected, the live virus will be present in these particles. These particles in our breath can spray quite far (several metres). If there is poor ventilation and no air movement, they can hang around in the air. They can land on surfaces (where the virus may survive for some hours) and if you are close to someone they can land on your eyes, nose or mouth. Most people who become infected get the coronavirus by direct contact with an infected person. It is also possible, but less common, to be infected from touching your mouth, nose or eyes when your hands have the virus on them from touching a surface.

    What is the impact of the three Ds?

    Distance: The further away you are from someone who is infected, the less likely you are to be infected by them or to breathe in particles they have breathed out.

    Dose: To become infected you need to have contact with a minimum dose, which takes time and exposure to people with the virus. The longer you are exposed to an infectious person, the more people you are exposed to, and the fewer barriers (like cloth masks) between you, the more likely you are to be exposed to the virus. People who have symptoms or are about to develop symptoms, including mild illness, are generally more infectious – i.e., are able to produce larger doses of infected respiratory particles.

    Dispersion: Because smaller particles hang around in the air, the movement of air makes a really big difference. The particles disperse quickly if you are outside, particularly if there is a breeze or wind. We also know that sunlight breaks down the virus. Small, enclosed spaces with closed windows are high risk, especially when they are crowded.

    The three Ds interact! If you are outdoors, at least one metre (but preferably two metres) apart from others, for less than 10 minutes, your risk of becoming infected is incredibly low. On the other hand, if you are stuck in a room with closed windows, with someone with symptoms, your risk of getting the disease increases, whether or not you wear a cloth mask. Large known outbreaks have arisen in indoor functions in churches, weddings, music events, and restaurants or bars: places where a crowd of people are indoors, close together and talking and singing for hours.

    Businesses, factories, workers and families urgently need to pay attention to the interaction of the three Ds. Physical distancing is very effective when outdoors or for short encounters (10 minutes); once you are in a closed space, its effectiveness dramatically diminishes. Masks and two metres distance are not enough if you are with people in an unventilated space all day. Evaluate your office, place of worship, business, planned funeral or other event in terms of the intersection of the three Ds.

    What can we do?

    Physical distance: This is your major defence from infection. The good news is that although the virus spreads easily, short periods of contact will not get you infected. Passing someone in a supermarket, paying for your groceries, brushing past a runner in a park is no problem. But sitting in a taxi with closed windows, being alongside a sick co-worker at a work station, or singing in a packed church, is.

    Go for outdoors and open all windows: Outside air is your best friend, and we may all have to start dressing more warmly in winter as many activities move outdoors and windows stay open. Open windows whenever possible on public transport, in shops or at work. Unfortunately, the interaction of the three Ds means that taxi rides of more than 15 minutes are risky, even if everyone is wearing a mask – unless the windows are open.

    Businesses, factories, offices – look at your windows and work out how to get air flow. Open all windows and utilise outside space. Restaurants, bars and shebeens should consider outdoor seating wherever possible. Streets with a number of restaurants should inquire into closing the street a few evenings a week, or every day, and putting tables and chairs outside.

    Socialise outside if you can, keeping a two-metre distance. An outside braai or picnic is much safer than visiting someone in their house. Avoid visiting people or being visited inside homes for more than a few minutes. Have work meetings outdoors, if possible. If you want to have a gathering, such as a religious gathering or funeral, do it outside if you can. An outside shebeen, with physical distancing, is far safer than an indoor shebeen with masks and obsessive hand washing. Outdoor sport is very low risk, unless involving close prolonged contact. (Even outdoors, don’t talk to someone up close for long; maintain distance.)

    Wear masks: There is now lots of evidence on the effectiveness of wearing cloth masks in the community. A cloth mask traps the virus-containing respiratory particles during breathing, coughing or talking, and helps prevent them from moving away from the mask-wearer. (But why has mask advice changed? *See our comment at the end.) People who have very mild symptoms or are about to develop symptoms can spread the virus – this means that each of us might spread the virus unknowingly. If everyone wears a mask the amount of virus in the air is much reduced: we all protect each other. Therefore you should always wear a mask whenever you are close to people other than those in your household, especially indoors. It is also vital that you wear your mask correctly – it must cover from the bridge of your nose to over your chin at all times. Wash your mask daily with soap or detergent.

    Offices, factories, banks, shops, malls, government services – any indoor space where people come into contact – must require everyone to wear masks. Employers should distribute reusable cloth masks to employees. Reusable cloth masks should be distributed in communities where people can’t afford them.

    As important as masks are, in an indoor space they are not a substitute for ventilation and distancing – you need all three.

    Work in homes: If you work in someone’s home (domestic workers, plumbers, etc) or someone comes in to work in your home, insist on windows being open and don’t be in rooms at the same time as them for long. Wear a cloth mask, carry and use your own hand sanitiser, and keep your distance.

    Soap and surfaces: The virus is incredibly fragile, and washing your hands with any soap for 20 seconds kills the virus. Make soap and water (or hand sanitisers with an alcohol solution of at least 70 percent) as widely available as possible at workplaces, malls, shops, transport and offices. Soap works much better than alcohol-based sanitiser, is cheaper, and will result in less cracked hands. Invest in mobile handwashing stations in areas with a high concentration of people, like hospitals and clinics. 

    It is unclear how likely you are to contract the virus from surfaces, but it is wise to clean commonly touched workspaces and public areas often. Minimise touching and wipe down frequently touched surfaces – like door handles, lift buttons, railings, credit card machines. The virus dies quickly on surfaces; in laboratories it has been found in low doses beyond 24 hours on plastic and steel (but not on porous surfaces such as park benches, or grass). Whether this is enough virus to infect you is unknown, but surface transmission is very unlikely to be the major way you will be infected. Washing your clothes after going out, or washing your car, and wiping all your groceries is not necessary; just wash your hands and keep surfaces around you clean and dry.

    If there is an outbreak in a venue, or an employee tests positive, wiping surfaces down with soap and water, followed by bleach, or other common disinfectants, is very effective in removing any viral particles that may still be present. And if you can leave the venue open and ventilated for 24 hours, this should be enough. There is no need for special chemicals, or “deep cleansing” or “fogging” or “disinfection tunnels”; they are no more effective than soap and water, and are associated with other health risks, including making asthma, eye and skin conditions worse. There is no need to shut down a facility for days; once surfaces have been cleaned, dried and disinfected, and spaces ventilated, work can continue.

    Gloves are unnecessary for most people: you still need to wash them so you may as well just wash your hands. The one exception may be someone who handles lots of items – like a dishwasher or a cashier, where exposure may be higher (and they must wash their hands after taking the gloves off).

    Air-conditioning: Employers, businesses, restaurants, offices: understand your air-conditioning system. A system that recirculates air is very risky, and has been linked to several call centre and restaurant outbreaks. You are essentially guaranteeing that everyone breathes everyone else’s air. On the other hand, an air-conditioning system that extracts air and brings in air from outside makes an indoor space safer. But simply opening windows, where possible, especially if combined with use of a fan, may be more effective if it increases the movement of air. If well ventilated, a room can be safe in minutes, even if someone is coughing and highly infectious.

    Hours: All shops and businesses that can extend opening hours to reduce crowding should do so. Limit the number of people in shops. Lines on the floor to signal distancing requirements have been very successful. Consider discounts for coming in at unpopular hours. All shops should consider having a pensioner-only (or also people with a health-risk note) hour at the beginning of the day. Older people, and people with diabetes, hypertension, HIV, cancer and obesity may be more at risk (we are still learning about the extent of risk), and enabling them to shop when it is least crowded, and when other people have not yet been into the shop, helps protect them. Consider leaving hotel rooms empty and ventilated for a day after someone leaves, and ask guests to open the windows when they leave, to protect cleaning staff. Factories, mines, offices and other workplaces should consider staggering work hours or days so that not every employee comes in at the same time or on the same day. Take turns in lifts (and always wear cloth masks). Tea and break rooms must be well ventilated and break times staggered to reduce crowding.

    Family: We are social creatures; we need human contact. Many extended families have regular get-togethers. Unfortunately, if you are indoors with people who don’t live in the same home, you are seriously increasing the risk of spread to your family. Even if you know who each person has been in contact with in the past two weeks (and you may not), one person who was exposed in a shop or transport or work, who is not yet showing symptoms, can expose a whole extended family, who can then expose everyone they work with. A high percentage of people are infected in their own homes and take the virus to work. In China, many infections occurred in the home, so homes with vulnerable members in them should consider wearing masks at home. Meet outdoors wherever possible.

    We know that children are much less likely to be infected with the virus and even when infected have no or mild symptoms. Going to school is unlikely to be dangerous for them (though schools have to think about protecting teachers). Children are probably also less likely to pass it on others. But, sadly, you still may want to hold off from children hugging vulnerable grandparents for a while. One of the hardest parts of the lockdown has been stopping children from playing together. There is no easy answer here. From current knowledge it seems that there is likely to be some risk, and children’s behaviour when they are together is a challenge to all three Ds. If children play together, encourage outdoors, masks or face shields and lots of handwashing (before, during and after). Consider who they come into contact with at home (an elderly grandparent, someone with diabetes) when deciding about play arrangements. Perhaps discourage hugging and kissing.

    Personal risk factors: People of all ages and levels of health have become very ill and have died of Covid-19. But we know that some people are at much higher risk than others. The most significant risk factors for being badly affected are older age (especially over 65), diabetes, hypertension, HIV, uncontrolled asthma and obesity. If you or your family member has one of these factors, consider getting someone less vulnerable to do the shopping, consider going to shops at opening time, before anyone else has been in them. Vulnerable people should avoid taxis, trains, buses and gatherings if they can.

    Protect others: Stay home if you have any of these symptoms: a fever, a cough, body aches, difficulty breathing, loss of sense of smell or taste. Encourage workers to stay home if they have these symptoms. When you are not at home, wear a cloth mask to protect others, especially indoors. Wearing a cloth mask protects other people – and they protect you.

    When should you test? Getting a PCR test for coronavirus is less useful than many people think. A test that comes back negative does not mean you don’t have the virus; it has a very high “false-negative” rate – almost a third of tests. Unless you need hospital care (in which case you will be tested), the test won’t affect how you look after yourself, and if you have symptoms you should isolate anyway as you may be infected.

    How should you isolate? If you have symptoms or have been in close contact with someone who has tested positive, try to self-quarantine. Once you understand the three Ds, self-quarantining is not difficult to understand. If living with people, try to spend time in a room on your own or spend time outdoors. Try to avoid communal spaces wherever possible; when you can’t avoid using these (the kitchen or bathroom), try to spend as little time as possible, wipe surfaces, wear cloth masks, and open windows.

    Public toilets: There is some evidence that flushing a toilet sprays particles in the air which can have the virus in them. Tell customers, employees, and passengers on planes to put toilet seats down before flushing. Consider adding signs in all public restrooms with this message.

    What about thermometers? Thermometers, especially the “point at your forehead” or oral ones, are actually very poor at telling your temperature, and may falsely create the impression that an infected person is not infectious. At a business or venue entrance they require close contact with the person with the thermometer. A person who has a fever from Covid-19 is likely to have other symptoms, so a simple symptom check is all you need.

    Can you fly? Planes have very good air-circulation systems with particle filters that remove the virus from the air, which means that they are very low risk during the flight. But be careful of surfaces, and on short trips avoid the toilet if you can. You are far more likely to contract the virus in the airport while queuing, or waiting in a lounge or restaurant, than on the plane.

    Communicate: Have clear communication about how to manage risk at work. Managers and policy advisers should realise that although policies need to be clear and not too complicated, at the same time advice that is nuanced but actually doable has better results than advice that is very simple but unrealistic in practice. Compare telling people they can prevent HIV by never having sex rather than by giving information about safe sex practices. The former is simpler but does not result in HIV prevention; it may be true but it doesn’t help because it is not realistic. Businesses should anticipate they might have to shut down for a day and openly communicate.

    No shaming: Don’t judge or stigmatise people with Covid-19. Getting infected does not mean they were careless or have bad hygiene. Anyone can get infected, millions of people worldwide have been, and in South Africa, for every case diagnosed there are likely to be 10 others who have it but have not been tested, and may not have symptoms; it may be you. A workplace may have an outbreak despite taking all necessary measures. There is no need to shout at people exercising outdoors without a mask but at a distance, or in the park with their family; they are not going to infect you. Be kind.

    Take it seriously: Covid-19 is real! If we all act together and help each other, we can dramatically limit spread, reduce deaths and protect our hospitals. Remember that anyone can get Covid-19 and become very sick. Those who were seriously ill can take a long time to fully recover. Even if you are not high-risk for severe illness, your actions create risks for others. Covid-19 is spreading rapidly in South Africa and this is the time for more, not less, vigilance.

    This is in our hands: Covid-19 is here to stay for a while and is rapidly spreading; but we need to live, to see each other and to work. South Africa had an early and strict lockdown, but we always knew we couldn’t do this for long. The easing of the lockdown does not mean the threat of infection has decreased. In fact, the opposite is true. We must not give up on containing spread: there is a lot practically that we as individuals, commuters, workers, managers and trades unions can do to protect ourselves and each other as South Africa reopens.

    Why has information on masks changed? Early on we were advised not to wear masks, now we’re told everyone should wear masks – what gives? Three things. First, as this new pandemic hit, there was a worldwide shortage of masks that healthcare and other emergency workers needed. It was more important for them than for the rest of us to get the masks, as they are more exposed, and also expose more people. Second, we were told initially that masks are more important for sick people than for protecting those not infected. This hasn’t changed, but what has changed is understanding how much spread could be caused by people who have mild symptoms or do not yet have symptoms. This means that everyone is potentially a sick person who is spreading, and if we all wear masks we limit spread. Third, the world is learning fast about this new disease: more information is emerging all the time about how much of an impact universal mask-wearing can have on reducing spread.

    Lucy Allais is Professor of Philosophy, University of the Witwatersrand and UCSD, Director, Wits Centre for Ethics. Shaheen Mehtar, Professor of Infection control, Stellenbosch university. Willem Daniel Francois Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, University of the Witwatersrand. David Francis, Deputy Director, Southern Centre for Inequality Studies, University of the Witwatersrand. Shabir Madhi, incoming Dean of the Faculty of Health Sciences, 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. 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, outgoing Dean of the Faculty of Health Sciences, Professor of Surgery, University of the Witwatersrand.

    This piece has been produced by an interdisciplinary group of academics working on Covid-19 and responses to it. The technical input is provided by members with medical expertise and has also been fact-checked by a number of other medical professionals, in accordance with the latest science.

    This article was first published in the Daily Maverick/Maverick Citizen.

    SA's budget for COVID-19 fails to pave way for more equal society

    - David Francis and Imraan Valodia

    The budget is one of the key tools that government has to effect meaningful change.

    The COVID-19 pandemic has not only generated a far-reaching social and economic crisis in South Africa, but is also exposing two major fault lines in the society.

    First, the pandemic has starkly exposed the country’s high levels of inequality. Every way in which South Africa is unequal has been exacerbated by the pandemic. Those with high-paying office jobs have largely been able to work and earn an income from their homes. Those in low-paying, precarious work have lost their jobs and income, or have been forced out to work. These same workers have to risk infection on public transport and in crowded shops. Children at private schools continue learning online, while the vast majority of learners in the public system have not had any schooling for almost three months.

    Second, the pandemic has exposed the deep gender inequalities in the country. Not only has South Africa continued to experience the most abhorrent forms of gender-based violence under the lockdown, but the pandemic has also exposed the deep gender-based inequality in both paid and unpaid work. Women are having to bear a disproportionate responsibility for unpaid care work, while at the same time bearing a heavy burden for job and income losses in both the formal and informal economies.

    Any economic policy proposals from government would have to address these inequalities if the country were to emerge from the pandemic with a more equal and fair society, and a more resilient economy. The budget is one of the key tools that government has to effect meaningful change, though it can’t address all these problems on its own. Of course, the rebuilding is a long-term process, but the budget is a key starting point.

    In many of its pronouncements on managing the economic fallout from the pandemic, the government has emphasised its intention to forge a new economic growth path that would address the high levels of inequality in South Africa. Indeed, in a recent speech President Cyril Ramaphosa outlined his vision for a new economy thus:

    We must transform and restructure. We are operating under an economy both colonial and racist. We need a reset of the economy for inclusive growth. We need an economy that responds to poverty. We can’t countenance 10 million people out of work.

    How does the supplementary budget announced by Finance Minister Tito Mboweni move South Africa towards this objective? And what can be learnt from the budget about government’s plans to seriously work towards such a new economy?

    To be fair, it is not the sole job of the finance minister to address inequality. However, the budget of the government, which is his responsibility, should provide a strategic financial framework for prioritising the key objectives of government. Sadly, we are of the view that there is very little in the budget he set out this week that creates a pathway to a better, more equal economy.

    Balancing competing imperatives

    We don’t deny that the financial and fiscal challenges which face South Africa are immense. There are no simple solutions. However, the budget needs to balance competing and sometimes incompatible imperatives:

    • spending which protects and assists the poor and vulnerable;

    • financial management which allows the country to raise debt affordably and repay it sustainably; and

    • spending which promotes equitable growth.

    In addition, the budget should indicate how the fiscal consolidation plan will address the major inequalities in the country. It should also show how the adjustment will affect the country’s ability to address key social and economic challenges, in both the short and the long term.

    There are three main messages in the supplementary budget.

    First, the narrower measure of the budget deficit for 2020/21 has, as a result of COVID-19, shifted from 6.8% of the gross domestic product (GDP) to 14.6% of GDP. Government had, in the original 2020/21 budget, projected its revenue for the fiscal year to be R1.398 trillion. As a result of the shutdown and lower economic growth, government now expects revenue to be R1.099 trillion – a shortfall of almost R300 billion. Expenditure, on the other hand, which was initially projected at R1.766 trillion, is now projected to be R1.809 trillion – an increase of about R44 billion. The net result is that the deficit, originally expected to be R368 billion, is now estimated to be R709 billion.

    Second, within the current fiscal year, government has cut R101 billion from various budget lines, and reallocated R145 billion worth of expenditure for COVID-19 measures – hence the R44 billion of net additional expenditure.

    Third and most strikingly, government plans to have a primary budget surplus (that is, the difference between revenue and expenditure before debt payments) by 2023/24, in order to deal with its growing debt.

    This raises two important questions. The first is why it is necessary at all to have a primary surplus in the budget. An obsession with balanced budgets dates back to the Thatcher/Reagan era of the 1980s. But there are many compelling arguments for why it is not necessary for a government ever to run a balanced budget. The austerity measures required to balance a budget can inflict permanent economic damage on the poorest and most vulnerable citizens, and deepen inequality.

    Second, how will this surplus will be achieved, and at what cost, to whom? The indications are that the budget will be balanced through significant cuts in expenditure (rather than rapid revenue growth), projected at R230 billion in 2021/22 and 2022/23, and even further in 2023/24. Unfortunately, we are not provided with details on where these cuts in expenditure will occur. But there is little doubt that they will disproportionately affect those dependent on state services.

    There is little in the 2020 adjustment budget to suggest that the government is serious about building a fairer economy which addresses the already high levels of inequality. Essentially, we have been told to wait until the October mid-term budget, and the 2021 annual budget, to see the detail about how the government will achieve its goals.

    The fallout

    On the basis of what has been said (and not said) in the supplementary budget, we can expect inequality to rise significantly. Government expenditure is progressive and significantly reduces the levels of inequality in our society. Cutting expenditure at the magnitude planned will certainly lead to higher levels of inequality. Moreover, because of the nature of social spending, the impact of spending cuts will fall disproportionately on women.

    There are two very worrying aspects of the desire to run a budget surplus. The first is that spending cuts required to achieve it are extreme, and contrary to the expansionary fiscal policy being adopted by many countries around the world. The second is that there is little information in the adjustment budget about who will bear the brunt of these cuts. This matters for inequality.

    If government is serious about addressing inequality and building a less unequal economy, what should the budget do? Inequality cannot be addressed without an active economic strategy that:

    There is, unfortunately, very little in this supplementary budget to suggest that government has an economic strategy to lower inequality in South Africa.The Conversation

    David Francis, Deputy Director at the Southern Centre for Inequality Studies, University of the Witwatersrand and Imraan Valodia, Dean of the Faculty of Commerce, Law and Management, and Head of the Southern Centre for Inequality Studies, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    More money for COVID-19 but SA lacks a spending strategy

    - Alex van den Heever

    South Africa's public health system has been allocated R21.5 billion more to fight the Covid-19 pandemic but there's no strategy to guide how it should be used.

    The supplementary budget tabled last week by South Africa’s finance minister, Tito Mboweni, whose primary objective was to make more money available for the fight against the COVID-19 pandemic, sheds no light on the relative prioritisation of prevention over treatment for COVID-19.

    The required health system response to COVID 19 broadly falls into these two areas: prevention and treatment. The two are closely interlinked. And there are severe shortcomings in both.

    On the prevention side, interventions include social distancing as well as rapid testing, contact tracing and quarantining. These require massive upscaling to have a preventive effect.

    Prevention also involves public health interventions separating infected from uninfected people.

    For its part, treatment requires that health services address the needs of COVID-19 patients while at the same time protecting health service workers and non-COVID-19 patients from undiagnosed patients presenting for non-COVID conditions.

    But for this to happen there has to be rapid turnaround of test results. In the absence of this, all patients awaiting results need to be treated as potentially COVID positive. This, in turn, requires staff to have full personal protective equipment when treating all patients. But public sector facilities aren’t able to reliably provide personal protective equipment.

    COVID-19 patients also need expensive hospital-based care together with oxygen, ventilators (when oxygen proves insufficient on its own) as well as a variety of medications. Using private sector inpatient data from the Hospital Association of South Africa, the distribution is: general ward (64.2%), high care (15.7%) and intensive care units (20%).

    The supplementary budget announced by the minister of finance makes provision for an additional R21.5 billion for health to be split between the provinces, which will get most, and the national department of health. The problem is that, though money has been made available, there’s no associated strategy that sets out how it will be spent. This is a major omission that suggests the funds will not have any meaningful impact.

    Missing strategies

    The number of cases has been rising steadily in South Africa since around 22 April 2020. The lockdown was implemented on 27 March 2020 to stop the epidemic until such time as alternative prevention strategies could be put in place and to ready health services. Neither objective was achieved. Not only did the lockdown not stop new infections, as has been achieved elsewhere, but testing and tracing at scale was not implemented by the end of April as promised, and health services are in no position to cope with an uncontained outbreak.

    During April, May and early June 2020 the Western Cape experienced increasing new cases relative to all the other provinces. During the course of June the outbreak appears to have peaked due to interventions targeted at hotspots (Figure 1).

    Over the same period the Eastern Cape and Gauteng provinces have seen a spike in new infections (Figure 1). Inpatient numbers and expected deaths have not yet caught up with these steep increases. But the impact on services is likely to rise steeply.

    Gauteng is fairly well-resourced in critical care beds (2,690 with only 819 in the public sector), when both the public and private sectors are aggregated. But the Eastern Cape is far behind (400, with only 241 in the public sector) (Table 1).

    Source: Daily data provided by the National Institute of Communicable Diseases (NICD)

    Given what lies ahead, how will the supplementary budget help?

    Of the additional R21.5 billion made available for health, R16 billion will be transferred to provinces as an adjustment to the provincial equitable share allocation (formula-based and allocated at the discretion of the province). The remaining R5.544 billion is allocated to the National Department of Health.

    The biggest problem is that these allocations are not connected to any strategy. The budget documents state broadly that the funds are meant to support testing, community health workers, expanding hospital capacity for critical care and field hospitals, PPE, oxygen, ventilators and new staff.

    A number of immediate concerns therefore arise.

    First, the R16 billion is a general augmentation of provincial health budgets. It gives no consideration to differences in the provincial COVID-19 disease trajectory or likely impacts on services.

    Second, it is unclear how testing and tracing infrastructure is to be expanded. For example, does it include funding university and private sector laboratories?

    Third, no clarity is provided on how the R5.544 billion is to be spent by national government.

    What this means is that funding is likely to be allocated inefficiently. Some provinces won’t get what they need while others will waste allocations on less important functions. Because the funds aren’t earmarked, provinces can also choose not to allocate them for COVID-19 health interventions.

    Another major gap is that the budget doesn’t offer any strategy or strategic targets when it comes to testing. Provincial governments will have to fund testing out of their existing budgets for the remainder of the year. This could, based on my own estimates, range from R3 billion (15,000 tests per day) to R8 billion (40,000 tests per day).

    Provinces also need to fund quarantine sites and additional hospital beds. No strategy on either is outlined.

    Overflow requirements for beds in the private sector are priced at R16,000 per day for critical care. Given that an overflow requirement introduces a demand-driven element into the budget process, significant contingent fiscal risks arise.

    Again, however, no strategy is outlined.

    South Africa only has critical care bed capacity for the remainder of the financial year of around 468,433 bed days (account has been taken of existing occupancy), of which 90,400 bed days (16.3%) are in the public sector. However, if the epidemic trajectory continues as at present, COVID-specific critical care bed need may be as high as 2.9 million bed days over the period July to December 2020.

    As this would exceed both the financial and human resources of both the public and private systems, prevention strategies would need to be substantially more effective than at present.

    It would therefore have made more sense to clarify the strategy. This would logically require flexibility in the budget process to enable prioritisation between prevention strategies and differential provincial treatment needs.

    The increase in the equitable share allocation by R16 billion has, however, removed any flexibility for national government to shift funds to the highest strategic priorities by province. The remaining national allocations appear insufficient to fine tune prevention strategies or to augment provinces in greater relative need for hospital beds.

    Source: Compiled by the author from various sources including the Department of Health and the Hospital Association of South Africa.

    Now what?

    The relative prioritisation of prevention over treatment for COVID-19 is neither explicit in government’s COVID-19 strategy documents, nor determinable from resource allocations in the supplementary budget. While this distinction may appear unimportant, disease prevention can only succeed if resourced at sufficient scale to avoid the catastrophic demand for critical care services for which no preparation will be sufficient.

    Consistent with the handling of the pandemic to date, however, there is no evidence of a strategy. The supplementary budget for health is merely further evidence of this.The Conversation

    Alex van den Heever, Chair of Social Security Systems Administration and Management Studies, Adjunct Professor in the School of Governance, University of the Witwatersrand. This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Ideological responses, traditional economic theory won't lift SA out out of Covid-19 slump

    - William Gumede

    South Africa will have to prioritise new business, employment and growth based on the current and new domestic and global needs unleashed by Covid-19.

    Given the cataclysmic nature of the Covid-19 economic crisis, conventional economic responses - of pursuing counter-cyclical fiscal policy, which is increasing public spending and cutting taxes, to stimulate the economy, employment and growth - on their own, will not do as solutions for South Africa.  

    Ideological responses or wishful thinking will also not do. 

    The government will need an integrated economic stimulus response, which should focus on rebuilding neglected public and social infrastructure – housing, education, water, transport and technology; while at the same time focusing on saving current critical businesses, jobs and opportunities, and creating new businesses, job creation initiatives and economic diversification.

    An integrated response must also include overcoming the social impact of Covid-19, ranging from gender-based violence, mental illness, to a rise in crime. The backbone of an integrated economic response would therefore be based on building value chains that will produce the infrastructure, skills and material to deal with all these problems in an integrated way.

    Such an integrated economic strategy must focus on both on Covid-19 relief, as well as post-Covid-19 economic reconstruction – both at the same time. A new integrated Covid-19 response strategy should carefully select the strategic sectors to be expanded or newly created, to diversify the economy, and which new technologies will help South Africa benefit from the Covid-19 acceleration in the digital economy.

    Here are at least 12 pillars for an integrated Covid-19 economic recovery plan.

    The first pillar would be to support current industries and create new ones, through expanding neglected public services in the areas which have increased the spread and impact of Covid-19. South Africa has large informal settlements, dilapidated township and rural housing – where no social distancing is possible. This is an opportunity to use a giant rollout of new housing to sustain existing construction-related businesses and create new ones,as well as jobs and growth.

    The second pillar should be to foster a housing material manufacturing sector, where all the inputs, equipment and material that go into construction would be manufactured. New mass post-Covid-19 skills training for the poorly skilled would then be built around such a sector.

    Crumbling water and sanitation infrastructure in the townships, informal settlements and rural areas will fan the Covid-19 spread. The third pillar would be expanding water and sanitation across the country, with similarly, a manufacturing arm which would build the inputs, material and equipment for the rebuilding of a water and sanitation sector.

    South Africa’s public education system is falling apart – whether it is the poor quality of education itself, or s