100% taxi capacity will do nothing to slow transmission says top expert

Government’s new regulations allowing for 100% seating in taxis for short-distance trips cannot be backed up by science and will do nothing to stop the spread of Covid-19, a top scientist has said.

Professor Shabir Madhi, professor of vaccinology at the University of the Witwatersrand who will take up the position of dean of health sciences in January 2021, says government’s taxi regulations are especially confusing in light of the fact that many people take more than one taxi to work.

Madhi is a member of the Ministerial Advisory Committee (MAC) advising government on Covid-19, although he spoke to News24 in his personal capacity and not on behalf of the MAC. His views also do not reflect official MAC recommendations, which are not public.

On Tuesday, News24 reported that two other MAC members had also criticised government’s approach.

Their views suggest that government and members of the scientific community are still miles apart in terms of the best approach to take, from a purely scientific point of view, to slow the rate of transmission of the virus.

On Sunday night, President Cyril Ramaphosa addressed the country and announced a ban on alcohol sales and distribution with immediate effect, a curfew from 21:00 to 04:00 and new rules for taxis. Taxis will now be allowed to operate at 100% capacity over short distances and at 70% capacity over long distances.

‘A recipe for transmission’

Speaking to News24 on Tuesday, Madhi said the new rules would do nothing to slow the spread of the virus.

Madhi said he could not understand why government was differentiating between long and short distance trips.

“The reality is that, even in terms of local taxi transport, the time of exposure is usually about 15 to 20 minutes, which constitutes a close exposure. And in fact, the frequency of the close exposures are going to be even more common by taking short trips than taking long trips.

“If someone has taken a long trip that’s going to last four to five hours, [they] are only going to be exposed to the same people over that five-hour period. In many cases in South Africa, what happens is that people need to use two taxis to get to their place of work, which basically means they’ve got multiple number of exposures on a single day with different people.”

He said allowing for 100% taxi occupancy was even more problematic when one considered that many taxis were not abiding by the rules already – opening windows and making sure passengers wear masks.

Professor Francois Venter, head of Ezintsha and also a member of the MAC, called the new taxi rules “insane”.

He said: “The taxi rules are insane. Everything we talk about – don’t crowd, avoid closed spaces, be quick – are next to impossible. It’s a recipe for transmission. Limiting numbers, dressing warmly, insisting windows are all down, and wearing masks, are a good compromise and will make it much safer.”

On Monday, Health Minister Dr Zweli Mkhize denied that government had capitulated to demands from the taxi industry, which previously threatened to operate at 100% occupancy because of a lack of subsidisation by government.

Mkhize reportedly said government had sat down with taxi bosses, and they were understanding of the scientific issues at play once these were explained to them.

Curfew and alcohol ban

Government’s decision to impose a curfew for a second time – between 21:00 and 04:00 – and the return of the alcohol ban have been put in place largely to reduce the strain on trauma and intensive care units (ICU) in hospitals from alcohol-related accidents and violence.

Venter said there were valid arguments for and against the curfew and the alcohol ban. But ultimately, he said, South Africa had bigger fish to fry.

“I can think of fair reasons for the alcohol ban and curfew, but I think we have so many greater priorities – sorting our public transport, addressing coherent physical distancing guidelines for public places, tackling the oxygen issues in public, dealing with hunger – that these seem like a distraction,” Venter said.

Madhi said the curfew made sense in terms of “avoidable causes of death” which typically occurred at night. But he was not convinced that the total alcohol ban was the right tactic for government.

“I think that’s one approach,” said Madhi of the liquor ban.

“The other approach was basically to continue allowing for responsible use of liquor while having put a curfew in place. What really lends itself to an increase in trauma is related to alcohol abuse, and the evidence indicates that much of that occurs in the evenings, over weekends and at night.

“So it’s really trying to sort of shut the gates, which lends itself to that sort of abuse. Whether banning alcohol is going to achieve that particular purpose, I’m not convinced.

“I think the initial alcohol ban during Level 5 [of the lockdown] was under a very different set of circumstances, where there was very limited movement of people. What we’ve got now in place is a curfew, which itself is not going to limit the movement of people during the day.

“It will be difficult to untangle whether it’s the effect of the curfew or the effect of the alcohol ban that will probably bring down the number of hospitalisations that are taking place because of accidents and violence and injury,” Madhi said.

Data

Mkhize defended the alcohol ban at a press conference on Monday, and said alcohol-related trauma was placing a strain on the health system. He said the ban was evidence based.

“Conversely, when alcohol restrictions were lifted during Level 3, facilities reported up to 60% increase in trauma emergency centre admissions and up to 200% increase in ICU trauma admissions,” Mkhize said, News24 reported.

Venter agreed that the ban could relieve trauma units and ICUs, but said there was another way to do this: reduce the legal speed limit.

“We should drop the speed limit to 40km/h, using this argument (and, in fact, I think it is not a bad suggestion). A lot of the spike wasn’t alcohol, just more SA bad drivers back on the road.”

Listening to science?

It is not the first time that Madhi, Venter and other senior scientists and MAC members have publicly disagreed with government. Venter and Madhi have publicly criticised government’s testing strategy, for example. It has led some to question whether government is taking on board the advice of scientists.

But Madhi said government has many forces to balance, including the economy and science, when making decisions.

“What has been put forward [the regulations] has been trying to balance the science to the realities on the ground, in terms of the type of disruption the different sort of regulations are causing in terms of the livelihoods of people and in terms of the economy.”

However, Madhi maintained there was no science behind the new taxi rules.

“But you certainly couldn’t argue from a scientific perspective that allowing for 100% occupancy in taxis is in any way going to assist in terms of slowing the rate of transmission of the virus,” he said.

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