Another hard lockdown ‘unnecessary’, says public health experts

Though public health experts have bemoaned the overall disregard for Covid-19 control measures, they are also against a return to hard lockdown, saying this would not only be bad for the struggling economy, but was also unnecessary.

Widespread complacency has been the biggest concern of the move to Covid-19 lockdown Level 1, with police having to clamp down on noncompliant clubs that have emerged as super-spreaders.

With President Cyril Ramaphosa expected to address the nation this week amid fears of government reinstating stricter measures to curb the spread of Covid-19, trade union Solidarity has threatened to take government to court if tighter lockdown regulations are reintroduced.

Dr Atiya Mosam, a public health medicine specialist, believes SA will not return to a hard lockdown soon but said people’s behaviour has been a real cause for concern.

“The December holiday period is not far away and the festivities should not be a means of complacency as this will most certainly lead to increased cases. We have seen a steady amount of new cases being reported of late but this masks a picture where some provinces are showing a decline in cases while provinces such as Eastern Cape are showing an increase,” she said.

Dr Shakira Choonara, an independent public health practitioner, said it seemed South Africans “have thrown caution to the wind”, especially when it comes to social gatherings, but said the economy would not survive another lockdown. She said one of the benefits of the first lockdown and stringent measures is it shaped behavioural norms such as social distancing, wearing of masks, regular hygiene and sanitising.

“Now, business owners and individuals need to now institute these measures and be responsible,” Choonara said.

She said it could not be said what has been learned regarding the severity of Covid-19 on those living with HIV and TB as evidence had been a mixed bag.

“Around June, the Western Cape health department released data which showed that PLHIV [People Living with HIV] had a two to threefold risk of dying. However, this was primarily among PLHIV who had underlying conditions,” Choonara said.

She said according to a recent study in bioMed central infectious diseases, descriptive analysis has shown that Sars-CoV, Mers-CoV and Covid-19 associated with HIV or TB were more common in males and the time-to-recovery was longer compared to the nonexposure groups.

Meta-analysis suggests that HIV/TB co-infection or tuberculosis exposures increase the risk of severe or critical Covid-19 deaths and that the current TB group has an increased risk of Covid-19 compared to the previous one. The study also notes the HIV/ TB co-infected group has the highest risk in the Covid-19 mortality rate and a poor recovery rate.

Choonara said she has never been a fan of herd immunity, when a virus cannot spread as it keeps encountering immune people until a significant proportion of the population is no longer susceptible. She said the World Health Organisation (WHO) also adopted a stance that herd immunity was unethical.

“WHO is of the view that we are still learning about Covid-19 to reach any definite conclusions about herd immunity. In SA, we also have little information on Covid-19 reinfections, if any,” Choonara added.

– siphom@citizen.co.za

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