Covid-19: Clues to survival in 2021

By now almost every South African knows somebody who died because of Covid-19; often, it is someone from your family or a colleague from work or friend of many years.

The vaccine, says the president, will only be available in the second quarter of 2021 and even if so, priority groups (front line health workers, the aged) and the logistics of distribution mean that getting that shot in the arm might only happen towards the end of the next calendar year, or later.

How on earth do we survive until then? Fortunately, there are some vital cues from our behaviour in 2020 that will determine who stands and who falls because of the pandemic threat.

In SA, as elsewhere, there are stubborn denialists who are among the most likely to be infected and even die. They deny the science of coronavirus infections in the same way that a former president and his followers denied the science of HIV infections.

Even when loved ones die around them, the denialists have simple frameworks in their heads that explain away the tragedy before their very eyes. You cannot change minds with a crash course in epidemiology, the history of pandemics (especially second waves of infection, as in the Spanish flu), or vaccinology. Science denialism is not easily shaken. We know from the 2020 experience that there is little you can do for this group of citizens.

We also know from 2020 that those who enjoy the greatest immunity from infection do five things consistently. They stay at home as much as they can. They wear masks (properly). They hand sanitise. They observe social distancing. They avoid any crowds. These people are much less likely to be infected, fall ill, or die. Older people and those with comorbidities are the most vulnerable and the kinds of people who are compelled to be very strict about these mitigation measures.

But we know from 2020 that human behaviour is a lot more complicated than what these simple observances suggest. Humans need connection, even touch. There is no vaccine for loneliness. In fact, we now know there is a heavy cost to long periods of isolation, including mental and emotional health consequences. A rigid, intolerable enforcement of the laws denies our very human vulnerabilities as a species.

That is why I do not agree with the fine and/or prison sentence for not wearing a mask. Nor do I believe that anyone will be thrown in the slammer for mask violations, the contradictions are too obvious when criminals at the highest levels walk free among us. The call to “step aside” from a position in the ruling party, in the face of serious charges, has become something of a public joke.

We cannot shame people into safe behaviours or enforce policy by bullying surfers and bathers on the beaches. The best we can do is to persuade the majority who are prepared to listen. Show them in graphic terms the costs of non-compliance on utterly exhausted nurses, doctors, physiotherapists, and auxiliary health workers. Run media campaigns that show patients struggling to breathe as they wait at home or in corridors because of the non-availability of ambulances, a lack of beds and a shortage of oxygen. Demonstrate what happens to poor and working-class families when the sole breadwinner is incapacitated by Covid-19 or dies as a result.

But also give positive messages about why we are making sacrifices now. For example, few social media texts got as many “likes” as this one: “We do our part now so that when we gather again, no one is missing.”

It is so important to show compassion, even in the application of a new and extended lockdown policy. I am not sure who is advising our president but one of the strategic errors our political leader has made is to deliver speeches on lockdown regulations without taking questions from the people.

Questions serve two purposes. It gives people access to vital information such as “when will the vaccine be available, to whom, and at what costs?” But question time also gives citizens a sense of being heard, that the leader hears their voices and feels their pain.

Yes, the teary-eyed president won some affection towards the end of his latest announcement, but that is not enough. He needs to hear directly from the people and not only from journalists angling for a headline. This can be easily arranged with the new technologies available and with the necessary expertise on each flank. Imagine a bi-weekly Q&A with the people, where the president answers questions directly from the public (including children), with Professor Glenda Gray on one side and Professor “Slim” Karim on the other.

Most of all, give ordinary people a sense of hope, even as painful regulations are announced. Give them reassurance of a corruption-free supply chain for the delivery of life-giving resources. Show them that officials are being exemplary with respect to lockdown compliance. And remind them that this horrific experience will soon be behind us if we all play out part.

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