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[EXPLAINER] Levelling up: The balancing act of lockdown relaxation

Government went into more detail about what will inform lockdown relaxations.

Gandhi Square, Johannesburg. Picture: Gandhi Square Precinct/Facebook.

CAPE TOWN - With COVID 19 cases accelerating in across the country, and the economy in serious crisis, government is faced with an incredibly tricky balancing act.

Health authorities need to enforce adequate measures to delay the peak – to eke out the virus over months – in order to buy time to make the health system ready for what is to come.

At the same time, the lockdown is shredding the nation’s economy, and there is an understanding that a hard lockdown cannot go on for much longer, lest the cure be worse than the cause.

So what system is government using to balance the gradual return to normal, with the need to save lives?

There are three layers to the plan - the first is the alert system that’s driven by the virus itself, and the readiness of the health system to deal with it, the second deals with getting the economy turning again – albeit gradually and cautiously, the third deals with a longer-term behavioural change, and increased public awareness around how to curb the spread.

The trick is that all of these rely on constantly moving metrics – the rate of transmission, the level of crisis within the economy, the social welfare of the nation’s citizens, and how prepared the health system is to deal with those who contract the virus. As a result, the decision to move between levels is likely to be very complex.

SYSTEM ONE: THE ALERT

There are five levels of alert.

In determining these levels, government will look closely at community transmission, looking specifically at two metrics: the mass testing campaign (the more tests conducted, the better) and the rate of increase of positive results arising from that testing.

Authorities will also be looking closely at how many fixed and extra hospital beds are available for every 1000 people in the population.

Both public and private sector beds will be counted.

That will be balanced against how many hospital beds are being used at that point in time. So, if the proportion of beds being used for COVID-19 treatment is rising, and the addition of new beds is not rising, that would present a problem.

We are currently at Level 5, and therefore in full lockdown. Level 5 is characterised by a high spread of the virus and low preparedness of the health system.

On 1 May, we move to Level 4 characterised by moderate to high virus spread, with low to moderate health care readiness.

SYSTEM TWO: GETTING BACK TO BUSINESS

This is a system that takes the potential for transmission into account but also balances the potential damage of a hard lockdown to a sector, and the broader economy.

Government has decided which sectors to allow to return to work in a phased manner, by looking at the potential for increased transmission, as well as the sector’s value to the broader economy.

They’ve taken into account a sector’s contribution to GDP, its importance in the broader supply chain, and its benefit as an economic multiplier (the sector’s ability to drive knock-on economic activity linked to its operations.)

Importantly, this system also takes into account people’s livelihoods – specifically the livelihoods of those who are the most vulnerable.

For the moment, which sectors are allowed to return to work is a decision taken at a national level, but eventually, responsibility for that decision will devolve to provinces and districts.

When asked when that devolution of responsibility might happen, and what might trigger it, Cogta Minister Nkosazana Dlamini Zuma would only say: “We are not at that stage yet”.

SYSTEM THREE: A NEW WAY OF BEING

The third system is largely about behavioural change and ensuring that the relaxation of levels doesn’t result in a sudden spike in infections.

To this end, cloth masks will become mandatory in public. If you don’t have a cloth mask, you will have to cover your nose and mouth with a scarf, or a t-shirt.

Industries will be asked to allow as many workers as possible to continue working from home, going so far as to say all those who can work from home, must.

They want workers over the age of 60, as well as those with underlying conditions that could complicate COVID-19 (e.g inadequately controlled hypertension, diabetes, TB, lung issues) to be offered a work-from-home option or remain on leave.

All workplaces that are allowed to phase in operations must have screening protocols in place, as well as disease surveillance mechanisms, and a full plan to prevent the spread of infection.

WHAT'S NEXT?

As with everything under this unprecedented lockdown, these plans and systems are a work in progress. That means that as the virus progresses, and the health care system ramps up, things could change.

Government has published its full document on which sectors will be allowed to gradually spin up under Level Four restrictions.

Minister in the Presidency, Jackson Mthembu said at a lengthy briefing on Saturday morning, that they are open to conversation and input from affected sectors, echoing a sentiment expressed by President Cyril Ramaphosa earlier in the week, that government will be allowing excluded sectors to make their case for inclusion under level four.

By Tuesday next week, that process ought to be complete.

In case you missed the COGTA briefing, you can catch up below.