Professor Salim Abdool Karim. Photo: Supplied

  • Non-compliance with current regulations and "lockdown fatigue" are to blame for the current surge of infections in hotspots, says professor Salim Abdool Karim.
  • The head of the ministerial advisory committee on Covid-19, says super-spreader events need to be stopped and suggests limiting gatherings.
  • When hospitals become overwhelmed, like what is happening in Port Elizabeth, Karim suggests limiting but not banning the sale of alcohol.
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For the past six months, professor Salim Abdool Karim has been advising government on the best course of action in the battle against the Covid-19 pandemic. As chair of the ministerial advisory committee on Covid-19, Karim’s consultations with medical experts on the panel have been delivered to the National Coronavirus Command Council (NCCC) for consideration.

With certain parts of South Africa experiencing a sudden resurgence in Covid-19 cases, Karim has explored various containment strategies in line with government’s risk-adjusted approach. Speaking to Business Insider South Africa mere hours before president Cyril Ramaphosa is due to address the nation on coronavirus-related issues, Karim stresses the fact that non-compliance with current regulations is to blame for the recent uptick in active cases.

“We have, under Level 1, a set of rules that can really help us control the spread [but] we have to have them enforced,” explains Karim. “We cannot have a situation, where we have a set of rules, and people, especially in alcohol establishments, have 1,500 people indoors [with] no masks, no social distancing, inhibitions are low…  it’s deadly. If you want to spread a virus, that’s the best way to do it.”

More than 75% of new cases registered in the past 24 hours come from the Western Cape and Eastern Cape. Along the Garden Route, there has been a surge in hospital admissions, and all public events have been cancelled. Western Cape Premier Alan Winde recently confirmed that he was investigating options of a ‘mini lockdown’ as a last resort.

In the Eastern Cape, Nelson Mandela Bay mayor, Thsonono Buyeye proposed a list of restrictions to Health Minister Zweli Mkhize, with the municipality’s Disaster Management chairperson, Shane Brown, adding that a localised lockdown would be unavoidable.

With the need to balance lives and livelihoods, an extended lockdown, which crippled the economy for more than six months, is out of the question. Instead, South Africa needs to isolate hotspots and ensure that travellers from low-risk transmission areas do not become carriers when returning from high-risk regions.

To do this, Karim says, large crowds need to be limited and rapid testing strategies need to be hyper-focussed.

“You’ve got to put in processes to reduce super-spreader events,” says Karim. “You would need to reduce gatherings, to maybe 50 people [and] if you have [to have] gatherings, make sure they’re not very big. Things like weddings [and] large social functions would be out.”

“If we get to a point where hospitals are feeling the pinch, I would recommend that, at a local level, we control alcohol usage,” says Karim. “The medical effects of alcohol, drunk driving [accidents], interpersonal violence, pancreatitis… all of those things use the same medical care services that we need for Covid-19 patients.”

Karim says that while the festive season does pose a complex challenge, as a result of gatherings and interprovincial travel, restricting mobility from hotspots to low-risk areas would not be practical. Instead, Karim says, the use of masks when travelling and visiting destinations remains the best line of defence against Covid-19.

“So much of the transmission occurs from people who don’t yet know they have the infection, [who] in other words are pre-symptomatic,” explains Karim. “You have to wear a mask. Wearing a mask protects everyone else. This holiday season, we can prevent the kind of picture I’ve painted if we get people to wear masks.”

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