Western Cape's decisive leadership 'helped SA weather Covid-19 crisis'

SA's spirit of ubuntu, which emphasises the oneness of humanity, and decisive leadership may be behind the country's success against the Covid-19 pandemic, says the country's leading epidemiologist and infectious diseases specialist Prof Salim Abdool Karim.

The chairperson of the Covid-19 ministerial advisory committee also commended the role played by the Western Cape, which was Africa's first Covid-19 epicentre, highlighting that the province shared with the nation what they did right and wrong in dealing with the pandemic.

“I think we saw that when you are trying to deal with adversity, those who are most successful are those who understand our fundamental interdependence. Those who have chosen to go with me first, it's all about what I want ... the individualism that emerges in those countries that have seen disastrous responses to the epidemic. Nowhere is that more clear than in the US. We can never have a situation where we can believe that we can be safe, or I can be safe, when you are not safe.”

Abdool Karim was speaking during a webinar on Covid-19 and how the Western Cape became Africa's epicentre. The webinar was hosted by the Local Governments for Sustainability (ICLEI) on Tuesday.

“This virus is about how it spreads from you to me or me to you, you are safe because I'm safe. I am safe because you are safe. That interdependence is fundamental to our approach. If we are divided and we are quibbling among ourselves we are weak, and this virus knows how to exploit weakness the moment we are weak. It uses that as an opportunity to spread,” he said.

On Wednesday evening President Cyril Ramaphosa is expected to announce that SA will be moving to level 1 of lockdown, which will see the country's borders opening up and international travel permitted after declining daily infection rates and rising availability of beds at trauma units. So far SA has had 651,521 cases in total, with 772 new cases in the latest figures, closer to the World Health Organisation threshold of one positivity case per 100,000, or less than 600 new cases a day.

Abdool Karim said the Western Cape's decisive leadership had been instrumental in the success the country has seen so far.

As the province went through the epidemic, “we learnt from them, they became the teachers telling us what they did. We are blessed with the ability to really understand each other and work with each other.”

This was despite very little data about how to tackle Covid-19, “but it is in these periods of uncertainty that leadership is important”.

“It is in these periods that leadership is in a position to understand that the risks are high but the decisions have to be taken even if the benefits are not clear. It's their ability to make the difficult decisions to act that becomes important.”

One example of effective leadership was the repurposing of Cape Town International Convention Centre into a field hospital.

“If you had to ask me in February this year, can you take the Cape Town ICC and convert it into an 800-bed hospital, and I want you to provide oxygen at every one of those beds, and I want you to create an ICU facility? And I'd like you to do all of that in six weeks. I would say, are you crazy? Do you even understand what it takes to do that as well?

“You know, you look at an airport and you see aeroplanes landing and taking off and you think, that's it, that's an airport. No, airports are complicated organisations and structures. Hospitals are even more complicated. Just think about it. You need X-ray facilities. You need kitchens to cook. You need laboratories for tests and so on. Is it really possible? I would have said no. Well, we had effective leadership because they did it. We had a functioning, capable field hospital in the Cape Town ICC. Fortunately, we didn't need all 800 beds, but we did use up to about 500 of those beds. That's how important a role this played.”

Western Cape Premier Alan Winde said when he got a phone call from Ramaphosa in March declaring a state of disaster in the country, “we'd already started thinking about it”.

His caution to his government colleagues was that the Western Cape had to learn from other parts of the world.

“What I didn't want to happen is, I didn't want to run out of beds in our hospitals and I didn't want to have piles of coffins. We saw in parts of the world how this pandemic just consumed everything. We didn't want people waiting in their cars outside our hospitals and we couldn't service them,” he said.

Winde said the Western Cape experience with drought a few years ago and the work that went into behaviour change in preparation for day zero had also helped the provincial government to change behaviour during the pandemic.

“I think about the regularity of meetings during the day zero and how we had to get behaviour change in civil society. You know, it's all very well trying to manage the usage of water but if you don't get your citizens to play their part, you're never going to succeed.

“We are still using less water today, even though we have now passed that problem and we've got rain and our dams are filling up. We changed behaviour. So, absolutely, the learning is carried through. But of course, as the magnitude of this pandemic [was so great], we took those learnings, but we took them to a new level.”

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