Covid-19 lockdown: alcohol ban halves violent death rates

Since the lockdown and the ban on alcohol began, murders and road deaths in SA are down by more than half.

Expected figures for unnatural deaths in this quarter were about 800 a week, peaking above 1,000 at Easter, according to the rapid mortality reporting system developed by the burden of disease unit at the South African Medical Research Council (SAMRC) and the University of Cape Town's Centre for Actuarial Research.

Actual deaths were in line with expectations until the day the lockdown began. Then they quickly plummeted to about 400 a week and stayed there.

Unnatural deaths are mainly homicides and road fatalities, but also include other unintentional-injury deaths, which likewise are fuelled by alcohol.

This means that at least 2,000 lives were saved in the first five weeks of level 5 lockdown. At that time, April 30, the national Covid-19 death toll was 103.

Many countries are reporting tens of thousands of "excess deaths" as a result of the pandemic, but in SA fewer lives have been lost than normal.

Richard Matzopolous, co-director of the SAMRC unit, told the Sunday Times that the rapid reporting system showed the profound effect of the lockdown and the alcohol ban on usual murder and car crash deaths.

"There is a two- to three-week delay on each report, but the latest weekly report includes non-natural deaths and you can see the dramatic decrease coinciding with the lockdown," he said.

Social distancing and the lockdown have meant that not as many people "are in contact with others in public spaces", and the added intervention of the "reduced access to alcohol" has changed the landscape of violence.

"There is a decrease in road crashes and certain types of violence due to people's reduced exposure to one another," said Matzopolous.

"The first intervention [lockdown in homes] forces people into a more confined social space and one would expect to see an increase in other forms of violence as a result, for example, domestic abuse, child abuse, and others."

However, "the second intervention [the alcohol ban] has had a dampening effect on this. So although we see an increase in domestic abuse, for example, this would likely be much worse if there wasn't also a simultaneous alcohol ban."

In the minutes of a recent parliamentary portfolio committee meeting, police minister Bheki Cele is quoted as saying: "Many crimes are caused by liquor...research by the medical fraternity is showing that hospital beds and spaces have opened up in trauma units."

He said this is because there are "fewer car crashes and people being shot, stabbed and seriously injured due to alcohol".

These statistics informed the decision of the "non-availability of alcohol" being continued under level 4 of the lockdown, because "otherwise it defeats the whole programme of keeping South Africans safe", Cele said.

According to the most recent State of Urban Safety in SA report, "murder and attempted murder are usually the outcome of disagreements or conflicts between young men, and usually in the context of the consumption of alcohol".

The "availability of firearms significantly increases the risk of fatalities in such contexts".

In trauma units, this period is a possible lull before the next storm - a rare stretch of quiet time between an overflow of trauma victims and the Covid-19 peak predicted by epidemiologists to arrive in late August or early September.

"We have always been faced with the problem of a trauma epidemic, which we consider preventable," said professor Andrew Nicol, director of the Groote Schuur Hospital trauma centre in Cape Town.

"Now, we are seeing an almost two-thirds reduction in the number of trauma cases. The average number on the weekend would be 150. Now it is 37 to 40. What we feel is that this reduction is due to the ban on alcohol, and also restricted movement and fewer cars on the road."

He added: "We would like to point out that trauma is a public health issue and the levels of trauma can be reduced quite dramatically if we get certain measures in place."

Dr Fallin van Rooyen, who works in the trauma unit at Mitchells Plain District Hospital in Cape Town, said she supports the alcohol ban because in normal times almost every patient at the weekend is drunk or has been injured by someone who is drunk.

The lull has given her and the team "time to care for other patients who are sick and not injured".