The emotional pressure COVID-19 has placed our country under is incredible and the economic impact is unfathomable. As a species, we are by our nature social beings, however the definition of socialising has taken on a new persona with COVID dragging many of us kicking and screaming into the fourth industrial revolution. There are only so many Zoom meetings, Skype calls, Teams discussions one can stomach; only so many quiet weekends focusing on ‘me’ and learning a new hobby we can embrace; only so much homeschooling or no-schooling; only so much ingestion of COVID news – samples, tests, results, admissions, deaths, body bags, starvation, another new virus?
The head starts spinning. The craving for normalcy and connection, despite the privileges of concern we have, is very real and unsettling, and the mental toll is seen in the fear and anger on online forums.
There seems to be no light at the end of the tunnel, either, as we are told that while a treatment or a vaccine will provide us with a degree of protection and certainly much-needed rest for frontline healthcare workers (and their support teams), these are still a long way off.
But there is one thing South Africans are masters of: resilience.
And so, amongst all this chaos, we want to help cancel some of the noise and provide you with adequate information to enable you to manage your risk, not through fear, but through understanding the basic principles of transmission within the context of everyday activities, and which each of us can have some level of control over.
Much like driving a car, our lives are fraught with risk – the best we can do is to mitigate that risk based on science (such as servicing our car, wearing a seatbelt, etc) – each of us decide daily on the trade-offs we are prepared to make in relation to risk vs benefit. Currently we have, albeit limited, the ability to recursively and rapidly reflect upon interventions implemented in relation to the dreaded “Rona”, allowing us to take the best of the global intervention “basket” tailoring to the South African context. If we are smart about it, we can almost have a sense of “hindsight as the perfect “science”, but we do need to be willing to challenge our perspectives and adapt our chosen mitigation strategies.
South Africans are not risk averse and some would say we have a strong affinity for living life “on the edge”! We have made a national sport of trying to break every conceivable rule we can; to quote Captain Jack Sparrow, “They’re more guidelines, see.” Be it driving 80 in a 40km/hr zone, jumping red lights when it suits us (all the while complaining when we see others doing the same), smuggling ciggies to our friends, driving after drinking a couple of beers, or sneaking across the border into Lesotho to see snow, he more we are challenged on these minor infractions, the greater our disdain for the law and our resistance to abiding by its rule.
Herein lies the COVID-rub. We need to consider how best we can minimise the risk (emotional, physical or economic) to ourselves and those closest and dearest to us, while navigating our way to a new sustainable normal. Small actions will, like the Butterfly Effect, ripple through this pandemic and tame its course.
We are bombarded with Twitter feeds and Facebook posts questioning what all the fuss is about? There is prolific fake news, which doesn’t help a climate of fear and angst.
The problem becomes apparent when one considers the very real factors in relation to the “Rona”:
- We agree, not everyone will become infected (the CDC estimated that 20% – 40% of the population will)
- Infected people are infectious before they show symptoms that could warn them
- A large number of infected people will not show symptoms – but they will continue to spread the disease (~16% of new infections are from asymptomatic individuals)
- If you become ill (~20% of those who are infected) and require hospitalisation (~5% of infected)
- Our hospitals have been buckling under the burden of disease experienced. COVID-19, by virtue of its rapid spread, high infection rate, and high demand on the health system (all in a very acute time frame) is set to potentially break the back of an already ailing health system. Despite efforts to clear beds, and create field hospitals, our system does not have the human resource infrastructure to care for the high volume of patients requiring acute care. We do not have readily available funds to repair the system. Even if we did, we can see from the global pandemonium within the health setting that COVID sets a trajectory for chaos.
- Not all health systems in South Africa are equal
- Medical Aid cover does not necessarily guarantee you a bed in a private facility especially during peak periods
- Resources are further strained when trained medical staff are unable to care for critically ill patients when themselves are becoming infected
- While some pre-existing conditions make you more vulnerable, COVID can also severely affect healthy individuals too and there is growing evidence that it may leave them with chronic conditions
- Due to the contagiousness of the virus, you may only see your loved ones once they leave the hospital – either dressed in PPE or in a body bag. There are no guarantees.
We understand the reticence to masking-up, the resistance to socially distancing, and the definite requirement to earning a living. “Pandemic fatigue” is real. The trick to making an educated decision lies in ensuring you have sufficient information to assess your own risk and adapt as necessary. But people have to see the value in making the change to have the desire to actually make it. Caring for oneself and those you love most, in this instance, is not self-indulgent but rather a necessity.
In order to do this, we all need to understand the points of greatest risk: Close physical or proximal contact with someone who is infected. The longer the contact period (>15 minutes), the greater the risk. The less protection from inhaling viral particles, the greater the risk. Do you really love your grandparents? Then leave them alone.
This means that there are some really simple actions each of us can take to minimise our risk of contracting or spreading COVID-19. Prevention is going to be about the trade-offs and level of altruism. What can you live without and how much do you want to protect other people? So, while government grapples with the broader socio-politico-economic climate, we, the people of South Africa, are the ones that can have a big impact on the trajectory of this pandemic and the complex implications it has on our lives – Japan is an excellent example of a citizen-led campaign that has smashed their covid curve.
HOW DO WE EACH ASSESS OUR OWN PERSONAL RISK?
- What is YOUR risk profile:
– pre existing conditions / comorbidities (diabetes, recovering from cancer, etc)
– what is your living situation (isolated or crowded)
– what is your work situation (home or business, crowded, indoors, personal contact)
– transport situation (public or private)
– access to sanitation (ability to wash hands, clothes, sanitise areas)
– access to healthcare (basic care and wellness)
- What is the ACTIVITY risk profile; for example from lowest to highest:
– walking the dog alone outside
– going to the shops in quiet time, with a mask and sanitiser
– attending a concert and sharing water bottles with strangers
This is a US-based graph that doesn’t account for access to sanitation or public transport.
If you can cross index your own risk with the risk profile of your activity, you can be better armed to decide if it is worth the risk, not only to you, but to the people around you.
The basic Personal Covid Survival Tool Kit includes the following items:
- A well-fitting, breathable mask, preferably with a medical grade filter
(see the www.heroeswearmasks.co.za for more information)
- Hand sanitiser in your bag, car, home, and office
- Frequent access to soap and water
- Hand cream if your hands get dry
- The ability to judge 2m space between you and the next person
- Spare mask (for in case)
- A shopping list so you can be quick
- The desire to exercise (optional but advisable!)
Imagine risk of COVID infection functioning on a continuum, with one end being negligible risk and the other high risk. Each tool you utilise will move you towards a negligible risk, likewise the fewer tools you employ, the greater your risk. You need to add into your risk calculation factors such as underlying medical condition, the nature of your working environment, whether someone in your household is infected with COVID-19, and the density of the population in the areas where you are living/working/playing. This will require a level of commitment and assumes access to basic resources.
But we believe that our nation has the capacity to effect change, and we are committed to being part of it.