THE COST OF SAVING LIVES AT ALL COST

                                                                                    10 April 2020                        

DEAR MR PRESIDENT…                                                                    

Covid-19

THE COST OF SAVING LIVES AT ALL COST

I have written an open letter to you dated 5 April urging you to lift the lock down with immediate effect. Last night you have extended it by two weeks, for now…

Please allow me to summarize the essence of my letter:

  • By imposing the initial three week lock down, we have taken the very maximum doses of medicine (with extreme side effects), only intended for when the symptoms are much more serious. We have emptied our ammunition before the enemy got properly in range.
  • Obviously the reasoning is to get a hold on it and limit the numbers asap and to so call, “flatten the curve”. Problem is, we are not flattening it, we are deferring it, and when the time comes that we need to flatten it, we will have no means left to do it. We must accept that we cannot legislate Covid-19 out of existence. Yes, it may have a slight breaking effect, but the cost of an unsophisticated broad based lock down vs its effectiveness in South Africa, makes it a suicidal option we should not even contemplate. As we are in the initial phase the numbers will keep growing for a few months to come still, whether we are in lockdown or not.  If the infection rate is what you use as justification and extension of lock downs, then it follows that as the numbers grow, not only from the spread of the virus, but also and likely moreso from the increase in the tests being done, the case to extend the lock down every time we near the end of it, will be stronger than the previous time. I ask you Mr President, acting on this basis and against this background, what will provide you with justification for ending the lockdown? The only possible answer is social and public upheaval on an unprecedented scale born out of poverty and hunger that will make the country ungovernable and laws ineffective anyway. Following your current strategy is clearly unsustainable and will lead to catastrophe. 
  • Surely you agree that we can never afford this. The country will be (and is) dumped into a downward spiral leading to anarchy that few of us can at this stage contemplate. Unemployment as a result of business closures will reach unprecedented levels against which our UIF fund will be helpless. No law enforcement will be able to contain the lawlessness, violence and anarchy which will follow. The country will be destroyed. It will lead to a self induced depression. We could possibly survive a lock down of three weeks, although with disastrous consequences, from which we would take years to recover, but five weeks, or more Mr President, we will not survive. By the time it becomes evident that the above is not a dramatizing of events to unfold, it will be too late to do anything about it. The country would have become a lawless society driven by hungry people who had to become criminals in order to feed themselves.
  • Yes, your actions are in line with international practice, although much more draconian (with no extra effectiveness). And it seems like the right thing to do as numbers seem to grow relatively slowly. By acting in line with the most stringent measures of the international community involves little or no risk on your part in terms of acting responsibly. Fear has united the country against the common enemy and ruthless action seems to be the safe route to take.
  • Problem is we cannot afford to take this “safe” route. By choosing this route we are guaranteeing a scenario of anarchy on an unprecedented scale as referred to above. The situation calls for strong leadership and a willingness to stick out government’s neck and act appropriately and responsibly to a situation which calls for action according to what is effective and what we can afford, not according to how other governments reacted. We must acknowledge that the vast majority of our people has no reserves and that we as a country do not have the luxury of finances and stimulation packages that the developed world has. Economists calculate our rescue package at 0,1% of GDP compared to the 7,5% of the developed world. Because we barely have more to offer, we cannot apply the same policies. And on top of this our lock down and thus economic consequences are much more harsh than most (or all?) other countries.
  • I am not advocating Covid-19 is not a serious problem deserving out of the ordinary measures, but we need to ensure we have proper perspective and a proper understanding of what we are dealing with. As an example, according to the Italian Health Institute the average age of Italians who died withthe Covid-19 virus is 82. Almost half of them had at least three serious medical preconditions. We need to analyze figures carefully in order to make sensible decisions.
  • Our poor people live shoulder to shoulder in townships, where lock down has almost no effect or benefit other than destroying the livelihood of millions. The rules of the lock down are draconian and very poor from an efficiency vs disruption of life and economic cost point of view. The broad rough brush is destroying everything in its way under the cover of fighting the enemy, showing no respect for even basic but important rights in life, many of which have an absolute zero effect on containing the virus. It smells of a militaristic power play and undermines goodwill that is so desperately needed in our country. The situation could be managed with almost the same result with a fraction of the cost.
  • Every life is surely sacred and precious, but we need to accept death, otherwise we will make life unbearable. How much of life of the whole are we prepared to sacrifice in our bid to defer death at all costs, even for the imminent? Is the deferment of death for a relative few of the people specifically infected by Covid-19, the ultimate triumph, worthy of the sacrifice by millions of the most basic human right of having adequate nutrition and shelter, which will result in their death anyway, either directly from starvation or indirectly from TB, flue or whatever, because of a compromised immune system? To add perspective, according to Lancet Laboratories the death rate for under sixties due to Covid-19 is 0,32%. What are we doing?!  How can we ever justify the catastrophe that will surely follow this lockdown. We are throttling the country to death.

Suggested Action:

  • Lift the lock down with immediate effect.
  • Emphasize that this should not be interpreted as a relaxation of our fight against the virus, but as an effort to save the country and its people from economic and social anarchy.
  • Focus on guidance
  • Maintain the effort via the media and other resources to promote precautionary measures like physical distancing, wearing masks etc and healthy living (going for walks, exercising etc). Focus on protecting the elderly and the ill.
  • Temporary laws can be considered regarding the maximum amount of people in a group etc, but certainly allowing a family to be together outdoors. (If they are together indoors anyway, why the heck not allow them outdoors??)
  • Do the maximum to help individuals and businesses in order to save jobs and the economy.

Generally laws should be specific, minimising disruption while maximising efficiency, the focus being on cost vs benefit, being the opposite of how it is now. The excuse/cover for this was the urgency of the situation. This excuse is not valid anymore. We had time to refine our shock reaction, instead we roughened up on it. Very disappointing.

Failure to lift the lockdown within the next week will leave us with nothing to save.

Thanking you.

Simon van Deventer

captivated@beachshack.co.za

Dear Mr President

DEAR MR PRESIDENT…

My essence is not to criticize, we all do our best under the circumstances and with the knowledge and information to our disposal, but in order to make good and wise decisions we need to consider proper information, proper interpretation of that information and then quality inputs on this information.  Then we need to consider all possible options and weigh up the implications carefully.

Please allow me to quote a few words of wisdom, because this is really what we need in this day:

“It is not the things we don’t know that really hurt us. It is the things we know for sure, but that is not so, that is really damaging to us.”

“All great discoveries have been made from a willingness, and ability, not to be right.”

“We routinely disqualify testimony that would plead for extenuation. That is, we are so persuaded of the rightness of our judgement as to invalidate evidence that does not confirm us in it. Nothing that deserves to be called truth can ever be arrived at by such means.” Marlynne Robinson; “The death of Adam”.

I ask of you to consider the following:

You have declared a state of lock down for three weeks. That means South Africa is taking the maximum dosage of medicine more or less immediately we become aware of the symptoms. This dosage has extreme side effects in terms of the economy and people’s lives. When the three weeks have passed, the statistics with regard to infections, deaths etc will be much more compelling to make us take another dose of the medicine, and at the end of another lock down even more so, and so on and so on. This is not sustainable, not even in the very short term. This is like shooting out all your ammunition before the enemy is properly in range. This surely kept the enemy from advancing yes, but they are still there in full strength. All we did was to delay the conflict but we depleted ourselves from any means to defend ourselves.

The dosage we have taken is already more than we as South Africa could afford. Yes, of course it seems to have been the proper thing to have done. It is in line with international handling of the situation and it seems commendable that we have acted swiftly and decisively.  Infections are really growing very slowly compared to some other countries. (Problem is the more we want to “flatten the curve” and slow the spread, the longer this virus will stay with us. More about this later.) To rule and govern along the lines of the international community involves very little or no risk on the part of the decision makers. It does not leave you open for criticism. No one can point a finger. It is indicative of prudence and responsible governance. 

Problem is we cannot afford to take this “safe” route. By choosing this route we are guaranteeing us a scenario of anarchy on an unprecedented scale. The situation calls for a willingness to stick out government’s neck and act appropriately to a situation which calls for action according to what we can afford, not according to how other governments reacted. We must acknowledge that we do not have the luxury of finances and stimulation packages that the developed world has. More of this later.

I am not advocating that Covid-19 is not a serious problem, although there is factual scientific and medical evidence pointing to a very skewed picture being portrayed because essentially all people dying with the virus are reported as dying from the virus. And the reported cases stems only from people being tested. This is obviously a fraction of people actually being infected as about 80% of infected people shows hardly any or no symptoms. Statistics of  normal flu casualties in previous years surely also need to be taken into account in order to form a true picture of the role that the Covid-19 virus is playing in the numbers. Not doing this does not skew the situation somewhat but skews it totally. This is not my opinion, it is a factual statement and it is not because statistics are being manipulated but because the denominator indicating the actual amount of infections is unknown and can practically not be determined.  Most medical sources agree that for the above reasons the death rate from the virus  at about 2% (some latest figures indicate 1,4%)  may be grossly overestimated. No one knows how many infections there actually are. The latest average statistics on age of deaths in Italy that I saw was 82, of which 75% suffered from hypertension, 35% from diabetes, 33% from cardiac ischemia, 24% from atrial fibrillation, 18% from low renal function, etc etc.  Nearly half of the casualties  suffered from three or more of these conditions.  It is the elderly, really above 80 years old according to statistics and the sick or those with compromised immune systems who are at risk and should be protected.

Many very highly respected epidemiologists are strongly of the opinion that we (the world) are handling it in totally the wrong way, that we are prolonging this unnecessarily, however well meant our intentions are.

I quote from the World Economic Forum: “At some point, we will return to and build our daily routines, with the new addition of the mental health crisis caused by weeks of fear, isolation and anxiety, much of which could have been avoided by an accurate and clear definition of the denominator.” (This of course refers to the actual amount of people infected so we could have a true perspective.) In staying on our current track, this though will be the least of our problems to contend with in South Africa.

Can you imagine the nightmare of realising afterwards that we paid this price unnecessarily because we did not have a proper perspective? Yes, we will be able to say, but many others did the same. We only did what we thought to be best.  Yes, indeed so, but that will not save us from the anarchy that we will have to contend with.

But let us be ultra conservative and ignore the above scenario for now. Let us assume the situation is as serious as it is being portrayed, or even more serious. So we do indeed need to react strongly and decisively. My plea is that we cannot afford this doses  of medicine that we are taking. Sure I understand the merits of harnessing the spread as much as possible and as effectively as possible, especially regarding the sick and elderly, but the medicine we are taking now in the doses that we are taking it will destroy almost all of us. The problem is that even if we are very effective in our management of the situation, this virus will probably be with us for many months to come. Actually the more effective we are, the longer it will be with us. At the moment we are not flattening the curve, we are deferring it. And when the time comes to flatten it, we will not be able to do anything about it. The longer we are in lock down mode, the longer the virus will obviously take to run its course. A thought to ponder…

Let us assume that in spite of the damage in terms of bankruptcies and the resultant loss of many many thousands of jobs, we survive the current lock down from a socio economic point of view. Then I humbly ask you, what happens after the three weeks have ended? Yes, the common justification is: “We need to flatten the curve”. But then infections will be higher, so the need for a lock down is even more. Surely you agree we cannot afford an extension? Lost jobs result in hungry stomachs, in desperation, in making criminals out of people who are not. We have enough criminals in this country, we cannot afford to add to them because people do not have a choice.

UIF may help somewhat and the government is surely doing its best by working on schemes to alleviate the situation on the ground, but waiting for a payout from UIF (that is inundated with applications) does not buy food on the table. According to economists The developed world is injecting stimulus packages into their economies equal to 7,5% of GDP. The value of our proposed stimulus packages are calculated at 0,1%. I am not criticizing this, because we do not have more to our disposal. I am pleading to you to become aware of where we are heading. Staying on our current track, we will become totally helpless in doing anything when we realise our mistake. We have very very little time.

Mr President, we need action NOW. We need to vomit out some of this overdose we took while we can. We need a balanced and responsible approach. We need to dissect measures by breaking them up into specifics and  weighing the cost (all aspects) up against the expected effect. The response of taking out the big paint brush of a total lock down and painting everywhere and everything in one colour was surely and even understandably born out of a global hysteria this pandemic caused. 

Again, we cannot afford this. At the time of writing this, we have not even passed the halfway mark of the lock down. I plead with you to consider for instance the lifting of this lock down in rural towns and areas where it seems to be clear. Every job saved means some food on a table somewhere.  Let the gardener come work in the garden while the property owner can still afford him and before his house is repossessed.  Open the economic taps to a degree so that some house owners can keep their houses and so the gardener can keep his job. 

I live in a town where fortunately no cases have been reported. Looking at the people and the town though, one gets the impression the virus lurks around every corner and in every pocket of air. And that may be fine and good to behave like that until we know more about this. I am not advocating irresponsibility. I am advocating for the government to lift the lock down in these towns and areas as a matter of  the utmost urgency and focus its energy on stressing the importance of responsible living under “lock down free” conditions. The fear and crisis that this virus has caused provides a valuable opportunity for the country and its people to unite in showing responsibility. The cost of enforcing responsible behaviour by law enforcement is extremely high and very inefficient. It is this price we cannot afford and of course I am not referring to the cost of enforcement. I am talking about the indiscreet, rough, painting everything with the lock down brush approach.

We have now had breathing space (sorry, not space, I mean time), time to assess. As an interim measure, regulate minimum space (why do we call it social distancing and not physical distancing?), maximum number of people gathering, unless it is a family of course, the wearing of masks by employees, or people in taxi or bus, or in any forced close proximity situation, etc etc. But please Mr President, let us get the wheels of the economy start turning before they fall off completely.  Protect the elderly and sick, but relax the lock down with immediate effect. We are bleeding to death.

The cost of this lock down is unaffordable, but more so, unnecessary. We can have virtually the same effect ito slowing the spread of the virus, but with a fraction of the cost. Maintaining the current “theme” of  the plan necessarily implies  an extension of the lock down. The bankruptcies and liquidations, unemployment, social unrest, uncontrollable crime etc etc that will result from this, will send this country into a state of anarchy that will bring unbearable hardships to our people. I truly believe that this scenario will be much worse than the worst effects of Covid-19, even in terms of lives lost due to hunger, poverty and a total lawless society. The real risk here is that by the time one realises that the above was not dramatising a socio economic scenario, we may be on a unstoppable, even unbrakeble run away train to anarchy.

Yes, you may argue that we may get that run away train scenario with the Covid-19 virus if not managed properly and strictly. I agree that we must keep that absolutely in mind and have written the above and made my suggestions on that basis. We have two fires here to manage. The danger is we focus too much on the one and think we will be able to control the other when we have the first one under control. There is also a third fire lurking, fear or mass hysteria. Last night on the news I heard of the infection rate in SA “surging ahead”, but without the actual increase being mentioned. The facts were that it went from 1505 cases on Friday to 1585 cases today, which is Sunday. Is this correct, responsible, true reporting? It is widely known and accepted that a good immune system is the best defense against the virus. An enormous energy of fear and stress is currently downloaded onto our people, the lock down situation being one of the main contributors, along with the media as mentioned. This is promoting a higher than necessary casualty rate among infected people.

Every life is surely sacred and precious, but we need to accept death, otherwise we will make life unbearable. How much of life of the whole are we prepared to sacrifice in our bid to defer death at all costs, even for the imminent? Is the deferment of death for a relative few of the people specifically infected by Covid-19, the ultimate triumph, worthy of the sacrifice by millions of the most basic human right of having adequate nutrition and shelter, which will result in their death anyway, either directly from starvation or indirectly from TB, flue or whatever, because of a compromised immune system? Minimising deaths does  not just mean those that we can identify and measure.

I thank you.

Simon van Deventer

captivated@beachshack.co.za

Plettenberg Bay

5 April 2020