On Sunday, President Cyril Ramaphosa said the country would remain on lockdown level 3, while reintroducing some new lockdown rules with immediate effect, as the number of COVID-19 infections rise in South Africa.
Among these is a re-ban on the sale, dispensing and distribution of alcohol as well as the reinstating of a curfew between 9pm and 4am.
While inter-provincial taxi capacity will remain at 70%, local taxis will now be able to ferry 100% loads.
Meanwhile, wearing of masks is now mandatory.
Briefing the media on amended lockdown regulations on Monday, Mkhize said as it stands, 52 districts across the country are now hotspots and the disease continues to grow very rapidly.
“This, of course, is telling, and if anyone doubted the aggressiveness of the pandemic I think we should be aware that it’s time to wake up and take notice of that,” Mkhize said, adding that hospitals are admitting patients every hour.
He has stressed the importance of behavioural change for the sake of the nation and human life.
“We did indicate in the past that we’ll be putting additional restrictions when necessary and this is the context around which the President has made these particular announcements.”
Mkhize said he consulted with the Minister of Transport, Fikile Mbalula, about the taxi industry.
He said while the original lockdown was useful in delaying the surge and bought government time to prepare the health services, however, it did have its shortcoming.
“We knew it would not be sustainable and it would be important for us to consider the issues of food security, income security and ensure that people would be able to get their regular income.”
Mkhize said the mainstay of transport was taxis that ferry 16 million people to and from work and school.
“Some studies done in China indicated that the virus spread very quickly between people sitting in a confined space for more than 20 minutes and that’s the issue.
“There are also other concerns about the virus being airborne, but this we’re aware there are quite a lot of debates at the WHO level and that some work is done at some level.”
Also, studies show that ventilation such as the opening of windows reduces the spread of infection, he added.
“According to the studies, ideally for every taxi there must be no people who are less than a metre apart and those who in front should not have people behind them very close. But that’s an ideal situation that doesn’t exist in the taxi.”
Drivers and their “conductors” should also complete a daily symptom check before being allowed on the taxi, which means they should be free of symptoms.
“The drivers and conductors should all times wear a mask and keep them with them for the duration of that particular trip,” he explained, adding that they must keep social distancing after every journey at taxi ranks.
In addition, the windows must always be opened for the droplets to escape from the vehicle.
“This doesn’t mean the window must be widely opened, but a slight opening is advised,” he added.
Also, door handles should be wiped once a day and people in the queue should stand further apart where possible.
“No person should be allowed in the taxi not wearing a mask. We can create our homemade masks.”
Alcohol ban to create space
The Minister also acknowledged that people may have been taken by surprise by the announcement on Sunday.
“But it is also important to say, that there has been a lot of people who have welcomed and supported this issue of suspension of the sale and distribution of alcohol.”
However, he said the move was about limiting the damage alcohol-induced trauma intends to create.
“We’re concerned that the consumption of alcohol is pretty high,” he said.
It is estimated that 31% of South Africans, 15 years and older are current drinkers or have consumed alcohol in the last 12 months.
Despite the low proportion of adults who consume alcohol, Mkhize said the country is one of the countries that drink the most and binge drinking ranks high as well.
Meanwhile, alcohol-related trauma patients are usually young, fit individuals.
Studies show that during levels 4 and 5 lockdowns there was a 60% to 70% reduction in trauma admissions.
“Conversely, when lockdown restrictions were lifted under level 3, facilities reported up to 60% increase in trauma emergency admissions and up to 200% in ICU.”
Mkhize said these are some of the models used to re-ban alcohol and are predicting a 20% reduction on alcohol-related trauma patients in the coming weeks.
“There are several instances you have to stop theatre and rush in someone who is having a trauma because of the nature of the bleeding just to save a life,” he said.
“That’s the nature of the disruption.”
During the peak of infections, government needs to focus on the increasing numbers of infections that need urgent medical attention, Mkhize told the media.
“We shouldn’t find anyone coming in only to find that the beds are blocked by those people who could have been saved from the accidents that brought them to hospital.”
Mkhize has pleaded for understanding and patience as they navigate through this difficult time.
Curfew to avoid the surge
Mkhize has noted that most car accidents happen during the night as people go and paint the town red.
The Chinese studies showed that about 75% of the infections spread through social and family gatherings.
“When we recommended that there should be a curfew, it’s also to assist and limit the numbers of the people who get infected in the process.”
The extent at which the surge is going to grow depends on how strictly social distancing is adhered to, he warned.
People with underlying conditions such as Tuberculosis (TB), HIV, Diabetes and cancers are advised to continue to get their treatment.
“We’ve noticed that during the lockdown, there was a reduction in the numbers of people who were coming for testing for HIV, TB and immunization and basic essential health services.”
Meanwhile, eight million live with HIV in South Africa, four million with diabetes, while one in every three in the country suffers from hypertension.
“We need to get this corrected because we need to live with this infection for a longer time. At the same time, the other diseases are still as important and will still cause death if not controlled,” he stressed.
Gauteng as the epicentre
Mkhize said they have opened all the hospitals in the province to deal with infections while increasing the number of beds.
“We must always stay ahead of the curve,” he said, adding that the models indicate that all the provinces except for the Northern Cape and North West may breach the numbers.
“Work is already being done in reticulating as many beds with oxygen and we are talking to service providers about the liquid oxygen.
“The reduction of oxygen levels in the blood becomes the first problem. Once you can counter that with administering oxygen and in the process, the use of dexamethasone is also one addition in terms of the ammunition to fight the disease.”