‘We want to avoid Covid-19 panic’

Pres­i­dency con­firms in­for­ma­tion is kept from pub­lic for fear of stigma, caus­ing alarm

Sunday Times - - Front Page - By JEFF WICKS and GRAEME HOSKEN

● The gov­ern­ment has ad­mit­ted to hold­ing back in­for­ma­tion from the pub­lic on the Covid-19 pan­demic, say­ing it is do­ing so to avoid panic.

Pres­i­dent Cyril Ramaphosa’s spokesper­son, Khusela Diko, con­ceded this yes­ter­day on in­quiries by the Sun­day Times, af­ter lead­ing ex­perts ques­tioned why Covid-19 mod­el­ling data is be­ing kept un­der wraps.

The move to keep the data out of the pub­lic eye comes af­ter an ear­lier model on which the strict lock­down was based was heav­ily crit­i­cised.

It pro­jected thou­sands more in­fec­tions and deaths than SA has ex­pe­ri­enced to date. As at Fri­day, 9,420 peo­ple in SA have been in­fected with Covid-19, and 186 have died.

“We don’t want to put these mod­els out to the pub­lic as if they are the gospel truth,” Diko said.

“There is an el­e­ment where we want to avoid panic in com­mu­ni­ties, and we’re also mind­ful of the stigma of the virus.”

She con­ceded that “we need to al­low peo­ple to feel more in con­trol. That is per­haps some­thing that is not be­ing done as well as we could, be­cause when peo­ple are armed with in­for­ma­tion, they feel like they are tak­ing charge of their lives rather than just re­ceiv­ing info from the gov­ern­ment.”

Diko said Ramaphosa vis­ited the Coun­cil for Sci­en­tific and In­dus­trial Re­search “to view the CSIR sys­tem, which can drill down to street level and al­low for pro­jec­tions. The CSIR raised that these are fluid, and we don’t want a sit­u­a­tion where we put out in­for­ma­tion when it changes by the minute.”

She added they were work­ing on ways to bet­ter com­mu­ni­cate with the pub­lic.

Ex­perts said the move to limit the flow of sci­en­tific data on the pan­demic means the gov­ern­ment will make its decision on whether to re­open the econ­omy fur­ther based on data that South Africans are not privy to.

The data will in­clude epi­demi­o­log­i­cal mod­els drawn up by lead­ing sci­en­tists, ac­tu­ar­ies and math­e­ma­ti­cians track­ing how ef­fec­tive the lock­down has been.

Con­sti­tu­tional and med­i­cal ex­perts are call­ing for greater trans­parency, es­pe­cially be­cause the rate of eas­ing the lock­down is cru­cial to the fu­ture of an econ­omy that has been brought to its knees.

But those work­ing with the data con­firmed to the Sun­day Times this week they had been told to keep it con­fi­den­tial.

With in­fec­tion rates soar­ing this week and poor peo­ple starv­ing be­cause they can­not work, the pres­i­dent and the na­tional com­mand coun­cil face de­ci­sions that will af­fect many lives. These are chal­lenges lead­ers across the world are grap­pling with, as many coun­tries be­gin to ease lock­downs in a bid to re­vive dy­ing economies.

With eco­nomic data for April be­gin­ning to show the dev­as­tat­ing im­pact of the first full month, Busi­ness for SA has urged the gov­ern­ment to move quickly to level 2.

Mod­el­ling by the pri­vate-sec­tor um­brella group formed to fight Covid-19 shows that if level 4 con­tin­ues for a month, with a grad­ual move to lower lev­els, the econ­omy will con­tract 14.5% in 2020. A swift move to level 2 would re­duce the con­trac­tion to 10% and cut the num­ber of for­mal sec­tor jobs at risk from 2-mil­lion to less than half that. At level 2, 97% of the work­force is al­lowed to work.

The decision to keep the data con­fi­den­tial has been widely slated by in­de­pen­dent ex­perts who say that the more eyes on the data, the more quickly it can be re­fined and im­proved.

Wits Univer­sity health econ­o­mist Alex van den Heever said: “Data can eas­ily be skewed. Our en­tire re­sponse to Covid-19 is too de­pen­dent on gov­ern­ment act­ing on its own. The dan­ger with not re­leas­ing data prop­erly is that there is no ver­i­fi­ca­tion of the level of the out­break.”

He warned that if it is nec­es­sary for peo­ple to be­have in cer­tain ways, they have to be kept in­formed. “Pub­lic dis­clo­sure en­ables peo­ple to make their own de­ci­sions in re­gard to their per­sonal preven­tion strate­gies.”

Covid-19 min­is­te­rial ad­vi­sory com­mit­tee chair­per­son, Pro­fes­sor Salim Ab­dool Karim, said that he was not well placed to com­ment on what the pro­jec­tions, and how they are im­pacted by eased lock­down re­stric­tions.

“I do not do math­e­mat­i­cal mod­el­ling, bet­ter ask the mod­ellers about the pro­jec­tions. As an epi­demi­ol­o­gist, I an­a­lyse the avail­able data and trends,” he said.

Health spokesper­son Popo Maja said that al­though un­cer­tainty about trans­mis­sion rates at the com­mu­nity level re­main, as well as when the curve will steepen, the ac­cu­racy of pre­dic­tions is in­creas­ing daily with the data that floods in from the field “and the model is be­ing up­dated reg­u­larly”.

An early model, pro­duced by Na­tional In­sti­tute for Com­mu­ni­ca­ble Dis­eases (NICD) and the South African Cen­tre for Epi­demi­o­log­i­cal Mod­el­ling and Anal­y­sis (Sacema), which pre­dicted be­tween 87,900 and 351,000 deaths if the gov­ern­ment did noth­ing to stop the spread, was widely crit­i­cised.

For­mer NICD head, pro­fes­sor Shabir Madhi, de­scribed it as “flawed and il­log­i­cal” and said the pre­dic­tions did not rec­on­cile with data from the field. The pre­dic­tions were de­fended by the NICD and Sacema, which said they were based on the scarce data avail­able at the time and were ac­cu­rate.

Those close to the cur­rent mod­el­ling project — over­seen by the NICD and run by the South African Covid Mod­el­ling Con­sor­tium — said that pro­jec­tions are eas­ily mis­con­strued by the pub­lic.

The NICD’s Dr Harry Moul­trie said this week that the tra­jec­tory of the Covid-19 pan­demic is not cast in stone, be­cause of the state’s risk-ad­justed strat­egy.

“More re­cent mod­els in­clude a dy­namic

trans­mis­sion model, which is reg­u­larly up­dated to in­cor­po­rate new in­for­ma­tion and data,” he said.

Asked why the model can­not be made pub­lic, Moul­trie said: “The model is still be­ing re­fined. It is not ready for re­lease yet.”

A Wits physi­cist, pro­fes­sor Bruce Mel­lado — part of a mul­ti­dis­ci­plinary team that makes pre­dic­tions on the effect of the virus — said re­veal­ing the ex­act num­bers they plot is un­nec­es­sary.

“We have a ro­bust math­e­mat­i­cal ap­pa­ra­tus with which we can es­ti­mate the level of the spread with each level of lock­down.”

He said that ac­cord­ing to their cal­cu­la­tions, SA could con­trol the spread of the virus through lock­down mea­sures, as long as South Africans toe the line.

But health ex­perts said the se­crecy of the mod­el­ling goes against es­tab­lished prin­ci­ples of test­ing ev­i­dence by peer re­view.

Pro­fes­sor Lan­don Myer, of the Univer­sity of Cape Town’s school of pub­lic health and fam­ily medicine, called for trans­parency.

“If there is one mas­sive crit­i­cism gov­ern­ment is com­ing in for, it is a lack of trans­parency about who is get­ting tested, why they are get­ting tested and de­tails of the math­e­mat­i­cal mod­els they are us­ing.

“The more peo­ple look at things, the closer we are to get­ting it right.”

African Health Re­search In­sti­tute deputy di­rec­tor pro­fes­sor Thumbi Ndung’u said that based on the Septem­ber-peak model, it is clear SA is “not out of the woods”.

“You def­i­nitely do not want that be­cause it means in­fec­tions are on a con­tin­u­ous up­wards tra­jec­tory with no sign of them com­ing down, and could in­di­cate that gov­ern­ment’s strat­egy, which seems to have worked well for now, is not ac­tu­ally work­ing that well.”

Wits health econ­o­mist Van den Heever said what the coun­try is be­ing told does not make sense.

“Given how early the coun­try locked down, SA should be in the sit­u­a­tion South Korea, Tai­wan and New Zealand are cur­rently at, in terms of vir­tu­ally elim­i­nat­ing any new in­fec­tions. We in­ter­vened early and started to bring down the in­fec­tions, but now we see a rise in new in­fec­tions. What this shows is our lock­down ac­tu­ally had no effect on new com­mu­nity in­fec­tions.”

Con­sti­tu­tional law ex­pert Wes­ley Hayes said: “I fear that should the gov­ern­ment fail to act trans­par­ently, the good work un­der­taken by our pres­i­dent at the start of this state of dis­as­ter is and will be un­done.”

Pub­lic ac­count­abil­ity ad­vo­cate Paul Hoff­man said with­hold­ing the in­for­ma­tion was un­con­sti­tu­tional.

“Is the pub­lic too stupid to know what’s go­ing on? What the depart­ment needs to un­der­stand is that we live in a par­tic­i­pa­tory democ­racy, and the con­sti­tu­tion en­joins them to be open, ac­count­able and re­spon­si­ble,” he said. “If they say mod­els can­not be made pub­lic, they are in breach of the con­sti­tu­tion on all three grounds.” — Ad­di­tional re­port­ing by Claire Kee­ton

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