# An appeal by 19 SA doctors to President Ramaphosa: End hard lockdown now

- Link: https://dearsouthafrica.co.za/2020/04/21/an-appeal-by-19-sa-doctors-to-president-ramaphosa-end-hard-lockdown-now/
- Published: 2020-04-21T13:43:50+02:00
- Author: dearSA

![](https://cdn.dearsouthafrica.co.za/wp-content/uploads/2020/04/20191106/ou-1024x640.
png "ou")

## _Ongoing ‘hard lockdown’ will likely cause far greater suffering in the short and long term than the pandemic itself. As medical doctors who are most at risk, we do not request the easing of the lockdown lightly. But we see far greater harm to our healthcare system and our economy by further delaying the inevitable spread of the virus._

Dear President Ramaphosa,

We, the undersigned doctors, admire the leadership you have shown in managing the
outbreak of Covid-19. You have successfully galvanised unanimous support for the
tremendous challenge facing us as a country and specifically as the healthcare profession.

It has given the medical community time to prepare for the predicted surge of seriously
ill patients. The public has also been handed a clear indication of the gravity 
of the situation. It has not, however, eradicated the anticipated pandemic from 
our country, merely delayed it. While in Europe and North America, funding might
be available to balance the number of severely ill with the number of hospital beds
and ventilators, we do not see this as a viable option for South Africa.

Our healthcare system and the economy were already on their knees at the outbreak
of Covid-19. The negative effects of keeping the country on the present “hard” lockdown–
or even a relatively “light” lockdown – are innumerable. We appeal to you to lift
the hard lockdown as soon as possible.

Many patients without Covid-19 are not getting the treatment they require due to
the hospitals being emptied for Covid-19 patients. Many of these patients are avoiding
hospitals and having their out-patient appointments cancelled. Disruptions in regular
prevention programmes, such as immunisation schedules for infants or sexual and 
reproductive health promotion will undercut our few hard-won health gains since 
democracy. Together these are steadily building up a backlog of health care that
is potentially a crisis in itself.

Doctors in South Africa have sadly had to become accustomed to the harsh realities
of limited funding and limited beds for very sick patients. This means giving less
than optimal care and even letting patients die as comfortably as possible on a 
regular basis. As a country we have bought into an international rhetoric which 
is a poor fit for local circumstances. We are lucky that the present Covid-19 virus
does not predominantly kill young people as the flu virus of 1918 did. It does sadly
kill many elderly, but this is still a relatively small percentage of the population;
at this stage, we do not know the effects on people living with HIV who are not 
on treatment and those with TB.  If at all, a vaccine is unlikely to be developed
and distributed within less than 18 months. Our economy and our healthcare system
will be destroyed if we wait much longer and as always, our poorest citizens will
suffer the most.

Although current estimates of mortality are more than six times less than initially
estimated, at 0.5%, we are approaching winter and there are myriad reasons why the
pandemic will hit South Africans harder in winter months. We cannot afford to stay
on “hard” lockdown any longer. Each week that we delay is likely to worsen the outcome
of the pandemic.

As the health-related, social and financial side effects start to mount, we would
strongly urge a return to work for most people.

Those who can work from home or in isolation should be encouraged to do so, but 
we feel it is critical that the fit and robust return to work, in a staggered fashion
wherever possible. Close attention should be given to ensuring that public transport
operators adhere to the revised regulations to minimise the transmission risk to
their passengers. It might be prudent to keep certain forms of business closed, 
especially where people congregate, including bars, clubs and any meetings of groups
of people, including faith-based gatherings. Restaurants may be allowed to prepare
take-away food or arrange home deliveries.

Some restriction on the sale of alcohol during this crisis probably continues to
make sense, as it probably reduces the burden on hospitals from alcohol-related 
traffic accidents and violence resulting in trauma. Limited household budgets may
then be spent on food rather than alcohol. People withdrawing from alcohol may consult
doctors for help.

Schools (and higher education institutions) that are able to teach via the internet,
may continue to do so if they choose, but the vast majority of children cannot do
this and their parents need to go back to work to earn money to feed them. Many 
of these children need to go to school to access food programmes.

All South Africans should be encouraged to continue washing their hands, maintaining
physical distancing and taking other steps to slow the spread. Those that are most
at risk, the elderly and the health-compromised, need to continue to try to socially
isolate as much as possible and be helped to do so by their communities. Clear guidelines
describing how access to different levels of healthcare interventions will be prioritised
should be established and widely publicised in a transparent way. This will allow
South Africans who are at risk to be forewarned and allow them to take extra precautions
to reduce their risk of acquiring the virus.

We have a limited number of healthcare workers so prioritising their health is important.
Personal protective equipment (PPE) for healthcare workers needs to be a national
priority throughout the pandemic and we hope the government is actively encouraging
local industries who can manufacture these to specification to do so immediately.

Last and by no means least, it may be well served to reassure the public, as there
is an ill-founded fear that contraction of Covid-19 is fatal, and the misconception
that a lockdown would purge us of Sars-CoV-2.  This present fear has caused many
people to discount the future of our country, which is currently at risk.

Sars-CoV-2 is here to stay.  The truth is that people will die, but even more will
recover. We will do our best as a country and medical fraternity to treat the infected
patients, but we also need to start paying attention to the other illnesses which
have continued to progress relatively untreated.

As those who are most at risk once the pandemic takes off in South Africa, we do
not request this lightly. We see far greater harm to our healthcare system and our
economy by further delaying the inevitable spread of the virus. Ongoing “hard lockdown”
will likely cause far greater suffering in the short and long term than the pandemic
itself.

Sars-CoV 2 and Covid-19 have given us a moment of pause to reflect on many things.
We’ve examined our priorities. We’ve refocused on important issues like healthcare
and support of the less privileged.

While we hope that lessons learnt will contribute positively to our new normal, 
it’s time to hit the play button again. If we start the wheels turning soon, we 
stand a chance of recovering. If we languish at the bottom of this pit, we will 
do irreparable damage to our future and those of our children.

Life needs to go on if we are to survive in any respectable form. **DM**