We can stop Covid-19 – but we need a ‘grand bargain’ for mask wearing

25 Jun 2020

It seems everyone now grasps the ‘difficult truth’ Professor Salim Abdool Karim revealed to us on 14 April. He explained that our lockdown could only delay the exponential curve of infections and deaths. The delay is now over and infections and deaths are growing rapidly.

The mood in the country is divided. Within government and much of civil society there is fear and sadness about the coronavirus horror that will inevitably wash over us in the coming weeks and months. However, in a significant portion of the public there seems to be resignation – even defiance – that economic concerns must take priority over Covid-19 health concerns.

As lockdown restrictions have eased, the public has relaxed social distancing practices beyond what has been advised. We seem to be suffering from the global phenomenon of “lockdown and social-distancing fatigue”. But the virus remains highly infectious and, as people stop social distancing, infections and deaths will increase rapidly.

Our government, the media and thought leaders constantly remind the public that this is exactly the time that we need to be vigilant about social distancing and yet the public seems less and less inclined to head these calls. So, we seem to be in a fairly hopeless scenario with a public that’s resisting the only measures that can feasibly protect them from sickness and death.

What can we do? Do we just accept that infections and deaths will climb to horrific levels, that our hospitals will be overrun, that we may have to bury in mass graves our family members who die lonely deaths? Perhaps we don’t have to.

There is one option that is both economically, politically and socially feasible that could change the course of this epidemic in our country. In the past month, there has been more and more research showing that universal mask-wearing might stop the rapid spread of the virus.

The cost of masks is minuscule and the vast majority of South Africans can buy or make their own without state assistance. We don’t need a capable state to make this happen.

While it is widely known and agreed that sick people should be wearing masks, the challenge is policing this. In a street full of people there is no realistic way to ensure that the sick people are, in fact, wearing masks. It is not feasible to have “cough police” finding and instructing people with symptoms to wear masks. The reason why many East Asian countries chose universal mask-wearing is precisely because it is easy to ensure compliance. If everyone must wear a mask, those who fail to comply can easily be seen and can be subject to both social sanction and, if necessary, police intervention.

When everyone is wearing a mask, you know you are protected from the superspreaders who are also wearing masks. Of course, masks will not stop transmission completely but they will flatten the curve. And with the exciting news that vaccines have begun their final phase of testing in Gauteng, we may have an effective vaccine available to us by the end of the year. We just need to slow the spread between now and December.

The cost of masks is minuscule and the vast majority of South Africans can buy or make their own without state assistance. We don’t need a capable state to make this happen.

By far the biggest obstacle to this plan is getting the public to abide by a universal mask-wearing rule. And this is where the President should make a political “grand bargain” with the public. We need to make a deal: the government will relax all the irritating lockdown rules (tobacco!) and allow the economy to open on one simple condition: EVERYONE wears a mask outside their home ALL THE TIME. No exceptions. Police and soldiers will no longer harass the public for any reason other than this simple rule.

We can live like it is 2019 except that we all wear a mask all the time until the end of the year.

Even for members of the tiny minority who believe being forced to wear a mask impinges on their rights (though they seem OK with being forced to cover genitals in public) might be prepared to put up with this relatively trivial inconvenience in exchange for other rules being relaxed. We can easily rally the public around a simple intervention like this, which would cost us virtually nothing. Right now it is the only option we have to change course.

Mr President, let’s make this deal happen. DM/MC

David Martin is co-founder of the Bulungula Incubator, a rural health and education NGO.

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