As the number of Covid-19 cases increases each day, the government is going to need to employ decisive leadership and policies to fight the pandemic, writes Neil Cole. 

With close to 200 000 (about 100 000 active) Covid-19 infections and 10 000 new cases daily, the South African government's strategy to curb infections will need to change. The projections, based on the application of the government's risk-adjusted strategy, and actual infections are growing further and further apart.

Threatening to go back to a Level 4, or even a Level 5, lockdown is not going to do the trick, and it doesn't appear that the president's appeal for behavioural change is being taken seriously.

Many South Africans seem to have adopted a Trumpian attitude towards the wearing of masks and social distancing. And there's no way of knowing if people are washing their hands more regularly than usual.

The impact of moving to a Level 3 lockdown

Since moving to a Level 3 lockdown in June, Covid-19 infections have increased by almost 80 percent.

The worst-affected provinces are bracing themselves for longer and flatter peaks and their premiers warn that healthcare services are already reaching 100 percent capacity. The weak healthcare system in the Eastern Cape has long passed its capacity and capability.

The construction of more field hospitals will provide facilities which will need ventilators, drugs, N95 masks, hazmat suits and healthcare workers, to name but a few of the critical goods and services. This may require a further "supplementary" budget and a generous international community.

Lockdown Levels 5 and 4 have only worked partially and their accompanying regulations are not viable for a variety of social and economic reasons.

Healthcare services, non-compliance

Two things have not happened during the previous lockdown levels and the current one.

The first is that healthcare services have not been brought to a level of readiness to deal with the pandemic. There are many reasons for this – some were there before the Covid-19 pandemic and others emerged during Covid-19. The main lesson is that quality health systems that provide adequate access are developed over generations of relative periods of normality and not over three months of a pandemic. Innovation happens during times of plenty and seldom during times of scarcity.

The second is one of non-compliance with that which prevents infections, especially the wearing of face masks and social distancing.

We have a major problem comprising several causes and if the approach is not changed, we are going to fall off the cliff.

Decisive leadership needed 

This is the time to demonstrate decisive leadership in the style of Andrew Cuomo, who took New York from having the highest daily infections and deaths to a flattening curve.

It is also time to be authentic and truthful, as in the case of Jacinda Ardern, the Prime Minister of New Zealand, where beloved rugby teams can play in full stadiums because the country is free of Covid-19.

In both cases, the name of the game was "precautions to prevent infections". No other nonsense regulations were introduced, other than measures needed to prevent infections.

The South African government now needs to concentrate all its efforts on the things that prevent infections, and not waste time on the chaff. And by chaff, I mean crop tops and open-toe shoes. Here is my list, which is not necessarily comprehensive:

• The proper wearing of face masks when in public spaces must be made a legal requirement, Transgressors must be arrested or given spot fines. Those who claim it is not possible to jog or cycle with a face mask should take a break from their addiction. There will be ample time to prepare for the Two Oceans Marathon and Cape Town Cycle Tour.

• Social distancing must be applied at all times. Here we need the government to show courage in tackling the taxi industry. It is madness to tolerate the violation of the 70 percent occupancy requirement by the taxi industry, when 70 percent is probably outside of the World Health Organisation recommendation. There is no time to pander to dangerous and powerful lobbies.

• Businesses where infections have occurred must be closed and penalised. Social gatherings outside restaurants and coffee shops in more affluent neighbourhoods have become a common sight, with scant adherence to the wearing of face masks and social distancing. These have become the places where friends meet – it needs to stop.

• Visible policing will need to be stepped up, and it should become the temporary raison d'etre of the SA Police Service (SAPS). For SAPS to throw all their resources into this will require that they not be bothered by a silly cigarette ban. Government should also consider deputising volunteers as Covid-19 compliance officers to educate the public. Young people who casually meet their friends at the mall for a catch-up should be educated about their dangerous and, possibly murderous, behaviour. While they may not be in danger of fighting for their lives if infected, their parents and grandparents will be.

• The opening of places where infections are likely to spread more easily, such as schools, should be delayed. It is irrational to be opening schools when infections are spiking. School children may not be in danger, but our aging teacher population is. Considering our poor education outcomes, we don't need a further decline in the number of teachers.

• And finally, all of the above needs an effective communication strategy that is clear, concise, and based on facts.

If South Africans are going to continue with their Trumpian attitudes, then the above measures will be necessary. The government needs to be decisive, courageous and at the same time, authentic and truthful. The latter may be what gets the public to eventually comply, and comply voluntarily.

- Neil Cole is an expert in finance and public policy. His work covers the African continent.