SA’s drinks industry wants the government to reconsider future alcohol bans on the grounds that bans do not work but instead put livelihoods at risk.
The industry’s call comes in the wake of new data published on Thursday that claims there is no evidence the alcohol bans implemented during lockdown worked to reduce the number of trauma admissions to hospitals or that they curbed the spread of Covid-19.
“You have to be extremely careful making the claim for causality,” said independent data expert Ian McGorian who, along with Prof Mike Murray from the University of KwaZulu-Natal School of Mathematics, Statistics and Computer Science, conducted the analysis.
“You don’t look at one thing.”
The research, funded by global drinks manufacturer Distell, found that while trauma cases in SA under lockdown dropped 60%, this was more likely due to curfews and mobility restrictions.
The analysis used linear regression modelling to determine what effect the alcohol ban had on trauma admissions.
“When you put the ban and the curfew into the model, the outcome is that the curfew has the strongest effect on reduced trauma admissions,” McGorian told TimesLIVE.
“Whichever way we tested it, once you put a curfew in place, you did not get a greater effect by banning alcohol.”
The data showed that SA had seen a 60% drop in trauma admissions during the first lockdown.
However, the claim that the drop in trauma admissions was due solely to the alcohol ban was a weak one, said the study’s authors.
McGorian said the findings were supported by “counterfactuals” from other countries which imposed lockdowns but not alcohol bans and which also reported a significant drop in trauma cases.
These included the UK, which reported a 57% drop in trauma admissions, the US (54%), Italy (57%), Ireland (62%) and Germany (38%).
“The counterfactual cannot be ignored,” said McGorian. “This effect has been worldwide.”
Distell CEO Richard Rushton said the industry wanted the government to be open to considering the data before implementing further bans.
“Alcohol is a factor [in trauma] but it’s a lot lower,” he said, adding that the problem was much broader than alcohol.
“For a common understanding of the problem, we need a common understanding of the facts,” he said.
Rushton said targeted interventions were needed in hotspots where alcohol abuse was rampant.
SA Liquor Brand Owners Association chairperson Sibani Mngadi said while the industry was aware of the problems arising from irresponsible alcohol consumption, he hoped the research would allow for a better understanding of the problem.
“We accept that we have a responsibility to help eliminate the abuse of alcohol and the social ills that go with it, knowing, also, that we can’t achieve this alone,” he said.
The alcohol bans were the result of “political expediency” and the association’s members — from tavern owners to glass manufacturers — were suffering under the bans, he added.
“The small business owner is in great trouble now,” said Rushton. “Larger companies with strong balance sheets can work through this. But bar owners, taverns … these businesses are in peril.”
Chairperson of the SA Medical Association (Sama), Dr Angelique Coetzee, said the suggestion that the curfew rather than the alcohol ban reduced the number of trauma admissions “had merit”.
“Restricting peoples’ movements means there is not a lot of time to go out and drink,” she said.
Coetzee noted that Sama had asked for a curfew. “We didn’t say ban alcohol,” she said.
It was common sense that there is less alcohol-related trauma during the day than later at night, she said.
“The more chance people have to drink the greater chance they may harm themselves,” she said.
Dr Suhayl Essa, a front-line doctor at a public hospital, supported the alcohol ban.
While he agreed that the curfew was likely a significant factor in reducing trauma injuries, that, coupled with the alcohol ban, reduced the risk even further.
“If you don’t have alcohol and you’re sitting at home, there’s not much chance of hurting yourself,” he said.
Essa said his personal experience working in trauma units showed a predictable relationship between alcohol and admissions to trauma units.
“We can predict how busy we are going to be based on when people get paid and go out and buy alcohol,” he said.
While Essa agreed that the evidence was anecdotal, “any doctor [would say] that alcohol has an affect on health care”, he said.
In June, as SA emerged from its grinding hard lockdown and trauma cases began rising again, Milpark Hospital trauma director Prof Ken Boffard noted that alcohol-related trauma cases accounted for 60% of all trauma-related admissions.
During the hard lockdown, however, he recorded a 70% drop in trauma cases, he told TimesLIVE.
The theory gained traction during the second lockdown when hospitals reported sharply reduced numbers of trauma patients.
On New Year’s Eve, the trauma unit at Baragwanath Hospital in Soweto had no patients in its trauma unit for the first time in its history, while in January, Prof Mervyn Mer, a principal specialist in critical care and pulmonology at the Charlotte Maxeke Academic Hospital in Johannesburg, told Sunday Times Daily that alcohol restrictions had helped the hospital cope with the influx of patients, as trauma beds had been spared.
Mngadi said the effect of curfews on mobility and social gatherings, along with other protective measures such as hygiene and sanitation, had been recognised globally as the most effective approaches to slowing the spread of Covid-19.
Banning the sale of alcohol sales for home consumption over the Easter weekend, while increasing the size of permitted gatherings, did not make sense, he said.