New study looks at the effects of alcohol restrictions and the curfew on the number of unnatural deaths in South Africa

Cape Town | 03 July 2021 | Researchers from the South African Medical Research Council (SAMRC) and University of Cape Town (UCT)’s Centre for Actuarial Research (CARe) have published new research today in the South African Medical Journal, on the effects of alcohol restrictions and the curfew on the number of unnatural deaths in South Africa.

The study used data from January 2020 to mid-April 2021, sourced from the weekly mortality surveillance data prepared by the SAMRC-UCT collaboration.

The study found that the impact on the weekly number of unnatural deaths is only statistically significant if the restriction on the sale of alcohol is complete, while partial restrictions on the sale of alcohol are largely ineffective in reducing the number of unnatural deaths. Sensitivity analyses using publicly available mobility data from Google to measure the effect of curfew does not produce materially different conclusions, highlighting the robustness of the findings.

Alcohol plays a significant role both in traumatic injuries and their ultimate consequence - unnatural deaths in South Africa, which are high by global standards. However, the authors of the study caution that complete restrictions are not a viable long-term solution to averting unnatural death. They further caution that the observed effect of complete restrictions may diminish over time, as a result of the reimposition of restrictions often being widely anticipated, and the emergence of illicit supply.

According to the lead author of the study, Professor Tom Moultrie, Director of UCT’s Centre for Actuarial Research, the research showed that the weekly number of unnatural deaths was 49% lower than expected during the Level 5 hard lockdown from March-May 2020, and was 26% lower than expected when the sale of alcohol was banned together with curfews of between 4 and 7 hours.

“However, the study found no reduction in unnatural deaths when there were partial or no restrictions on the sale of alcohol, with the exception of the 6-week period in June and July 2020, following the end of level 5 lockdown.” Prof Moultrie said. He added that during that period, when the sale of alcohol was restricted for off-site consumption, and banned for on-site consumption, deaths were some 13% lower than expected.

The study’s conclusions note that “while complete restrictions on sale of alcohol might avert unnatural deaths and contribute to preventing overload of the healthcare system during surges of COVID-19, long-term implementation of this policy would require significant trade-offs in terms of economic activity, as well as lives and livelihoods”.

Professor Charles Parry, Director of the SAMRC’s Alcohol, Tobacco and Other Drugs Research Unit (ATODRU) and the study co-author, said that by demonstrating an association between alcohol and unnatural deaths, the study adds to the body of evidence that enables South African policymakers to adopt evidence-based strategies known to reduce alcohol harm.

“These include stricter advertising and promotions restrictions, minimum unit pricing, increased excise taxes, raising the minimum drinking age, restrictions on container sizes among others,” says Parry.

The absence of detailed cause of death data limits the ability to assess whether there has been a differential impact, for example, on homicide, suicide, or traffic related deaths. Co-author of the study and Co-Director of the SAMRC Burden of Disease Research Unit (BODRU), Professor Richard Matzopoulos, said that the SAMRC is planning a repeat survey to collect data from forensic pathology mortuaries for 2020 to compare the injury profile with data collected prior to the pandemic.

“However, data systems should urgently be improved to make available, in near- real-time, cause of death and health service data to allow better monitoring and improve the response to future communicable disease outbreaks,” said Matzopoulos.

NOTE TO THE EDITOR:

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