Restricting on-consumption alcohol trading saves lives

It is expected that, government will advise the country on whether the current Level 4 lockdown restrictions will remain in place as we fight the 3rd wave of the COVID-19 pandemic, the Delta variant in particular. One of the issues under consideration will be whether to continue with the suspension of the sale of alcohol in order to curb the spread of the virus and reduce pressure on our hospital system.

The Southern African Alcohol Policy Alliance in SA (SAAPA SA) welcomes the recent paper published in the SA Medical Journal by Professor Tom Moultrie and others (Unnatural deaths, alcohol bans and curfews: Evidence from a quasi-natural experiment during COVID-19, July 2021). In it, they demonstrate convincingly that stopping the sale of alcohol in South Africa at various points in the pandemic resulted in a significant drop – between 26% and 49% – in  the number of unnatural deaths resulting from, inter alia, interpersonal violence, car crashes and suicides.

While SAAPA SA doesn’t ordinarily argue for the banning of alcohol, it is impossible to ignore the fact that it has strengthened the fight against COVID-19. But is it the only option for reducing the negative impact of alcohol use on our efforts to defeat the virus?

Moultrie’s paper shows that the main alternative strategy adopted by government has been to limit the operating hours of off-consumption outlets, usually banning sales from Fridays to Sundays and on public holidays, with on-consumption trading only limited by a curfew. However, the evidence in the report indicates that this had zero impact on reducing the number of unnatural deaths. But there was one other intervention which warrants attention.

In the period 1 June to 11 July, immediately after the lifting of the first suspension of sales, on-consumption sales were not allowed. However, all licensed outlets, whether on-consumption or off-consumption, were permitted to sell ‘take-aways’ for people to consume at home. Significantly, the paper shows that there was a 13% drop in unnatural deaths in this period. This was not as high as the reduction that occurred under the complete suspensions, but it was 13% higher than the periods when there were only restrictions on off-consumption sales.

Long before the Moultrie paper was published, SAAPA SA was arguing that restricting on-consumption trading was better than limiting off-consumption sales. The reality is that on-consumption outlets contribute to the spreading of the virus – because on-consumption outlets are essentially social gathering points where, once a few drinks have been consumed, patrons stop observing the non-pharmaceutical preventative measures of mask-wearing, social distancing and sanitising. In addition, alcohol-related trauma injuries caused by interpersonal violence and car crashes are more likely to occur as a result of the on-consumption use of alcohol than from off-consumption purchasing for home use.

SAAPA SA therefore urges government to consider carefully whether to lift the suspension on the sale of alcohol and to do so only if it is clear that the virus is under reasonable control. If it is considered appropriate to ease the restrictions, then tentatively allowing access to alcohol through off-consumption sales, while retaining the suspension of on-consumption trading, is clearly the best option.

If government wants to reduce the economic damage to livelihoods and jobs caused by not allowing on-consumption drinking, it can allow on-consumption outlets to sell take-aways to drink at home, as was the case in the period 1 June – 11 July which saw a reduction of 13% in unnatural deaths. Allowing off-consumption sales seven days a week will also help to avoid a rise in illicit alcohol trading.

If the benefit of targeting on-consumption rather than off-consumption outlets was not clear before, the paper by Prof Moultrie and others has proved it beyond doubt. And, as we have noted many times before, it is also significant that everywhere else in the world where alcohol has been restricted but not banned during the pandemic, on-consumption outlets have been shut while off-consumption sales have continued. We urge government to take this evidence very seriously when making its decision.

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For more information or interview requests, please contact:
Terri-Liza Fortein, Communications, SAAPA SA or 079 9765 489
Maurice Smithers, Director, SAAPA SA 082 373 7705