Experts worry over implications of pandemic-related drinking bans
South Africa is slowly emerging from one of the world’s strictest Covid-19 lockdowns.
As the threat of the pandemic loomed in March its government sealed national borders, restricted public transport use and — in a particularly controversial move — banned the sale of alcohol for several weeks
Government officials believe the drinking restrictions significantly reduced pressure on the country’s hospitals and have hailed the results as a policy success.
Yet the long-term impact of such strict measures is unclear. Elsewhere, the country’s alcohol trade bodies say the industry has been devastated by the ban. Many workers in the sector took to the streets to protest the ban in July.
Temporary drinking restrictions are back in vogue worldwide, thanks to coronavirus.
Social distancing has also dramatically altered alcohol consumption habits, though researchers believe it’s too early to say whether the impact will be permanent.
South Africa isn’t alone in imposing restrictions: Thailand and India both introduced similar drinking bans earlier in the year, while Kenya banned the sale of liquor in restaurants for 30 days.
Restrictions on outdoor drinking are in place in Spain’s Catalonia region and in the UK the city of Manchester banned outdoor drinking over the holiday weekend from August 29-31.
South Africa’s initial ban was in place from the end of March until June 1, but President Cyril Ramaphosa’s government reimposed the restrictions on July 12, citing the need to ease pressure on hospitals from drinking-related admissions.
“It is vital that we do not burden our clinics and hospitals with alcohol-related injuries that could have been avoided,” Ramaphosa said in a statement released at the time.
“We have therefore decided that in order to conserve hospital capacity, the sale, dispensing and distribution of alcohol will be suspended with immediate effect.”
The restrictions have since been lifted once again. The South African government says trauma hospital admissions and visits dropped by around 60% during the initial ban. Admissions rose during the period between the two bans.
“From speaking to the people in South Africa, one of the most poignant things we’ve seen is a significant reduction in hospital admissions,” Ian Hamilton, senior lecturer in addiction at York University, told CNN.
But, Hamilton added, it was still possible to obtain illegal alcohol in the country, which undermined the restriction.
The restrictions were met with fury from many South Africans, some of whom took to the streets in protest when the ban was in place and celebrated when it was eased on August 18.
Some liquor shops were looted at the height of the ban, while online searches for brewing home liquor spiked, according to Reuters news agency.
“The ban definitely had a beneficial impact,” Maurice Smithers, chair of the Southern African Alcohol Policy Alliance, an advocacy organization, told CNN.
“There was a dramatic reduction in alcohol-related trauma admissions to hospitals. That would have included alcohol-based violence, gender-based violence, car accidents and so on.”
Smithers acknowledges that some of the drop in hospital admissions was also caused by the conditions of the general lockdown period, with people less likely to need treatment due to staying at home.
A crackdown on social drinking
Governments and local officials have justified drinking bans through pragmatism — pubs and nightclubs have been repeatedly linked to outbreaks, as have many social spaces where distancing is difficult.
Experts are divided over whether such temporary restrictions help people develop a healthier relationship with alcohol.
CNN spoke to several experts who all agreed on one point, however — that banning alcohol completely is unsustainable and likely to backfire.
“Alcohol bans, if you look historically, have not worked. The US is the obvious example — prohibition did not work. It increases criminal behavior,” said Mark Leyshon, senior research and policy manager at Alcohol Change UK, a British charity.
“A [full-time] ban is an unsustainable solution,” Smithers agreed.
“It’s an artificial solution, unless you want to do prohibition which can cause a lot of societal problems.”
Smithers is hopeful that the temporary ban in South Africa could allow officials to impose firmer regulations on alcohol in the future, as the general public may be more willing to accept them having experienced the disruption of lockdown.
On a global scale, research suggests that drinking habits are already evolving as people adjust to life with Covid-19, depending on many factors such as class and age.
A survey from the International Alliance for Responsible Drinking (IARD) released in June found that 30% of respondents reported drinking less alcohol during lockdowns, while 11% reported drinking more.
The survey had 11,000 respondents across nine countries.
Respondents from Australia, South Africa, Mexico, France, United States, Germany, United Kingdom, Japan and New Zealand took part in the research.
In the UK, separate research on British drinkers from the charity Alcohol Change UK and Opinium found that more than one in three British people had cut back on their drinking during the pandemic, while one in five were consuming more alcohol.
“To my mind there are two groups — there’s moderate drinkers who’ve continued to moderate or even become abstinent during lockdown. [But] those who were previously drinking at fairly risky levels, are now drinking are even more,” Hamilton said, when discussing the Alcohol Change UK research.
Hamilton added that it was too early to tell if altered drinking habits developed during the pandemic would last beyond it.
“Younger people in the UK, even before the pandemic, were already cutting back on their alcohol intake,” Leyshon told CNN.
“For a lot of us during [the lockdown], that was an enforced period where people had less access to alcohol and for some of us that might have been an opportunity to sit back and reflect on how we drink and why we drink.”
Drinking at home
Yet in both the US and the UK, overall retail sales of alcohol have risen during the pandemic, suggesting that more people are drinking at home as opposed to in licensed premises such as restaurants and bars.
For those who are prone to heavier drinking, this can pose a health risk.
“Across Europe, UK and US we can see that retail sales of alcohol are rising,” Hamilton said.
“The problem with drinking at home is that people pour larger measures and have less vigilance and control.”
The academic said the issue of heavy drinking and dependency was also a socioeconomic one, with those from less wealthy backgrounds likely to be hit harder by alcohol dependency and the financial consequences of the pandemic.
“People have more time to drink,” he said. “And there’s all the anxiety of finances and jobs and relationship pressure [during the pandemic]. All these factors will play a part in how people drink.”
While Hamilton doesn’t believe in banning alcohol, he hopes the wave of pandemic restrictions prompts people to consider how they drink.
“At the very least it gets people talking about alcohol use — it gets us away from the complacency that exists around alcohol,” he said.
“The vast majority of people enjoy a drink don’t come to any harm. But for that group of drinkers that do, it’s useful to have [more discussion.]”