Unnatural deaths, alcohol bans and curfews: Evidence from a quasi-natural experiment during COVID-19

Moultrie, Tom A.; Dorrington, Rob; Laubscher, Ria; Groenewald, Pam; Parry, Charles; Matzopoulos, Richard; Bradshaw, Debbie

doi:10.7196/samj.2021.v111i9.15813

Cited by 36 publications

(38 citation statements)

References 11 publications

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“…Mortality is determined not only by the extent of the epidemic and the level of comorbidities in a country, but also by efforts made to intervene and manage the epidemic. In the case of SA, the very severe lockdown early in the epidemic, with a higher level of popular support and enforcement than the continued lockdown, based on less convincing reasoning, resulted in a near shut-down of the economy, the closure of schools, a sharp decline in unnatural mortality [7,13] and a reduction in non-COVID-19 communicable mortality, particularly in infants and young children.…”

Section: Discussionmentioning

confidence: 99%

The impact of the SARS-CoV-2 epidemic on mortality in South Africa in 2020

Dorrington

Laubscher

Nannan

et al. 2021

SAMJ

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Background. The impacts on mortality of both the SARS-CoV-2 epidemic and the interventions to manage it differ between countries. The Rapid Mortality Surveillance System set up by the South African Medical Research Council based on data from the National Population Register (NPR) provides a means of tracking this impact on mortality in South Africa. Objectives. To report on the change in key metrics of mortality (numbers of deaths, life expectancy at birth, life expectancy at age 60, and infant, under-5, older child and adolescent, young adult, and adult mortality) over the period 2015 - 2020. The key features of the impact are contrasted with those measured in other countries. Methods. The numbers of registered deaths by age and sex recorded on the NPR were increased to account for both registered deaths that are not captured by the NPR and an estimate of deaths not reported. The estimated numbers of deaths together with estimates of the numbers in the population in the middle of each of the years were used to produce life tables and calculate various indicators. Results. Between 2019 and 2020, the number of deaths increased by nearly 53 000 (65% female), and life expectancy at birth fell by 1 year for females and by only 2.5 months for males. Life expectancy at age 60 decreased by 1.6 years for females and 1.2 years for males. Infant mortality, under-5 mortality and mortality of children aged 5 - 14 decreased by 22%, 20% and 10%, respectively, while that for older children and adolescents decreased by 11% for males and 5% for females. Premature adult mortality, the probability of a 15-year-old dying before age 60, increased by 2% for males and 9% for females. Conclusions. COVID-19 and the interventions to manage it had differential impacts on mortality by age and sex. The impact of the epidemic on life expectancy in 2020 differs from that in most other, mainly developed, countries, both in the limited decline and also in the greater impact on females. These empirical estimates of life expectancy and mortality rates are not reflected by estimates from agencies, either because agency estimates have yet to be updated for the impact of the epidemic or because they have not allowed for the impact correctly. Trends in weekly excess deaths suggest that the drop in life expectancy in 2021 will be greater than that in 2020.

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Section: Discussionmentioning

confidence: 99%

The impact of the SARS-CoV-2 epidemic on mortality in South Africa in 2020

Dorrington

Laubscher

Nannan

et al. 2021

SAMJ

Self Cite

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“…16 Last, our results add to the recent work studying the impact of COVID-19 policy responses on crime, violence, morbidity and mortality in South Africa and other countries (e.g. Poblete-Cazenave, 2020; Leslie and Wilson, 2020;Bullinger et al, 2021;Nivette et al, 2021;Asik and Ozen, 2021;Navsaria et al, 2021;Moultrie et al, 2021;Chu et al, 2022). 17 The remainder of the paper is organized as follows: Section 2 describes the data and policy background, Section 3 outlines the empirical strategy we adopt, Section 4 reports the main results and robustness exercises, Section 5 presents an event-study analysis, Section 6 describes the additional results on interpersonal violence, and Section 7 concludes.…”

Section: Introductionmentioning

confidence: 64%

Alcohol, Violence, and Injury-Induced Mortality: Evidence from a Modern-Day Prohibition

Barron

Parry

Bradshaw

et al. 2024

Review of Economics and Statistics

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This paper evaluates the impact of a sudden and unexpected nation-wide alcohol sales ban in South Africa. We find that this policy causally reduced injury-induced mortality in the country by at least 14%. We argue that this estimate constitutes a lower bound on the true impact of alcohol on injury-induced mortality. We also document a sharp drop in violent crimes, indicating a tight link between alcohol and aggressive behavior in society. Our results underscore the severe harm that alcohol can cause and point towards a role for policy measures that target the heaviest drinkers in society.

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“…Moultrie et al concluded that the complete prohibition of alcohol had a significant reduction in unnatural deaths regardless of the length of the curfew. 35 Lastly, with the anticipated reintroduction of alcohol restrictions, people may have stockpiled alcohol, making it available to them during the time of repeat restrictions.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 lockdown restrictions on orthopaedic trauma admissions in a central academic hospital in Johannesburg

et al. 2022

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BACKGROUND: The novel coronavirus (SARS-CoV-2), commonly known as Covid-19, has caused a global economic and healthcare crisis. Many countries tried to curb the spread of the virus by implementing various lockdown restrictions to reduce transmission. The Republic of South Africa (RSA) implemented an alcohol ban as one of the lockdown restrictions. The objectives were to describe the effect of the lockdown alert levels and alcohol availability on orthopaedic trauma admissions, compared to the preceding two years. METHODS: A retrospective review of clinical records was conducted. Data included orthopaedic trauma admissions for the five-month period in a facility in Johannesburg from 27 March to 31 August in the years 2018, 2019 and 2020. Lockdown alert levels were categorised according to the Department of Health which included the ban, reintroduction and re-banning of alcohol consumption. Data collected for 2018, 2019 and 2020 included demographics of sex and age, as well as fracture location, open or closed injuries, polytrauma patients and gunshot injuries. RESULTS: Overall, 672, 621 and 465 patients were admitted in 2018, 2019 and 2020, respectively. There was a decrease of 25% of orthopaedic trauma admissions during the five-month lockdown period in 2020 compared to 2019 (p-value = 0.020) and 30% from 2020 compared to 2018 (p-value = 0.010). In 2020, admissions increased by 112% (n = 82) from alert level 4, when alcohol was banned, to alert level 3 (3a), when alcohol was reintroduced. Admissions decreased by 33% (n = 51) from alert level 3 (3a) to alert level 3 (3b), when alcohol was re-banned. Motor vehicle accidents (MVAs) were the commonest cause of admissions in alert level 3 (3a), accounting for 41% (n = 56). Covid-19 tests were positive in 10% (n = 34) of the 346 tests performed on orthopaedic trauma admissions CONCLUSION: Our study showed the decrease in orthopaedic trauma admissions due to the Covid-19 lockdown regulations. Furthermore, our study demonstrated the impact of alcohol availability on orthopaedic trauma admissions in a central academic hospital in Johannesburg. Level of evidence: Level 4.

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Unnatural deaths, alcohol bans and curfews: Evidence from a quasi-natural experiment during COVID-19

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 36 publications

References 11 publications

The impact of the SARS-CoV-2 epidemic on mortality in South Africa in 2020

The impact of the SARS-CoV-2 epidemic on mortality in South Africa in 2020

Alcohol, Violence, and Injury-Induced Mortality: Evidence from a Modern-Day Prohibition

The impact of the COVID-19 lockdown restrictions on orthopaedic trauma admissions in a central academic hospital in Johannesburg

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