Booze ban saved lives, study finds

The ban on alcohol sales meant to reduce the spread of Covid-19 did save lives, a new study has found.

According to research by the SA Medical Research Council and the University of Cape Town, published in the SA Medical Journal on Friday, the restrictions reduced the number of unnatural deaths.

“Coronavirus disease (Covid-19) restrictions, particularly relating to the sale of alcohol and hours of curfew, have had a marked effect on the temporal pattern of unnatural deaths in SA,” the researchers said.

The study is titled Unnatural deaths, alcohol bans and curfews: Evidence from a quasi-natural experiment during Covid-19.

The SA government has implemented a number of restrictions to try to curb the spread of the pandemic and reduce the burden on the country’s health system. These included curfews and restricted alcohol sales.

“In this present study, we performed statistical analysis on the effects of the policy implementation on the number of excess unnatural deaths in SA, making use of the extensive time-series of data on unnatural deaths compiled by a team of researchers at the SA Medical Research Council and the University of Cape Town ... ,” the researchers said.

They collected data of deaths from the department of home affairs’ national population register since March 2020.

“The data are collected and collated in near real-time, do not contain detailed information on the cause of death, simply whether the death was due to natural or unnatural causes. The data are provided weekly, and deaths are classified according to date of death (as opposed to date of reporting).

“The complete restriction on the sale of alcohol resulted in a statistically significant reduction in unnatural deaths regardless of the length of curfew. To the contrary, periods where no or limited restrictions on alcohol were in force had no significant effect, or resulted in significantly increased unnatural deaths.”

The researchers concluded that there is a “significant association between the weekly natural deaths and full restriction on the sale of alcohol”.

“This effect increases with the duration of curfew, but even with fairly modest curfew hours (4-7 hours), full restriction of alcohol had the effect of reducing unnatural deaths by around 42 deaths per day, or 26%.

“In all periods where there were full restrictions on the sale of alcohol for off-site consumption, the excess number of unnatural deaths was significantly lower than zero, indicating a protective effect of restrictions. Barring one situation (partial restrictions under no curfew), periods where there was no full restriction on the sale of alcohol (regardless of the duration of curfew) did not significantly impact on excess deaths (the confidence interval containing zero).”

The researchers said the results “provide compelling evidence that the restriction on the sale of alcohol rather than curfew is associated with the reduction in unnatural deaths observed during the Covid-19 outbreak in SA”.

“The present study highlights an association between alcohol availability and the number of unnatural deaths and demonstrates the extent to which those deaths might be averted by disrupting the alcohol supply. While this is not a long-term solution to addressing alcohol-related harm, it further raises the importance of implementing evidence-based alcohol control measures,” the researchers concluded.

“It also strengthens the case for the implementation of bans on the sale of alcohol as part of the emergency response to ease the demand for emergency healthcare services during Covid-19 or future infectious disease outbreaks in SA and other countries with high alcohol-related injury burdens. Yet such a strategy also raises complex policy-related issues.

“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. Further research into this aspect is urgently required.”

The researchers hope that the government will take heed of the study.

“By demonstrating an association between alcohol and unnatural deaths, the present study adds to the corpus of evidence that enables SA policymakers to adopt evidence-based strategies known to reduce alcohol harm through actions such as stricter advertising and promotions restrictions, minimum unit pricing, increased excise taxes, raising the minimum drinking age, restrictions on container sizes, etc,” they said.

“Furthermore, the possibility of capturing and making available near real-time cause-of-death data would represent a significant step forward in monitoring and responding to future outbreaks of communicable diseases.”

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