Who are the people most likely to be SA’s Covid super spreaders?

By Andrea Rademeyer, founder and CEO of Ask Afrika

South Africans can be divided into two broad groups: those that are largely adhering to Covid-19 preventative measures, and those that show only limited adherence to the recommended guidelines. It is this latter group that should be of concern as they are potentially super spreaders of Covid-19.

According to Ask Afrika’s COVID-19 Tracker study, the larger of these groups, representing around 65% of South Africans, can be classified as exhibiting high adherence to sanitation and preventative measures such as mask wearing and social distancing, while the remainder – 35% – can be classified as demonstrating limited adherence. The limited adherence group is least likely to observe behaviours pertaining to social distancing and isolating after testing positive for Covid-19 – potentially becoming super spreaders of the virus.

The COVID-19 Tracker study is a pro-bono study which was launched by Ask Afrika at the start of the lockdown in South Africa. Its aim is to regularly canvas the opinions of a demographically representative sample of South Africans in order to gain a better understanding of the socio-economic impact of the coronavirus, lockdown and gradual re-opening of the economy has had on South Africans.

The limited adherence group is less likely to have had a personal experience with Covid-19. They are unlikely to know someone who has contracted the virus, been hospitalised as a result of contracting the illness, or who has passed away due to Covid-19. This is one of the reasons that they are less concerned with non-compliance behaviour. They are similarly less concerned about contracting the virus and are less emotional as a result.
This group are significantly more likely to live in the Northern Cape, Mpumalanga and the North West and less likely to live in suburban or metropolitan areas. They are also significantly more likely to be younger in the 19 – 24 year age group.

Despite the fact that this group is less emotionally involved, they are more likely to turn to less constructive coping mechanisms such as denial, substance abuse or blaming others in the absence of a support structure outside their family.

In addition to being less motivated to adhere to preventative measures, they are also more exposed to stigmas against practicing preventative behaviours which consequently deters adherence. These stigmas are primarily related to mask wearing and social distancing behaviours.

Our study found that there has been a drop in the number of people adhering to the recommendations between February and March 2021. Those staying at home as much as possible has dropped from 90% to 80%; maintaining social distancing has dropped from 73% to 71%, and those who won’t go to gatherings of more than 50 people dropped from 64% to 57%.

Similar to the pattern seen in social distancing behaviours, respondents are displaying a reduced tendency towards maintaining recommended mask practices although there has been a minor increase (3%) in those who will cover their mouth and nose when they have the flu. This latter
increase is likely to be due to the increased salience of the topic as flu and cold season approaches.

A concerning trend as we head into winter is declining preventative behaviours such as covering sneezes, avoiding touching one’s face or surfaces, and taking vitamins and supplements.

Despite similar levels of concern around the safety of the vaccine between the two groups the limited adherence group is less likely to want to receive the vaccine. They are also less likely to trust health experts, the World Health Organisation, and doctors or nurses for vaccine related advice.

Ironically, however, these individuals and entities remain the best channel through which to promote vaccine uptake.

Our research indicates that government influence is relatively low with only 57% saying they would take cognisance of governmental advice leading to the adoption of preventive behaviours.

Nearly half of those surveyed experience stigma against adhering to preventative measures including social distancing from others, wearing a mask and avoiding close contact when greeting.

The most common stigmas are against social distancing and mask wearing. There is also a stigmatisation against the use of hand sanitiser with the result that there was a 20% decrease in the use of hand sanitiser between February and March this year.

Those belonging to the limited adherence group are more likely to be negatively influenced by stigmas, which has an overall negative  influence on their behaviour and attitude to adhering to preventative measure.

We urgently need initiatives to address these stigmas in order to address these deteriorating metrics. Despite society’s general fatigue with all things Covid-19 related, the preventative guidelines are crucial for general hygiene and should become a long term habit. Life is not back to normal and the threat of a third wave remains.