Subscribe to our Newsletter


click to dowload our latest edition

The variant that scuppered our new-year hopes

Published

on

OP-EDS

Since its arrival, COVID-19 has challenged physicians to gather evidence and make firm decisions. This isn’t a behaviour to which good evidence-based doctors are accustomed.

A fair, scientific development of a pathway of care is usually the exploration of an idea, an attempt to falsify it, and only when it proves reasonable, recommending it.

When the National Institute for Communicable Diseases announced a new variant of the SARS-COV-2 virus on the shores of South Africa that had three mutations in its spike proteins that could possible lead to a different disease picture for our population, I took the position of simply raising an eyebrow. This meant that I noted the transparent efforts of the South African government in contributing to international knowledge, and I labelled this finding in my mind as probably not significant. Many of my colleagues adopted the same approach.

Viruses mutate. The SARS-COV-2 virus had shown little mutation since its appearance, and a mutation such as this seemed inevitable.

Furthermore, mutations in viruses often result in the weakening of their clinical picture. We all remember how every case of swine flu required admission in 2010. Now, swine flu is largely defeated at home. Indeed, this new variant may have been good news. This was perhaps finally a COVID-19 natural evolution in a positive direction.

The predictions I made were wrong. A month later, this new variant has shaken our world. I field calls daily of young, healthy individuals who seek my advice regarding the “summer flu” they have contracted.

Most of these callers are either intrigued or adamantly object when I suggest that their rather typical COVID-19 symptoms of headache, sore throat, and either diarrhoea or sinus pain could in fact be COVID-19. Interestingly, the denialism is often fuelled by the fair logic that since they have followed the rules of social distancing, mask wearing, and sanitising, how could it be possible that they contracted COVID-19?

After some convincing, I manage to send them off for a PCR test, and perhaps 20% to 30% of these patients’ swabs are coming back positive.

Professor Salim Abdool Karim, the chairperson of the government’s Ministerial Advisory Committee on COVID-19, cited this week that a working group had demonstrated over a sample of 100 000 cases that the new variant (officially named 501Y.V2) is 50% more transmissible than last year’s variant.

It explains why so many more patients are accessing their doctors and testing positive now. Eighty percent of analysed new cases in hotspot areas are indeed the new variant. We can blame Rage and irresponsible behaviour for this devastating second wave in South Africa, but the reality is that this variant should share part of the responsibility.

This has been a difficulty week in our practice, and we aren’t alone. Every day or two, a patient of the practice or a patient related to a patient of the practice has succumbed to this dreadful virus.

We have admitted a patient to hospital for high-flow oxygen and intravenous steroids almost every day. Doctors are trained to be saviours, and it feels disempowering so often to have to shift into the role of empathy only because all other options are exhausted.

I’m encouraged, however, by more community members becoming more cautious with regards to the virus. Fear drives caution, and caution saves lives. So, fear has been positive.

I’m also encouraged by the countering statistics reported by Dr Mary-Ann Davies from the department of health, Western Cape, where the probability of death over a 30-day period was compared between the two waves. The study concluded that there was “no difference in mortality by age group between the waves”. This reliable evidence seems contrary to what we have experienced on the ground, but it’s worth noting as a beacon of hope.

The tentacles of the spikes of this variant have reached further than expected – into our schools, shuls, and places of work. We all realise that hope for a new reality as we began 2021 was a pipe dream.

I don’t think anyone predicted the level of restriction COVID-19 has re-imposed upon us. I have been flooded with the question, “Should my kids be going to school orientations and younger kids back to pre-school?” We learnt last year that with the correct controls, schools aren’t cesspools of COVID-19 spread. In fact, they are probably the safest place for our kids to be. Nevertheless, I have adopted the position that over this brief spike, other than short safe orientation days where I believe guards are up and the probability of lax behaviour is low, we shouldn’t be sending our kids back to school yet.

I’m aware of the tremendous strain that home schooling is placing on families – emotionally, financially, and logistically. However, after a long meeting with a group of academic doctors who advise one of the community schools, I agreed that it made no sense to send young children to school. Unfortunately, they are poor adherers to social distancing and scrupulous behaviour, so it isn’t wise to go back to school in the face of a more contagious variant when hospitals are near capacity and ventilators are unavailable.

The value we give to life – even one life – overpowers the tremendous inconvenience we are experiencing. The status quo isn’t a long-term solution. As soon as health facilities are coping well again, I believe children should return to school with safety measures in place.

The second wave in South Africa has been devastating for so many in our community. Now is the opportunity for each of us to reach out in support of those personally infected and affected.

Let’s take this variant as a cue to a better type of approach and formidably march forward in our determination to overcome this pandemic and get ourselves back to normal life. I look forward to “variants” of novel treatments, newer and more efficient screenings, even vaccines.

  • Dr Daniel Israel is a family practitioner in Johannesburg.

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

OP-EDS

Death and destiny during pandemics

Published

on

I have lost friends, colleagues, and family members this year, people of all ages. How many of our legendary, most distinguished spiritual leaders have been taken from us around the world this year alone? How many wonderful young people have left behind grieving spouses and young children?

These are some of the troubling philosophical questions that arise from the COVID-19 pandemic. Others that we have thought about are:

•     How are we to understand the deaths of young people in the prime of their lives from this pandemic? Was it their time? Was it part of G-d’s plan for them, or was it perhaps the fact that they broke the rules and interfered with the higher plan?

•     Was the Holocaust part of G-d’s plan? Was it a punishment for something we did?

•     Is there any spiritual insight to all of this?

Naturally, these are all very thought-provoking questions, and each one is deserving of a full essay – or an entire book – on its own. But this isn’t a scholarly dissertation. I shall rather share some general principles of Jewish philosophy and theology on how Judaism views the world, how G-d runs the world, and the interface of our own actions with providence, or G-d’s higher plan for the world.

First, it’s a principle of our faith that G-d not only created the universe, but that He continues to manage its affairs, even on the most micro level. He hasn’t retired, or semi-retired. He hasn’t gone on holiday to Mauritius and handed over the management of the world to a corporate hierarchy of gods and goddesses, demi-gods, or any celestial powers.

If G-d is running the world, then there can be no “accidents” and no “mistakes”, not even mere coincidences. Everything happens for a reason. Do we know why bad things happen, often to good people? Definitely not. We certainly cannot see the whole reason with all the hidden meaning behind every event. Our eyes of flesh behold only the external, the superficial, the tip of the iceberg. And even when we think we ‘get it’, there are still layers and layers beneath the surface that we are completely oblivious to. Indeed, there is, in the immortal words of Tevye in Fiddler on the Roof, a “vast eternal plan”, and every single event that occurs is part of that higher plan.

When it comes to the mysteries of life, we should try to understand that we cannot understand. Maimonides and other sages of old that said “the ultimate knowledge is to know that we don’t know”. Even Albert Einstein once famously said, “The more I learn, the more I realise how much I don’t know.” And Einstein’s most famous line on the subject was that, “G-d doesn’t play dice with the universe.”

We mustn’t just take the proverbial “shtum powder”, shrug our shoulders, and resign ourselves to not asking questions. No, we may ask. But we should also be wise and humble enough to understand that finite mortals cannot reasonably expect to grasp the workings of an infinite supreme being who is, by definition, impenetrable.

My late father, obm, once told me a story of two great spiritual leaders of old who had the following conversation. Rabbi Levi Yitzchak of Berditchev was a renowned defender of his people. He poured his heart out to his friend and colleague, Rabbi Schneur Zalman of Liadi, the author of the Tanya.

“Why do so many of our people have to suffer the oppression of the czar? Why are so many poverty-stricken? If I were G-d, I would see to it that every Jew has the necessary livelihood and good health to enjoy a better life.”

Zalman, more the philosopher, replied, “If I were G-d, I would do exactly as G-d does.”

“What?” cried the Berditchever. “How can you say that? Have you no compassion for your people?”

Zalman answered, “Don’t you realise? If I was G-d, then I would see the world with G-d’s eyes. I would know exactly why He does things. And I would obviously understand that what He does is, in fact, correct.”

When it comes to the Holocaust, there are simply no explanations and certainly no rationalisations for such a horrific tragedy – quantitatively the worst in our entire history. An event of such enormity is inexplicable and unfathomable to finite men and women.

My saintly teacher, the Lubavitcher Rebbe was extremely critical, even angered, by those who gave explanations for the Holocaust, when they argued that it was because of certain “sins” of that generation. No sins could ever justify such a punishment! When I hear people say such things, I cringe. To rationalise the Holocaust is an insult to the memory of the six million! Who can dare to justify more than a million innocent children being butchered? Or thousands of rabbis, roshei Yeshiva, chassidim, Yeshiva students, and millions of fine, innocent, Jewish men and women? My father was the sole survivor of his entire family in Poland. Were all those holy martyrs sinners? G-d forbid six million times! In our lifetimes it will, no doubt, remain one of the deepest secrets and mysteries of life.

Of course, we believe that G-d has His own reasons and a higher plan for everything. But this one is clearly beyond human comprehension. We will never understand it until we reach the world to come.

Now, although each one of us does indeed have a destined number of years to live, it’s possible for one to forfeit years of one’s life through irresponsible behaviour. A person can cause his own premature death if he behaves recklessly. If a fellow decides to jump out of the window of the 17th floor wearing a Superman cape, arguing that, “If it’s not my time, G-d will find a way to save me”, he is pretty much committing suicide. Yes, he did have an allotted number of years which may not have been up yet. But the problem is that he has now gone and put G-d on the line, forcing Him to perform a miracle for him. But that individual may not be worthy of a miracle. Sadly, he will have then forfeited his life.

I have heard a doctor say that, generally speaking, COVID-19 is taking people whose time had come. That’s easier to accept when it comes to 90 year olds. But what about young people?

Concerning the great flood in the generation of Noah, Rashi, quoting the Midrash, says that there are extraordinary times when pandemic, chaos, and calamity come to the world and may sweep away good people with others. Is the COVID-19 pandemic such an event? I don’t know, but perhaps it may be.

Does anyone know the deeper reason for this pandemic? In the days of Noah, the people of his generation had become completely degenerate and lost all moral perspective. I cannot bring myself to say that this is a punishment for our sins today.

Clearly, there is a bigger picture behind a universal pandemic. No doubt, we should all be doing some serious soul searching as individuals and as a society. While we may not find the reason, we should certainly try to find the message. We should listen carefully, and if we hear a message that resonates with us and inspires us to do good, to improve our behaviour, to reach out to others in need, then let’s do so, and help make the world a better place.

Thankfully, much good has already come out of this pandemic as well. Many innovative ways of teaching and working have emerged. So much kindness and outreach is happening, which is nothing short of inspirational.

Please G-d may the pandemic soon be behind us, and may our world be completely healed.

  • Rabbi Yossy Goldman is the rabbi at Sydenham Shul and the president of the SA Rabbinical Association.

Continue Reading

OP-EDS

Six myths about land reform

Published

on

Parliament’s plans to change the property clause in our Constitution to allow the state to expropriate land without compensation (EWC) have stalled. However, a freshly drafted Expropriation Bill has recently been distributed for public comment.

One of the more alarming features of the Bill is a section that would allow the government to confiscate land without compensation “where the land is not being used and the owner’s main purpose isn’t to develop the land or use it to generate income, but to benefit from appreciation of its market value”.

Government alleges that EWC is necessary to restore land that was stolen during apartheid; to redistribute land so that home ownership matches racial demographics; and to appease an electorate that’s crying out for land.

President Cyril Ramaphosa not only claims that EWC won’t hurt the economy, but that it will bring more people into the fold by helping beneficiaries to become farmers. Before adopting such a radical policy at a time when our economy has been devasted by the pandemic and lockdowns, we should do some much-needed myth busting.

Myth one: land hasn’t been given back to its rightful owners

South Africa has a dark history of land theft. Justice requires that the wrongs of the past are addressed by awarding compensation to the victims of land dispossession. Over the past 25 years, the Land Claims Court has resolved more than 95% of the claims that have arisen. More than 1.8 million individuals have received compensation either in the form of land or money, and fewer than 3 500 claims remain unresolved.

Myth two: home ownership is skewed along racial lines

Amidst the cry for land reform is the claim that we need to have a more equitable distribution of land based on the country’s racial demographics. We should be suspicious of racial-demographic thinking because it’s exactly what the apartheid government specialised in. However, for those who are sympathetic to it, home-ownership data demonstrates that racial groups own homes in almost perfect proportion to their numbers.

Myth three: people are crying out for land

When South Africans are asked about the country’s most serious unresolved problems, almost 40% identify unemployment, 33% raise lack of service delivery, while less than 1% are concerned about land distribution.

When people win their land-claim cases, they are given the choice of receiving land or financial compensation. In 92% of cases, people choose money over land. This shouldn’t come as much of a surprise because money translates into freedom. Beneficiaries can use that money to start businesses, pay off debts, or invest in the market. The facts show that land isn’t a burning issue for ordinary citizens. It’s an issue being capitalised on by a few radicals with big loudhailers.

Myth four: anyone can be a farmer

The government spent more than R1.4 billion buying farms in the Eastern Cape to redistribute to aspirant farmers. Of the 265 farms purchased, only 26 remain viable. In 90% of those cases, once thriving farms that produced food and employment are now in ruin. Being a farmer isn’t easy. It’s a technical job that requires an enormous amount of time, expertise, and money.

Myth five: the Constitution impedes land reform

Section 25 of the Constitution provides a roadmap for land reform while ensuring that no one is arbitrarily deprived of property. It empowers the state to expropriate property in the public interest, which includes land reform. A classic case would be the construction of the Gautrain project, which needed to run through privately owned land; or the acquisition of land to build RDP (Reconstruction and Development Programme) homes. The Constitution recognises that in such cases, private owners deserve compensation and the following test is used:

The amount of the compensation and the time and manner of payment must be just and equitable, reflecting an equitable balance between the public interest and the interests of those affected, having regard to all relevant circumstances, including:

(a) current use of the property;

(b) the history of the acquisition and use of the property;

(c) the market value of the property;

(d) the extent of direct state investment and subsidy in the acquisition and beneficial capital improvement of the property; and

(e) the purpose of the expropriation.

Myth six: EWC won’t damage the economy

This is akin to saying that a vow of celibacy won’t affect your sex life. Unfortunately, life involves trade-offs. You can’t remove property rights and have a flourishing economy. Foreign investors won’t risk having their land confiscated in South Africa when they can pick any number of other nations that will protect their investments.

One doesn’t have to look at Chairman Mao’s Cultural Revolution or the horrors of Joseph Stalin’s regime to know how bad this idea is. When Robert Mugabe implemented EWC in Zimbabwe, it led to the world’s worst case of hyperinflation. It wasn’t just the original land owners that were hurt, the average man on the street was left destitute after the economy was annihilated.

What this means

Once the above myths about land reform have been revealed, the following becomes apparent. Almost all victims of land dispossession have been compensated. Home ownership matches racial demographics. Barring a few opportunistic politicians, almost no one views land reform as a burning issue. The transfer of functioning farms to ill equipped beneficiaries has been a spectacular failure. EWC has been tried in communist regimes around the world, and it has wrought riches for a few elites and devastation for everyone else.

  • Mark Oppenheimer is a practising advocate and member of the Johannesburg Bar.

*All statistics have been sourced from the Institute of Race Relations.

Continue Reading

OP-EDS

Let’s not go back to “normal” in education

Published

on

For many of us in education, 2020 would be the year in which we expanded our vision, innovated our offering, and showcased the many ways we continued to integrate technology into our students’ day-to-day learning.

What began as an exciting start to the year quickly transformed into a time of uncertainty, change, and a complete rethink about how we educate students remotely instead of on campus.

Before the pandemic, technology had mostly become an innovative addition to the classroom, including robotics, coding, and drones. Very few educational institutions had made the courageous leap into the mostly unknown world of online learning. They cited concerns about the social and emotional well-being of students, a lack of time to build the necessary platforms, and an overwhelming belief that teachers should be in the classroom where they have always been.

COVID-19 was the unexpected and unwelcome push that derailed our collective objections and drove us forward into exploring the largely unchartered educational waters that technology had to offer. As the well-known proverb says, “Necessity is the mother of invention”. Or, as I like to say, “We had no choice!”

During those early days of recording lessons, setting up Google Classroom and virtual live classrooms, I was struck by how much progress can occur when people have no choice but to power through and get the job done.

It wasn’t easy, and it definitely wasn’t perfect, but we soon realised that as long as students had an electronic device and data, they could continue to be educated. So, educate them we did – with a fair amount of trial and error amidst the uncertainty about how long we would all have to do this and when life would return to “normal”.

However, I don’t believe that school life will ever return to what we once saw as “normal”. Nor should it. Instead, the global pandemic has been the disruption that we so desperately needed, under undesirable circumstances, to move education forward in ways we might never have had the time, drive, or courage to do.

As such, we have learnt new methods, new ways, new advantages, and new possibilities of educating our children in a manner that adequately prepares them for a world that doesn’t yet exist. This is a future where they will continuously be required to change, adapt, pivot, unlearn, discover, and recreate.

Therefore, it doesn’t make sense to go back to what we once thought was normal in the same way that it doesn’t make sense to go back to communicating with our parents through the post office.

Here’s what we have learnt and why I think it’s worth keeping even after COVID-19 is a distant memory; and why education in general and matric in particular will never be the same:

1.    Having a beginner’s mindset

The pandemic forced most teachers to adopt a beginner’s mindset when the old ways of doing things were no longer an option. Having a beginner’s mindset allows educators to rethink their material and how they present it, approach teaching, and learn with a different perspective.

Teachers who successfully adopt a beginner’s mindset will reimagine the learning environment in its many forms without the pressure of having to conform to previous pedagogies. This openness to new possibilities and outcomes will spring-clean outdated, preconceived ways of doing things and be a breath of fresh air for all involved. In essence, it’s the perfect breeding ground for curiosity and innovation in education to thrive.

2.    Finding new ways to educate vastly different students

COVID-19 resulted in many teachers pre-recording videos of their lessons, which allowed students to pause, rewind, and replay challenging sections and learn at their own pace. Stronger and more advanced students also had the opportunity to speed through the content and move onto self-study or practical tasks without getting bored.

We would be remiss in losing this unprecedented insight and practice, which could be a gamechanger for students long after COVID-19. I’m confident that it will reduce the number of students falling behind and those needing extra lessons as they will be able to review, revise, and relearn the relevant content at their own pace and in their own time.

3.    Finding new ways to connect with students and parents after school

The pandemic allowed us to reimagine how we connect with both parents and students outside of the classroom. For example, parents’ evenings can be held effectively online without parents needing to spend hours at the school.

In the same way, students will be able to schedule a quick 15-minute Zoom call with a teacher to ask a question or go over a specific section of work without needing an “extra lesson”. In this way, teachers will be able to streamline their time and use it more efficiently.

4.    Finding new ways to assess students

There is a very definite roadmap that teachers have used over the years: teach and test. Education in the time of COVID-19 allowed us to find new ways of assessing students in a way that allowed them to relearn and revisit content until their understanding and grasp of it became more important than an assessment itself.

5.    A hybrid learning model

Having said all of the above, I don’t believe that a post-pandemic education will mean an end to traditional face-to-face learning. Instead, online learning taught us that students missed campus life and face-to-face teaching and learning, and that a hybrid model of learning will be the way to go moving forward.

This will include days on and days off campus, learning content at home with pre-recorded videos that will allow students to learn at their own pace, and classroom time spent applying skills to content already learnt.

There is no doubt that the disruption to traditional education brought about by COVID-19 has inspired the rethinking of traditional education. Changes that would have been inconceivable before the pandemic, have been made due to necessity. This has made it possible to reassess educational models that were assumed to be fundamental and unchallengeable in the past.

Progressive schools and educators will never be able to return to “normal”, and will instead harness the disruption that has occurred in education to have a beginner’s mindset and continue to innovate and make education more suitable for the evolving needs of our world.

  • Joseph Gerassi is the executive head of Redhill School, former principal of King David High School Victory Park and the Absa Jewish Achiever Professional Excellence Award 2019 winner.

Continue Reading

Trending