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The impact of banning alcohol during Covid-19
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Some countries have experimented with alcohol prohibition during the pandemic to keep hospitals emptier. What was the impact?
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This story is from an episode of Business Daily, presented by Ed Butler and produced by Ed Butler and Edwin Lane. Adapted for text by Bryan Lufkin. For more from Business Daily, click here.

 

The Covid-19 pandemic has left people across the globe holed up inside for months, many worried about job security and health issues. It’s clear that in many nations, some people have turned to alcoholic beverages to take the edge off. An April survey revealed that 21% of Brits started drinking more after they entered quarantine, with similar numbers in Canada.

But in South Africa, the government rolled out new rules that prohibited the sale and transport of alcohol entirely. The reasoning was that hospitals would be better able to free up beds for Covid patients if there were fewer people being admitted for alcohol-related illnesses or injuries. South Africa wasn’t alone, either: Thailand and India also rolled out bans during the coronavirus crisis, and Kenya banned alcohol sales in restaurants.

South Africa’s four-month ban finally lifted on 15 August – a move welcomed in a nation home to some of the world’s heaviest drinkers, according to the World Health Organization (WHO). Alcohol consumption became a way of life after Apartheid, under which illegal bars were symbols of resistance during white-minority rule, and black South Africans weren’t allowed to drink. “I don’t know what to say – I’m just overwhelmed,” one patron at a bar told Business Daily, saying the lifting of the ban made her day. “It’s like I won a million bucks,” says another, on his way to buy a cold Castle Lager.

So what was the effect of the ban? It could be argued that South Africa didn’t have much of a choice: by early August, it had the fifth most Covid cases in the world, and the virus’s widespread penetration demanded more hospital beds. But some wonder if banning booze was the best way to do that, like Johannes Ramatsi, a bartender who lost his job during the temporary prohibition and still doesn’t have a new one. “I feel bad. I want to go back to work, full force, because I must give my children something to eat. I’ve got four kids.”

‘Social ills’

Certainly it’s meant that the alcohol industry has taken a hit. Lucky Ntimane, head of the Liquor Traders’ Association, says a million people in South Africa have jobs tied to the alcohol industry. “I will argue the economy of the country is somehow driven by this industry,” he says. “Three percent of the GDP of the country comes from the liquor industry.” He also points to another common negative effect of alcohol prohibition: illegal trade on the black market.

That’s been the case in many countries that have banned booze throughout history, like in the US in the 1920s and 1930s. It’s also the case today; some Mexican states temporarily restricted alcohol during the pandemic too, leading to the deaths of citizens who drank black-market moonshine containing poisonous methanol.  (Sure enough, an underground market also sprung up in South Africa in May for not only alcohol, but cigarettes, too, which the government also banned during lockdown.)

Restaurant workers in Cape Town protesting alcohol restrictions during the pandemic (Credit: Alamy)

Restaurant workers in Cape Town protesting alcohol restrictions during the pandemic (Credit: Alamy)

Yet there is no denying the detrimental effects of legal alcohol, too. The WHO calls it one of the world’s leading health risks, associated with some 60 types of major disease and injury, and the cause of 4.5 million deaths annually. In South Africa’s case, it has one of the highest “non-natural” death rates in the world. Over 14,000 people die on the road each year alone. Sixty are murdered daily.

Bongiwe Ndondo, a researcher who tracks violence against women, says many assaults are fueled by alcohol, and that the restrictions during the pandemic had a positive effect on society.

“A lot of women on the ground that we have spoken to are telling us that their communities have never felt better. They’ve never felt safer. They’ve never looked cleaner.” She says a lot of people have been happy with the ban, and that some are waking up to what the country might look like without booze and “all the social ills” that come with it.

These ills were glaringly apparent after the ban lifted; emergency visits to hospitals in South Africa subsequently doubled, with 85% of them down to alcohol-related events such as car accidents, motorbike accidents, stabs, shootings and assaults. “A lot of the patients are coming in intoxicated, to the point where you’re wondering if they have a head injury. It’s absolutely exhausting,” says Dr Katie Jordaan at Tygerberg Hospital. Her colleague Scott Mahoney says there’s been a particular uptick in domestic violence. “So much alcohol dependence leads to violence and accidental harm in a country that’s already struggling with healthcare provision,” Mahoney says.

The end of prohibition in the US in 1933. The banning of alcohol had actually led to more violence once an underground market emerged amid nationwide restrictions (Credit: Alamy)

The end of prohibition in the US in 1933. The banning of alcohol had actually led to more violence once an underground market emerged amid nationwide restrictions (Credit: Alamy)

Prohibition’s pitfalls

Yet the Liquor Traders’ Association’s Lucky Ntimane – who says that the government has left the hundreds of thousands of people who’ve lost jobs high and dry – believes banning booze full-stop doesn’t address the real issue and that re-education is a more viable and effective long-term solution.

“As a country, we are avoidant dealing with the issue of alcohol abuse and its societal harm. This Covid-19 pandemic actually allows us to re-examine our unhealthy relationship with alcohol,” he says. “I’m in a better situation as a tavern owner to be able to drive the message of responsible drinking. I’m able to tell my patron: ‘You now have had enough’.”

Jeffrey Miron, an economist at Harvard University, says that alcohol bans often end up causing more problems, especially as they so often drive alcohol use and trade underground.

“Underground markets have a bunch of characteristics which we tend not to like: they tend to be violent, they tend to have poor quality control, so one gets more accidental poisoning and overdoses,” he says. “You forgo the opportunity to collect tax revenue. And they tend to be imposed and enforced in racially prejudiced ways.”

Miron says that while tax revenue from alcohol is not a huge amount of money in most economies, outlawing the entire industry “has a significant negative effect on the economic outcomes” and can “contribute to bad health outcomes when people lose health insurance because people have lost their jobs, or people are depressed because they’ve lost their jobs”. When it comes to Covid-19, he says restricting activities that spread disease, like people being in indoor restaurants and bars, is a more effective public health measure – and allowing those shops to do takeaway or alcohol-to-go can help offset economic impact. And as far as banning booze to curb violence, Miron says that doesn’t work, either. “In the US case, violence went up” during prohibition, he says, in regard to organised crime and illegal trade on the black market. Why? Because “people resolve underground disputes in markets often with guns rather than with lawyers.”

Emily Owens, who studies criminology and economics at the University of California, Irvine, points to the balancing act that many countries try to strike. “Alcohol is something that people enjoy drinking. It’s pleasant. We get utility out of alcohol consumption. But at a certain point, alcohol consumption really is problematic for society.” She believes that higher taxes and making alcohol pricier would allow people who really want to drink the ability to do so legally, but “maybe discourage people on the margin from consuming as much as they might currently choose to”.

Whatever the long-term answers are, South Africa’s short-term alcohol ban gave Bongiwe Ndondo, the domestic violence researcher, a glimpse of improvements that could be achieved with greater regulation. “South Africa has got a lot of binge drinking,” she says. “How can we continue to have some form of restrictions in place, but more sustainable than a complete prohibition?”

Finding an answer to that question would no doubt serve many nations and communities well – whether it’s during a pandemic, or not.

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