SA Covid death toll is one of the worst
• About 157,000 excess mortalities in a year • Huge discrepancy with confirmed fatalities
A new report from the Medical Research Council (MRC) says SA has experienced one of the world’s worst death tolls from Covid-19 relative to the size of its population, highlighting the devastating effect of the pandemic in the past year.
It estimates there have been 157,000 excess deaths from natural causes in the 12 months to May 8, a figure that is three times higher than the official death tally of 52,687.
The age-standardised excess death rate per 100,000 population stands at 258 for the past year, placing SA in the top five countries for which excess deaths are measured, including Peru, Mexico and Ecuador, said one of the report’s authors, Debbie Bradshaw, director of the MRC’s burden of disease unit.
Standardising for age and population allows a fair comparison between countries and provinces, she said.
The report shows a massive range between provinces, but even those that appear to have got off relatively lightly were in fact hit harder than most European
countries. The Eastern Cape fared worst of all, with an age-standardised excess death rate of 420 per 100,000 population, followed by KwaZulu-Natal at 382. Gauteng came in at 166 and the Western Cape at 184 per 100,000.
The MRC publishes a weekly mortality report, based on death records from the department of home affairs.
PANDEMIC
Each report includes the forecast range of natural deaths per week, with an upper and lower bound, calculated from historical data. Excess deaths are those above the upper bound of the forecast range, while natural deaths are those caused by disease or age. Non-natural deaths are due to accidents or violence.
The close correlation between the timing and geographical pattern of the excess deaths recorded in the past year makes it clear that they were mostly directly due to the pandemic, says the MRC.
“While some, particularly during the height of waves, may be collateral deaths associ
ated with overwhelmed health services … about 85% of the excess deaths are due to Covid-19,” says the report.
It highlights a huge discrepancy between the confirmed Covid-19 deaths and the number of excess natural deaths observed in many provinces, which the MRC attributed to the under-reporting of Covid-19 deaths that occurred outside hospitals. In Mpumalanga, the number of confirmed Covid-19 deaths was only 12% of the excess deaths, while in the Western Cape the figure was 69%.
SLOW BURN
The report also draws attention to the steady rise in excess deaths from natural causes in the Free State and Northern Cape, which it says are showing “concerning signs of a possible third wave”.
The weekly deaths reported in the metros remained within the forecast range, suggesting the pandemic was maintaining a “slow burn” in non-metro areas in these provinces, said Bradshaw. There has been a recent uptick in excess deaths in Gauteng, which is also occurring outside the metros, she said.