Business Day

Fall­ing weekly deaths fuel hope pan­demic turned

• It looks quite hope­ful that there has been a turn, says co-au­thor of re­port

- Ta­mar Kahn Science & Health Writer kahnt@busi­nesslive.co.za Alexan­der Health · Infectious Diseases · Health Conditions · Medical Research Council · Free State

Af­ter three months of steadily in­creas­ing weekly deaths, the num­ber of fa­tal­i­ties re­ported in SA has fallen for the sec­ond con­sec­u­tive week, fu­elling hope that the coun­try may be over the worst of its coro­n­avirus epi­demic. Weekly all-cause mor­tal­ity fell 10.6% be­tween the week start­ing July 15 to the week of July 29, largely due to a de­cline in deaths from nat­u­ral causes, which in­clude those from Covid-19.

Af­ter three months of steadily in­creas­ing weekly deaths, the num­ber of fa­tal­i­ties re­ported in SA has fallen for the sec­ond con­sec­u­tive week, fu­elling hope that the coun­try may be over the worst of its epi­demic.

Weekly all-cause mor­tal­ity fell 10.6% be­tween the week start­ing July 15 and the week of July 29, largely due to a de­cline in deaths from nat­u­ral causes, in­clud­ing those from Covid-19.

The govern­ment is un­der pres­sure to ease re­stric­tions on trade and travel as a grow­ing num­ber of in­di­ca­tors in­clud­ing a de­cline in hospi­tal ad­mis­sions for Covid-19 cases, sug­gest in­fec­tions may have plateaued and be­gun to de­cline. By Tues­day, SA’s tally of con­firmed Covid-19 cases had risen past 566,000, the world’s fifth­largest recorded caseload.

The lat­est weekly mor­tal­ity re­port from the Med­i­cal Re­search Coun­cil (MRC) shows nat­u­ral deaths — those caused by in­fec­tious dis­eases or con­di­tions such as can­cer and di­a­betes — fell from a high of 15,524 in the week be­gin­ning July 15 to 14,497 in the week of July 22, and con­tin­ued to de­cline to 13,798 in the week of July 29, a drop of 11.1%.

Deaths from nat­u­ral causes plateaued or fell in all prov­inces dur­ing the week end­ing Au­gust 4, and de­clined in all met­ros ex­cept for Man­gaung.

“It does look quite hope­ful that there has been a turn,” said re­port co-au­thor Deb­bie Bradshaw, di­rec­tor of the MRC’s Bur­den of Dis­ease re­search unit.

“How it will un­fold ... is any­body’s guess — that is go­ing to de­pend on how peo­ple be­have.”

The re­port also re­veals a mod­est de­cline in non-nat­u­ral deaths — those caused by events such as traf­fic ac­ci­dents or mur­der — in the month since the govern­ment reim­posed an evening cur­few and a ban on al­co­hol sales in a bid to lessen the load on hospi­tal trauma units and free up re­sources for treat­ing Covid-19 pa­tients. Non-nat­u­ral weekly deaths fell from 963 in the week be­gin­ning July 1 to 796 in the week of July 29.

More strik­ing was that non­nat­u­ral deaths did not fol­low the usual month-end in­crease and were 34% be­low the level usu­ally ex­pe­ri­enced at this time of year for the week end­ing Au­gust 4, said the re­port’s au­thors.

The MRC es­ti­mates there were 33,478 ex­cess deaths be­tween May 6 and Au­gust 4, a fig­ure close to four times greater than the of­fi­cial Covid-19 death tally of 8,884 on Au­gust 4.

Ex­cess deaths in­clude those di­rectly at­trib­ut­able to Covid-19 and those oc­cur­ring from other nat­u­ral causes that could not be treated or pre­vented be­cause there were con­straints on health ser­vices or peo­ple were afraid to seek care. The of­fi­cial Covid-19 death toll re­ported by the min­is­ter on Au­gust 4 was 8,884.

The gap is not unique to SA, as in of­fi­cial Covid-19 death re­ports world­wide the true ex­tent of the dis­ease tends to be un­der­es­ti­mated be­cause they only re­flect deaths oc­cur­ring in fa­cil­i­ties where pa­tients have been tested. How­ever, there are strik­ing dif­fer­ences be­tween prov­inces, with the gap be­tween of­fi­cial Covid-19 deaths and ex­cess deaths nar­row­est in the West­ern Cape, and widest in the Eastern Cape and the Free State.

“We are con­cerned about the qual­ity [of] the re­port­ing of con­firmed deaths from Covid-19,” said Bradshaw. “We think most of the prov­inces are very fo­cused on pub­lic health ser­vices and not nec­es­sar­ily get­ting the deaths that oc­cur in pri­vate fa­cil­i­ties or in the com­mu­nity.”

DEATHS FROM NAT­U­RAL CAUSES PLATEAUED OR FELL IN ALL PROV­INCES DUR­ING THE WEEK END­ING AU­GUST 4

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 ?? /Sun­day Times/Esa ?? Track­ing: A health of­fi­cial tests a pa­tient who shows symp­toms of Covid 19 in Cape Town. Dur­ing the week end­ing Au­gust 4, deaths from nat­u­ral causes de­clined in most met­ros.
/Sun­day Times/Esa Track­ing: A health of­fi­cial tests a pa­tient who shows symp­toms of Covid 19 in Cape Town. Dur­ing the week end­ing Au­gust 4, deaths from nat­u­ral causes de­clined in most met­ros.

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