The South African Medical Research Council’s (SAMRC) latest weekly death report has shown a huge discrepancy between the country’s confirmed Covid-19 deaths and the number of excess natural deaths.
This was according to Professor Debbie Bradshaw, chief specialist scientist and a co-author of the Report on Weekly Deaths in South Africa, which is done in collaboration with the University of Cape Town’s Centre for Actuarial Research.
Wednesday’s recorded daily Covid-19 death toll of 572 was South Africa’s highest. But an estimated 17 090 more natural deaths than expected between May 6 and July 14 has raised concern about the accuracy of the Department of Health’s reported Covid-19 deaths.
South Africa’s coronavirus death toll now stands at 5 940, with a majority of the deaths coming from the Western Cape (2 752 deaths), the Eastern Cape (1 345), Gauteng (1 156),and KwaZulu-Natal (477).
The Western Cape, Eastern Cape, Gauteng and KwaZulu-Natal are experiencing the highest number of excess natural deaths, the SAMRC report showed. These are the hardest-hit provinces in terms of confirmed Covid-19 deaths and cases.
Mpumalanga, the Free State, Limpopo and North West have also started showing increases in excess deaths from natural causes.
Data: SAMRC-UCT Weekly Mortality Report 22 July 2020
Between May 6 and 1July 14, excess deaths from natural causes were 17 090 for persons one year and older.
For people between the ages of one and 59, the excess number of deaths is 5 889 and 11 175 for people 60 and older.
As of July 14, the number of deaths from unnatural causes such as car accidents and murders was 20% below expected totals, the SAMRC said.
“In the past weeks, the numbers have shown a relentless increase – by the second week of July, there were 59% more deaths from natural causes than would have been expected based on historical data. It also means that reported deaths have shown a pattern that is completely different to those indicated by historical trends,” the SAMRC said.
Bradshaw said the timing and geographic pattern leaves no room to question whether this is associated with the Covid-19 pandemic.
“However, the weekly death reports have revealed a huge discrepancy between the country’s confirmed Covid-19 deaths and number of excess natural deaths,” said Bradshaw.
Professor Glenda Gray, the SAMRC president and chief executive, said: “The SAMRC has been tracking mortality for decades in South Africa, and this system has identified excess deaths associated with the Covid-19 epidemic.
“These may be attributed to both Covid-19 deaths as well non-Covid-19 due to other diseases such as TB, HIV and non-communicable diseases, as health services are re-orientated to support this health crisis.”
To quantify the impact of the Covid-19 pandemic on South African deaths, it was decided to focus on deaths from natural causes and remove the impact of changes in the unnatural deaths, the SAMRC said. The team also thought it would be necessary to consider that the lockdown had reduced the number of natural deaths.
“Faced with the challenge that South Africa had a stringent lockdown in the very early stage of the epidemic and that unnatural deaths are a higher proportion of the all-cause mortality (and were impacted very significantly by the stringent lockdown), the SAMRC-UCT team thought it was necessary to use a different approach.”
The excess deaths is calculated using the number of reported deaths from the National Population Register, which is maintained by the Department of Home Affairs. A forecast is calculated based on the number of deaths reported from natural and unnatural causes in past years.
“In general, these excess deaths are calculated using all-cause mortality. It is considered that excess deaths would comprise Covid-19 deaths that are confirmed, Covid-19 deaths that have not been confirmed, as well as other deaths that may arise from conditions that might normally have been diagnosed and treated had the public been willing and able to access health care.”
Tracking weekly excess deaths is not a new phenomenon, the SAMRC said, several countries in the developed world have been reporting these trends, particularly to assess the impact of influenza.
With the outbreak of the Covid-19 pandemic, more countries have started doing this. Such analyses have generally demonstrated that during the pandemic, countries experience and excess numbers of deaths over and above confirmed Covid-19 deaths.
“ In the UK, for example, it was realised that the confirmed Covid-19 deaths reflected only the Covid-19 deaths that occurred in the health services and that deaths that occurred in long-term care institutions and at home were not included in their COVID-19 statistics.
“ However, given the availability of cause of death data from the death registration process in the UK, they were able to add such deaths to their confirmed Covid-19 statistics.
“Nonetheless, there are still excess deaths over and above these Covid-19 deaths, which are assumed to be deaths from conditions that might normally have been diagnosed and treated had their hospitals not been overwhelmed,” the SAMRC said.