EXPLAINED | Spike in natural deaths during Covid-19 pandemic

31 July 2020 - 06:03
By Unathi Nkanjeni
Natural deaths in SA have seen a spike in numbers during the Covid-19 pandemic, according to the South African Medical Research Council.
Image: iStock Natural deaths in SA have seen a spike in numbers during the Covid-19 pandemic, according to the South African Medical Research Council.

SA’s natural deaths have seen a spike in numbers during the Covid-19 pandemic. This is according to the South African Medical Research Council (SAMRC) weekly report, which revealed the difference between the country’s confirmed Covid-19 deaths and the number of excess natural deaths.

From the first week of March to July 21, the country recorded 22,279 excess natural deaths, said the council.

It said the numbers have shown a relentless increase as by the second week of July there were 59% more deaths from natural causes than would have been expected based on historical data.

Huge discrepancy

According to chief specialist scientist and a co-author of the report, Prof Debbie Bradshaw, the timing and geographic pattern leave no room to question whether this is associated with the Covid-19 pandemic.

“The weekly death reports have revealed a huge discrepancy between the country’s confirmed Covid-19 deaths and the number of excess natural deaths,” she said.

To provide close to real-time insight into changes in mortality, the council's burden of disease research unit collaborates with UCT’s centre for actuarial research to analyse the numbers of deaths registered by home affairs on the national population register.

Provinces with the biggest gap

On Monday, during an interview with the health department, Bradshaw said the gap between the number of Covid-19 deaths and the excess deaths was most obvious in the Eastern Cape and Gauteng.

“'Excess' is the deaths that are over and above what you would expect to have. It’s been used particularly in looking at flu epidemics, where there’s a sudden surge in the number of deaths that’s just beyond what you’d expect,” she said.

“It’s important for us to do more work to get some research done to find exactly what’s causing that. It could be that there are Covid-positive people who are not getting to health facilities, thereby not getting into the statistics.

“People [are] dying at home, whether it’s [due to a lack of] access to transport to get to a facility or choosing not to go to a health facility. There are various reasons why there's an excess.”

Numbers

The number of these estimated excess deaths are from May 6 to July 21. Bradshaw said the rise in numbers of deaths from natural causes in July in Gauteng confirmed that the epidemic was spreading in the province.

According to the report, 6,620 excess deaths were reported in Gauteng, 6,411 in the Eastern Cape, 4,133 in the Western Cape and 2,632 in KwaZulu-Natal.

In the other provinces, 752 were reported in the Free State, 627 in Mpumalanga, 566 in the North West, 527 in Limpopo and 164 in the Northern Cape.

Estimated excess deaths between May 6 and July 21.
Image: SAMRC Estimated excess deaths between May 6 and July 21.

Lockdown impact

The council acknowledged that the lockdown had reduced the number of natural deaths.

It said a baseline was chosen that was consistent with the level that the number of natural deaths was tracking before the uptick in the trend.

“SAMRC has been tracking mortality for decades in SA, and this system has identified excess deaths associated with the Covid-19 epidemic,” said the council's president and CEO, Prof Glenda Gray.

“These may be attributed to both Covid-19 deaths as well as non-Covid-19, due to other diseases such as TB, HIV and non-communicable diseases, as health services are reorientated to support this health crisis.”

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