Covid-19: Gauteng’s excess natural deaths surge 31% in a week

Death toll is worse than peaks recorded during first and second waves

08 July 2021 - 13:05 By Tamar Kahn
The weekly number of excess natural deaths in Gauteng has rapidly accelerated since mid-May.
The weekly number of excess natural deaths in Gauteng has rapidly accelerated since mid-May.

Excess weekly deaths from natural causes in Gauteng have risen to a record high, as a third wave of coronavirus infections continues to exact a grim toll on the country’s most populous province, according to the latest report from the Medical Research Council (MRC).

It shows the weekly number of excess natural deaths in Gauteng has rapidly accelerated since mid-May, rising to 3,224 in the week to July 3, a 31% increase on the previous week’s tally of 2,459.

This figure is significantly worse than the peaks recorded during Gauteng’s first and second waves of infection, and markedly higher than the province’s weekly Aids deaths when the country’s HIV epidemic was at its worst.

The MRC routinely releases a weekly mortality report, based on death records from the department of home affairs. Each report includes a 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. Natural deaths are those caused by disease or age, while non-natural deaths are those due to accidents and violence.

While there are early signs that the increasing daily number of new coronavirus cases reported in Gauteng may have reached a turning point, the lag between diagnosis and death means the worst may be yet to come, since the weekly number of fatalities is expected to peak only several weeks after infections begin to diminish.


The MRC estimates between 85% and 95% of excess natural deaths are due to Covid-19, said report co-author Debbie Bradshaw, director of the MRC’s burden of disease unit. This means between 2,740 and 3,062 of the excess natural deaths recorded in Gauteng in the week to July 3 were due to Covid-19.

In 2004, when access to antiretroviral treatment was severely limited, Gauteng had an estimated 1,250 Aids deaths per week, said Bradshaw. Gauteng’s population has grown from 8.8 million in 2004 to 15 million in 2020, according to Stats SA.

Gauteng had less severe first and second waves than many other provinces, with excess natural deaths reaching a high of 2,172 in the week to July 18 2020 during the first surge, and a peak of 2,114 in the week to January 16 in the second wave.

In mid-March, its age standardised excess death rate per 100,000 population was the second lowest in the country at 172 per 100,000 population: it has now risen to 257 per 100,000 and is likely to increase further.

Excess deaths from natural causes rose particularly sharply in Johannesburg, to reach 1,330 in the week to July 3, well above its peaks in the first and second waves (760 and 650 respectively), said Bradshaw. The number of excess deaths from natural causes in Ekurhuleni and Tshwane has also risen above their peaks in the second wave.

Bradshaw said researchers were still puzzling over why Gauteng’s second wave was less severe than other provinces and speculated that it might have been partly because the restrictions imposed by the government in late December were implemented before infections began to surge in Gauteng and therefore helped slow transmission.

“That the third wave is going much higher suggests pockets of Gauteng may have had less immunity built up from previous waves,” she said.

The emergence of the highly contagious Delta variant in SA has also contributed to the rapid surge in Gauteng. Delta, which was detected in India in October, has spread to more than 95 countries.


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