- Eid social gatherings may have acted as super spreader events and caused an increase in Covid deaths in SA Muslim communities.
- With the third wave upon us, researchers are urging people to adhere to Covid safety protocols.
- Vaccination also remains critical for getting the pandemic under control.
Gatherings during Ramadaan and close social interactions on Eid may have inadvertently acted as Covid-19 super-spreader events and caused an increase in Covid-related deaths in the South African Muslim community, a new study by the country’s leading scientists reveals.
“ … deaths observed during the last three weeks from 20 May to 10 June 2021 likely materialised due to infections that coincided with the last third of the fasting month (Ramadaan) that is observed by Muslims, which culminated in the observation of Eid,” the authors wrote in a correspondence recently published in the South African Medical Journal.
According to the statistics, Muslims constitute 4.9% of Covid-19 deaths nationally but they only make up around 1.9% of the population, which indicates a heavy, disproportionate toll on this religious group.
“Although reasons for this are multifactorial, it is likely to include higher attendance in places of worship and social gatherings over the Eid celebration period,” Dr Salim Parker from the University of Cape Town’s (UCT) Division of Infectious Diseases and HIV Medicine said in a news release by the university.
Parker added that this pattern was not evident in 2020 when all places of worship were prevented from operating under the country’s stricter lockdown regulations.
Super-spreader events are directly or indirectly responsible for more than 80% of Covid infections, they said.
Gauteng Muslim community
The researchers also cautioned that the current weekly number of deaths in Gauteng’s Muslim communities had already surpassed the peak weekly deaths seen in the community during the first and second waves. The province has, so far, been the hardest hit by the third wave, President Cyril Ramaphosa stressed in June.
“These findings provide circumstantial evidence that gatherings at the end of Ramadaan and Eid-ul-Fitr likely led to super-spreader events among Muslims in Gauteng, which has resulted in a large number of avoidable deaths,” the authors wrote.
Delta variant could be responsible
They also said it’s unclear whether the highly contagious Delta variant (first identified in India) that has started to dominate infections in South Africa may have contributed to the early Covid outbreak in this community. The variant is estimated to be 60% more transmissible than the Alpha variant (first identified in the UK).
Parker said that Muslim organisations across South Africa report daily numbers of known Covid-19 deaths to a coordinating group called Muslim Stats South Africa.
The disproportionate figure may be due to underestimating the number of actual deaths in the country. “We know the excess deaths are much higher than actually documented,” Parker said in an interview with Radio 786.
“Muslim deaths are relatively accurately documented [via Muslim Stats SA] so we might have a case of accurate Muslim figures and underreporting of the total deaths among the other religious groups,” he added, but even when taking this into account, the Covid death figures in the Muslim community warranted investigation.
Parker also said that similar trends have been noted in Indonesia where Covid cases and deaths increased steadily after Ramadaan this year.
Indian/Malay descent: high Covid death risk
By mid-June, 2 826 Covid deaths were recorded in the Muslim community, predominantly of Indian/Malay descent. This group also appears to be at the highest risk of Covid death in the country, the authors said.
“[An] analysis of mortality by race group reveals that compared with whites, South Africans of Indian ancestry have a 35% increased risk of dying of Covid-19 when hospitalised, while black Africans and coloured people have a 23–24% higher risk of death following Covid-19 hospitalisation,” they wrote.
Moreover, this heightened risk is independent of other underlying risk factors such as diabetes – a condition that is highly prevalent in people of Indian ancestry compared with whites, they added.
Compared with all other race groups, South Africans of Indian ancestry have an 11% increased risk of death after Covid-19 hospitalisation.
'People don't adhere to protocols'
Speaking to Health24, Parker said there may be a perception of medical experts unfairly stigmatising the Muslim community, but that this was not the case.
“That is not the intention of any of the studies or any of the advice,” he said. “It is the behaviour of people and the breaking of Covid protocols that are aiding the spread. And it has been documented that where people don’t adhere to the protocols of wearing a mask, keeping a physical distance and interactions short, and being in poorly ventilated areas, the spread of the virus is aided.”
If Covid safety guidelines are in place and adhered to by congregants, case numbers would generally not be considered a problem. “But, unfortunately, it is being shown that people do not adhere to the protocols,” said Parker.
'The message is to stay at home'
He explained that there is also the perception that the findings mean people should avoid religious gatherings, but that any other social events or crowded places are safe to attend. “That’s absolutely not the case,” said Parker.
“The message is to stay at home and avoid any place where there are congregations, whether it’s going to a mall or attending a braai or a baby shower, for instance – any places where people gather should be avoided at least for the next few weeks,” he advised.
Vaccination remains key
As Covid cases continue to rise, the authors said it is important that adequate mitigation strategies be adopted nationally, including in the Muslim and other religious communities, to avoid additional, preventable Covid deaths.
Super-spreader events can occur in poorly ventilated indoor spaces, particularly in the absence of face mask-wearing, even if there is only a small crowd, they said.
“Public health and social measures to limit transmission, such as mask-wearing, physical distancing and hand-sanitising are important,” they stressed.
“Most importantly,” they wrote, “we cannot emphasise enough the importance of those who are most at risk (people aged >60 years) seizing the opportunity to be vaccinated. The Covid-19 vaccines have been demonstrated to be safe, and have close to 100% effectiveness in preventing severe disease and death.”
Achieving high vaccination coverage remains the most important goal to ensure fewer hospitalisations and deaths from Covid, they said.