- Excess deaths, a key measure used to track the impact of epidemics or even wars, are nearing 250 000 in South Africa.
- Researchers believe the majority of these deaths are linked to Covid-19.
- A top scientist is worried the daily reporting of deaths by the government is leading to South Africans being unconcerned over the impact of Covid-19, which may be far deadlier than the official numbers are showing.
Nearly 250 000 deaths from natural causes have been reported over and above what was expected since the start of the Covid-19 local epidemic in South Africa in March 2020.
The research, published weekly by a group of leading South African scientists, shows the Covid-19 outbreak is proving to be far more deadly than what the official, reported death toll is portraying.
"I worry that the daily announcements of the confirmed Covid-19 deaths leaves many South Africans unconcerned about the impact of the pandemic," said Professor Debbie Bradshaw, a senior scientist working for the SA Medical Research Council's (SAMRC) Burden of Disease Research Unit (BDRU).
She is one of the country's leading biostatisticians with extensive expertise in epidemiology and demography.
The BDRU together with scientists from the University of Cape Town's Centre for Actuarial Research (CARe) estimates 80% of the 249 000 excess natural deaths, which include the number of reported Covid-19 deaths, can be linked to Covid-19 - valuable evidence that the true death toll from Covid-19 is being significantly underreported.
According to the latest estimates prepared by the BDRU/CARe team published on Wednesday, 249 471 excess natural deaths were estimated to have occurred between 3 May 2020 and 28 August 2021 -165 000 of these deaths occurred in 2021, higher than the 85 000 in 2020.
In comparison, the National Institute for Communicable Diseases reported on Wednesday just over 88 000 people had died in hospital from Covid-19 since the outbreak began. The death toll reported by the national Department of Health is around 82 000.
News24 has requested clarity on this discrepancy, but no explanation has been forthcoming to date.
"Unfortunately, we do not have information about the underlying causes of the deaths and are having to interpret the numbers against trends from previous years. We consider that during 2020, Covid-19 must have been the leading cause of death, alongside HIV/Aids," Bradshaw said.
"It seems that during 2021, Covid-19 will become the single leading cause of death."
Information on underlying causes of deaths is shared directly with Stats SA, which processes the death notification forms to prepare subsequent reports.
Bradshaw previously called for this process to be prioritised to provide accurate data on causes of deaths to explain the major increases in deaths seen in the weekly mortality reports the BRDU/CARe teams have published since April last year.
Stats SA is believed to be currently processing death notification forms from 2018.
The SAMRC receives its data used to prepare the excess deaths estimates from the Department of Home Affairs, and the prediction bounds are determined with annual mortality data from 2014 to 2019.
Even without this data, however, Bradshaw previously pointed to the strong correlation between the timing and location of excess natural deaths, and surges in Covid-19 cases, as evidence to show most excess natural deaths were linked to Covid-19.
A News24 analysis of reported Covid-19 cases and excess deaths estimates showed this strong correlation clearly during the first and second waves.
The timing of third waves in various provinces has varied, yet the correlation persists not only nationally, but also at provincial level.
Similarly, a correlation between increases and decreases in weekly reported Covid-19 deaths and natural excess deaths can also be seen if plotted over time.
"We have been checking this [correlation] from time to time [last reviewed in July 2021] - and there is still a high correlation with the confirmed Covid-19 deaths that plays out for all provinces," Bradshaw said.
"This leaves us with no doubt that the majority of the excess deaths are Covid-19-related."
The weekly mortality reports are also a valuable tool to track the severity of surges of Covid-19 cases and deaths, particularly where testing strategies and reporting mechanisms delay the release of information to the public.
Bradshaw said the mortality data showed the third wave had unfolded with different timing across the country.
"We think that KwaZulu-Natal, Eastern Cape and possibly Mpumalanga are still on the increase, while Gauteng, possibly the Western Cape and most others are on the decrease. Northern Cape and Free State have experienced a protracted third wave which could still be continuing."
She added it appeared the death toll of the third wave (driven by the Delta variant) was going to be of a similar order of magnitude as the toll of the second wave (driven by the Beta variant).
"This has been surprising given the numbers of South Africans who must have already been infected with the virus and/or who have been vaccinated. It seems that the increased infectiousness of the Delta variant has counteracted this."
Previously, the Department of Health expressed the view that the strong correlation between the timing and location of excess deaths did not equal causation.
The department has steadfastly refused to include excess death estimates in its reporting on Covid-19 and said studies would be undertaken to determine the proportion of Covid-19 deaths going undetected.
A year after first being asked to comment on this issue and now as the excess deaths estimates near a quarter of a million, the department was asked whether its position has altered. No response was forthcoming at the time of writing.
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