Discovery Health CEO Dr Ryan Noach, together with his colleagues, recently held a webinar outlining new data that shows how COVID-19 has progressed in South Africa, how it’s changed health-seeking behaviours, the lifesaving impact of the early-onset lockdown, and many more insights.
13 million estimated to have been infected with COVID-19
On 11 September, health minister Dr Zweli Mkhize reported that South Africa had identified 644 438 cases of COVID-19 and recorded 15 265 deaths.
Global research has shown that a high number of COVID-19 cases remain undiagnosed and that the estimated rate of asymptomatic cases is as high as 40 – 45%. With this in mind, Discovery Health estimates that South Africa’s death rate could be 3,1 times higher than reported and that an estimated 13 million South Africans might have been infected by the virus since the first case was reported back on 5 March 2020.
“Based on the South African Medical Research Council data, up to 24 August 2020, estimates indicate that the COVID-19 death rate could be up to 3,1 times higher than reported,” Dr Noach said.
“Extrapolating from these insights, Discovery Health estimates that approximately 13 million South Africans have been infected – an infection rate of 22.0%, affecting more than one-quarter of adults in the country.”
The report explained that these findings are consistent with the initial results of a seroprevalence survey conducted by the Cape Town Metro which indicated that 37% of pregnant women and 42% of people living with HIV tested positive for COVID-19 antibodies, indicative of an initial sign of immunity to the virus.
A worrying trend
Another important insight from the report revealed that there have been some worrying changes seen in health-seeking behaviours.
“A serious, indirect consequence of the pandemic is a reduction in health-seeking behaviours among high-risk members who perceive seeing their doctor as increasing their risk of exposure to COVID-19,” Dr Noluthando Nematswerani, Head of Discovery Health’s Centre for Clinical Experience, said.
Some of these have included (compared to the same period last year):
- A 42% decrease in wellness tests and broader screening activities leading to fewer diagnoses of chronic conditions.
- A 44% reduction in breast cancer diagnoses and a 51% reduction in mammograms performed (with advanced cancers far more complex to treat and associated with poorer outcomes).
- A 51% decline in members registering for treatment for depression.
- Poor management of existing chronic conditions with 30% fewer GP consultation related to chronic care over the level 5 lockdown period.
Dr Nematswerani advised that all those who need general healthcare access it through digital or in-person visits.
“The light at the end of this tunnel is that the COVID-19 pandemic has accelerated the adoption of digital platforms that balance the need for routine healthcare and ensuring patient and provider safety,” she said.
- Transmission rates are highest among economically active adults working in the services sector, with COVID-19 in children often undiagnosed due to mild or asymptomatic presentation.
- Older members and those with chronic conditions face the highest risk of severe illness due to COVID-19. The impact of multiple chronic conditions is additive at lower levels.
- The positive effects of healthy living, encompassed by the Vitality programme, can offset the elevated COVID-19 hospitalisation risks of chronic conditions and aging
- Non-pharmaceutical interventions, including a stringent national lockdown, have been successful in flattening and delaying the COVID-19 peak while alleviating health system capacity to focus on COVID-19 cases (up to 16 000 South African lives will have been saved as a result of the country’s early lockdown and related measures).
“There is no doubt that our early-onset lockdown delayed the country’s COVID-19 peak, gave us time to learn from globally-emergent treatment advances and availed capacity within our healthcare system to deal with the pandemic,” Dr Noach said in conclusion.
“However, our positive reflection on the epidemiological and clinical aspects of the lockdown does not in any way detract from the very challenging economic impacts of the lockdown as evidenced in the most recent data around the contraction of our GDP by up to 51% in the second quarter. These developments make it clear that all of us must continue the national effort to curb the spread of COVID-19 and avert a second wave of infection.”