Excess deaths leap by another 5,782 but graphs finally take a downward turn

Reverend Didiza from Kagiso Methodist Church in the Mogale Circuit leads the funeral service of an 82-year-old woman who succumbed to Covid-19 on July 14.
Reverend Didiza from Kagiso Methodist Church in the Mogale Circuit leads the funeral service of an 82-year-old woman who succumbed to Covid-19 on July 14.
Image: Alon Skuy

Excess deaths have risen by 5,728 in the latest weekly report by the Medical Research Council (SAMRC). Only 1,889 people officially died of Covid-19 in the same period.

By July 28, excess deaths since May 6 - when the national mortality rate started to depart from the line it had followed since the start of the year - were estimated at 28,329. The official Covid-19 death toll on July 28 was 7,257.

However, graphs in the council's latest weekly report moved downwards.

"For the first week in the past 12 weeks, the weekly number of deaths of persons 1+ years of age from all causes has dropped from the previous week," said the authors.

"In the week July 21-28 there were 15,461 deaths, which is 59% higher than the predicted number based on historical data for this week.

"When compared with the predicted numbers, there was an excess of 5,728 deaths in the latest week, compared with 6,256 deaths in the prior week."

The researchers said the number of deaths from natural causes had also dropped for the first time in 12 weeks but remained "significantly higher" than the predicted number.

With the exception of Mangaung, deaths from natural causes in all metros had plateaued or declined during the week ending July 28. The same pattern occurred in all provinces except the Free State and Limpopo.

The number of excess deaths for the week ending July 28 declined for the first time in 12 weeks but was still 'significantly higher' than predictions based on historical data.
The number of excess deaths for the week ending July 28 declined for the first time in 12 weeks but was still 'significantly higher' than predictions based on historical data.
Image: Medical Research Council

"Compared with the predicted number of natural deaths from historical data in the week ending July 28, Free State had 121% more, Gauteng had 106% more, Eastern Cape had 96% more, KwaZulu-Natal had 69% more, Mpumalanga had 67% more, Western Cape had 41% more, Northern Cape had 52% more, North West had 38% more and Limpopo had 16% more," said the researchers.

"The number of deaths from unnatural causes (eg. road traffic fatalities and homicides) continues to track the lower prediction bound and was 26% below the predicted number for the week ending July 28."

How metros and provinces have been affected by excess deaths since May 6.
How metros and provinces have been affected by excess deaths since May 6.
Image: Medical Research Council

The researchers believe some of the excess deaths are "collateral deaths" linked to difficulties in the healthcare system caused by the burden of Covid-19.

“It is not unexpected that the excess natural deaths reported are higher than the official Covid-19 deaths report,” council president and CEO Prof Glenda Gray said last week.

“All countries are grappling with how to report excess mortality. Definitions and calculations should be consistent globally and locally. Our excess deaths will be different, given the demographics of our country, and compared to countries like the United Kingdom, appear at this stage of the pandemic to be less.”

The council said factors that may contribute to excess deaths include:

  • People dying from Covid-19 before they get to the healthcare facility. This may be due to lack of transport, delays in transport and hospitals being unable to receive them;
  • People dying from Covid-19 but the cause of death not being reported as such. This may be due to test results not being available or problems in provincial Covid-19 reporting systems; and
  • People dying from non Covid-19 conditions because health services are focusing on the pandemic. Examples include people who have not been diagnosed with TB and others with TB who have defaulted on treatment for fear of attending hospitals or clinics.
Deaths from all causes recorded a weekly decline for the first time since mid-April.
Deaths from all causes recorded a weekly decline for the first time since mid-April.
Image: Medical Research Council

"These phenomena are not unique to SA and have been observed or postulated globally by countries that are able to track their excess mortality," said the council.

"By making these observations, governments are able to home in on their unique issues contributing to excess deaths and therefore strengthen their health systems and monitoring and surveillance capacity."

Gray urged doctors to ensure that death certificates were filled in accurately, especially if a death was related to Covid-19.

Updating the media on Wednesday about the pandemic, health minister Zweli Mhkize said: "As part of improving the records of Covid-19 related deaths in response to reports on excess deaths, we now require that all the sudden deaths and those that occur at home must have specimens taken for Covid-19 before a death certificate is issued."

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