Cape Town – There has been yet another huge increase in estimated excess deaths in the country, largely due to Covid-19-related causes.
From May 6 to July 28, more than 28 329 excess deaths have been recorded compared to 7 257 confirmed Covid-19 deaths, the SA Medical Research Council (SAMRC) said in its latest weekly report.
Excess deaths have risen by 5 728 in the latest weekly report, while the Covid-19 death count was 1 889 in the same period.
This suggests that there are ‘’some Covid-19 deaths that occur in the community and that there may be collateral impact of the Covid-19 epidemic”, said the authors from the SAMRC and UCT Centre for Actuarial Research, who deem excess deaths to be “the number of observed deaths higher than what would be expected – a public health measure of the impact of a crisis”.
The World Health Organisation defines excess mortality as ’’mortality that is attributable to the crisis conditions“.
Health Minister Mkhize said today: “In response to reports on excess deaths, we now require that all sudden deaths and those that occur at home must have specimens taken for Covid-19 before a death certificate is issued.”
This week’s SAMRC report shows that “for the first week in the past 12, the weekly number of deaths of persons 1+ years of age from all causes has dropped from the previous week (babies under 1 years are excluded from analysis)”, but was still “significantly higher” than predictions based on historical data.
“This has resulted from a drop in the natural causes of death. Except for Free State and Limpopo, the trends in all provinces have plateaued or declined during the week ending on 28 July 2018,” the report said.
“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 report.
“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.”
The researchers believe most of the excess deaths are “collateral deaths” linked to difficulties in the healthcare system caused by the burden of Covid-19
The report highlighted the following factors that may contribute to observed excess deaths:
1. People dying from Covid-19 before they get to the health-care facility. This may be due to lack of transport, delays in transport and/or hospitals being unable to receive them.
2. People dying from Covid-19 but the death not being reported as such. This may be due to test results not being available at the time of death and/or challenges in the provincial Covid-19 reporting systems.
3. People dying from non-Covid-19 conditions because the health services have been reorientated to Covid-19. Examples include people who have not been diagnosed with TB and others with current TB who have defaulted on treatment for fear of attending the health services.
The Report on Weekly Deaths in South Africa is published every Wednesday by the SAMRC’s Burden of Disease Research Unit, which includes information on both natural (age, disease, infection) and unnatural deaths registered on the national population register.
In the previous report Professor Debbie Bradshaw, chief specialist scientist and a co-author of the report, said: “The weekly death reports have revealed a huge discrepancy between the country’s confirmed Covid-19 deaths and number of excess natural deaths.”
Commenting on what can be done to investigate the causes of death in recent weeks, the authors of the report highlighted four issues:
- Statistics South Africa and the Department of Home Affairs are encouraged to fast-track processing the death notification forms completed by doctors.
- National Department of Health and the National Institute for Communicable Diseases to work with the South African Medical Research Council to consolidate supplementary information using.
- Data linkage to consolidate health information about the deaths.
- Conducting verbal autopsy interviews with next of kin.