Between 3 May 2020 and 16 January 2021, the number of excess deaths in South Africa was more than 106,000, of which nearly 85,000 have been people over the age of 60.
This is the estimate of the latest weekly Medical Research Council mortality report. These excess deaths are, either directly or indirectly, due to the COVID-19 epidemic.
Groundup reports that some of those deaths may be because people with other diseases were squeezed out of the health system or were too afraid to seek medical help. But as explained several times before, the vast majority of these deaths were very likely caused directly by COVID-19. This is supported by the likelihood that there were a lower number of deaths from flu and other infectious diseases last year.
The report says the Health Department's confirmed COVID-19 death toll is a bit over 40,000. This undercount is primarily because many people die without having being diagnosed with COVID-19.
There were over 16,000 excess deaths in the week ending 10 January, worse than the grim record set the previous week. Groundup reports that to put this into perspective, that’s more than 2,000 excess deaths daily, more than double the worst weeks of the HIV epidemic in the mid-2000s, though the high Aids mortality went on for year after year (and is still too high at about 150 to 200 daily). Also, people with HIV on average die much younger than people with COVID-19.
In the worst week of the first COVID-19 wave in July, there were about 6,500 deaths. As of the week ending 16 January it is not clear yet if the peak of the second wave has been reached.
Groundup reports that the latest MRC report includes a detailed explanation of the methodology used. The MRC has actually been providing two estimates of excess deaths. One is based solely on historical data and is 106,787 for all causes of death. A slightly higher estimate adjusts for a drop in mortality during the first lockdown in March 2020 and this is 112,280 natural deaths (excluding accidents and homicides).
According to Business Day, the report shows a sustained decline in the weekly number of excess natural deaths recorded in the Western Cape since the beginning of the year, adding weight to Premier Alan Winde’s call last week for a review of the current level three lockdown restrictions.
Excess weekly natural deaths have dropped from a peak of 1,480 in the week ending 27 December to 1,306 in the week ending 16 January.
The SAMRC said since 3 May 2020, there have been nearly 85,000 excess deaths of people over the age of 60. And, Groundup reports, the SAMRC believes that most of these excess deaths are due to COVID-19 infections.
According to the 2020 mid-year population estimates from Statistics South Africa, there are 5.4m people over the age of 60. This would suggest that so far, 1.5% of South Africa’s elderly population has died from COVID-19 infections.
The report says there is no clarity on when vaccines will arrive in sufficient volume to protect this segment of the population – the elderly here, unlike many other countries, are second in line. It is possible that South Africa will not have sufficient vaccines by June this year, when the third wave of infections is predicted.
South Africa’s elderly people are particularly susceptible to the effects of COVID-19 because of high rates of obesity, hypertension and diabetes. Also, elderly South Africans, particularly those from medium- and low-income areas, already face difficulty accessing healthcare facilities.
Groundup notes that according to a 2019 report by the Samson Institute for Ageing Research (SIFAR), elderly South Africans “face particular difficulties with transport to clinics, long waiting periods (which impose physical burden on older persons) and a general lack of health worker expertise on the management of chronic illness and geriatric issues.” The report found that only 22% of the elderly have medical insurance, with very different rates of coverage across population groups. Only 6% of elderly black South Africans had medical insurance, compared to about 17% of elderly coloured people and about 74% of elderly white people.
And yet the elderly are often the breadwinners and primary caregivers for their extended family, responsible for the needs of many.
Also, the report points out, the elderly cannot simply isolate – many are integral to raising children. According to the 2018 South African Child Gauge, published by the University of Cape Town Children’s Institute, “over 7m children live in households where the household head is defined as their grandparent or great-grandparent, and in nearly half of these cases … the grandparent is under 60 years … Around 2.7m children live with grandparents in the absence of their parents. These grandparents tend to be slightly older on average, although 39% are under 60 years and therefore not yet eligible for an old age pension.”
Groundup says that South Africa is faced with the likelihood of many further deaths among the elderly. And the effect of the pandemic on South Africa’s families will be devastating.
[link url="https://www.groundup.org.za/article/over-100000-south-africans-have-probably-died-covid-19/"]Full Groundup report (Open access)[/link]
[link url="https://www.samrc.ac.za/reports/report-weekly-deaths-south-africa"]SAMRC weekly deaths report (overview)[/link]
[link url="https://www.samrc.ac.za/sites/default/files/files/2021-01-24/weekly16Jan2021.pdf"]SAMRC mortality report[/link]
[link url="https://www.samrc.ac.za/sites/default/files/files/2021-01-24/Methodological%20Note%20on%20Predicted%20Weekly%20Deaths%2020_Jan_2021.pdf"]Methodological Note[/link]
[link url="https://www.businesslive.co.za/bd/national/health/2021-01-25-weekly-excess-deaths-more-than-double-last-winters-peak/]Full Business Day report (Restricted access)[/link]
[link url="https://www.groundup.org.za/article/nearly-85000-older-south-africans-have-probably-died-covid-19/"]Full Groundup report (Open access)[/link]
[link url="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449977/#CR1"]SIFAR report[/link]