South African women's life expectancy dropped by a year in 2020 and is likely to fall further in 2021 because of COVID-19, found a University of Cape Town and SA Medical Research Council (SAMRC) study in the SA Medical Journal.
Between 2019 and 2020, the number of deaths increased by nearly 53,000 with two-thirds of the increase among females. Life expectancy at birth fell by one year for females and by 2½ months for males. Life expectancy at age 60 decreased by 1.6 years for females and 1.2 years for males.
Infant mortality, under-5 mortality and mortality of children aged 5-14 decreased by 22%, 20% and 10%, respectively, while that for older children and adolescents decreased by 11% for males and 5% for females.
Premature adult mortality — the probability of a 15-year-old dying before age 60 — increased by 2% for males and 9% for females.
“During 2020, the rapid mortality surveillance system was modified to track the weekly number of deaths and thereby provide critical insight into the impact of COVID-19 in near to real time. The two key features of the impact of the SARS-CoV-2 epidemic on life expectancy in SA in 2020 are the seemingly modest impact relative to countries with similar levels of infection and that the impact on life expectancy of females was greater than that on life expectancy of males.
“For example, only seven countries — all with lower prevalences of SARS-CoV-2 — out of 29 experienced a lower change in life expectancy between 2019 and 2020, and only three showed a lower drop in male than female life expectancy. All of these were smaller than those found in SA.
“Deaths due to all causes combined in 2020 in excess of what might have been expected without the epidemic are therefore estimated to be nearly 74,000, of which 71% were female.
“However, the drop in life expectancy in 2021 can be expected to be somewhat greater than that in 2020 because of the devastating second and third waves of the COVID-19 pandemic associated with new variants of the virus, and the waning effectiveness of interventions to control the spread of the virus.”
Study details
The impact of the SARS-CoV-2 epidemic on mortality in South Africa in 2020
R E Dorrington, R Laubscher, N Nannan, D Bradshaw
Abstract
Background
The impacts on mortality of both the SARS-CoV-2 epidemic and the interventions to manage it differ between countries. The Rapid Mortality Surveillance System set up by the South African Medical Research Council based on data from the National Population Register (NPR) provides a means of tracking this impact on mortality in South Africa.
Objectives
To report on the change in key metrics of mortality (numbers of deaths, life expectancy at birth, life expectancy at age 60, and infant, under-5, older child and adolescent, young adult, and adult mortality) over the period 2015 – 2020. The key features of the impact are contrasted with those measured in other countries.
Methods
The numbers of registered deaths by age and sex recorded on the NPR were increased to account for both registered deaths that are not captured by the NPR and an estimate of deaths not reported. The estimated numbers of deaths together with estimates of the numbers in the population in the middle of each of the years were used to produce life tables and calculate various indicators.
Results
Between 2019 and 2020, the number of deaths increased by nearly 53 000 (65% female), and life expectancy at birth fell by 1 year for females and by only 2.5 months for males. Life expectancy at age 60 decreased by 1.6 years for females and 1.2 years for males. Infant mortality, under-5 mortality and mortality of children aged 5 – 14 decreased by 22%, 20% and 10%, respectively, while that for older children and adolescents decreased by 11% for males and 5% for females. Premature adult mortality, the probability of a 15-year-old dying before age 60, increased by 2% for males and 9% for females.
Conclusions
COVID-19 and the interventions to manage it had differential impacts on mortality by age and sex. The impact of the epidemic on life expectancy in 2020 differs from that in most other, mainly developed, countries, both in the limited decline and also in the greater impact on females. These empirical estimates of life expectancy and mortality rates are not reflected by estimates from agencies, either because agency estimates have yet to be updated for the impact of the epidemic or because they have not allowed for the impact correctly. Trends in weekly excess deaths suggest that the drop in life expectancy in 2021 will be greater than that in 2020.
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