50% of Covid-19 deaths possibly not reported

At least one in two Covid-19 deaths in South Africa are not reported, according to scientists. This as concern grows that South Africa may be much farther from ‘flattening the curve’ on the infection rate than official data reveals.

This contrasts with the indication from recent official data showing the mortality rate was stabilising and the number of active cases were going down. If unreported deaths indeed are this high, this has devastating implications about the true number of active cases and the infection rate.

Epidemiologist and lecturer at the University of Stellenbosch Professor Jo Barnes first noticed the problem when tests were not widely available at the beginning of the lockdown, and deaths classified as natural causes other than Covid-19 began to climb substantially.

The South African Medical Research Council, which published weekly reports on the overall death rate, recently published a report demonstrating why death data is imperative for government to stay on top of its dealing with the pandemic. It emphasised the significance of excess deaths during a pandemic, particularly in the category of natural causes.

Barnes noted that a recent study by the SAMRC seemed to confirm scientists’ worst fears had been realised, that the true rate of Covid-19 deaths was obscenely under-reported.

“From the information that I am getting, I would guess our death rate is at least double. The SAMRC actually did a study which looked at natural deaths of the previous two years between April and July. They looked at the background of anybody who died of natural causes during this time, and noticed there was an excess number of deaths that far exceeded the previous years, even after compensating for all sorts of factors such as population growth. Even after this they still had just over double the normal excess death rate in 2020.”

According to the SAMRC, excess mortality is a scientific term that refers to the number of deaths that are occurring beyond what would have normally been expected. In 2020, excess mortality is considered in the context of the current Covid-19 pandemic.

Prof Glenda Gray, SAMRC President and CEO, says it’s expected that the excess natural deaths reported are higher than the official Covid-19 deaths report.

“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 group noted that in July, excess death numbers have showed a “relentless increase” and by the second week of July, there were 59% more deaths from natural causes than would have been expected based on historical data.

“All of us are now firmly convinced that the number of fatalities are way bigger than what is being reported,” said Barnes.

Another reason for under-reporting was the peculiar position of poor and rural communities where deaths often occurred without a doctor in attendance, usually at the home of the deceased.

Governance expert professor Alex van den Heever noted that outside of the Western Cape, the death rate in relation to total infections and recoveries has remained relatively more consistent than other provinces, which had oddly low death rates considering the number of cases. A possible reason for this was how each provincial government handled the reporting on deaths and the factors surrounding this.

“When I look at the mortality data for Gauteng, it looks problematic. It doesn’t follow a neat trend the way Western Cape data does. If I sit and look at the Gauteng mortality rate on new cases, it is incredibly low, and ranges between 2% and under 2%, whereas in Western Cape on a 10-day lag it seems to hover around 3,5%. So I think the Western Cape data is accurate, whereas the Gauteng data, I can’t trust.”

Last month The Citizen reported that the funeral industry was concerned that according to their data, Covid-19 deaths were up to three times higher than it was reported, given the number of natural causes deaths occurring outside of healthcare facilities and even among those who died in hospital and were not confirmed cases, but showed signs they may have been infected.

This prompted an industry wide safety regiment change, which included separating suspected cases and cases at mortuary facilities. The industry also started investing heavily in PPE for all their workers, costing them approximately R3 million per month, countrywide.

Simnikiweh@citizen.co.za

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