SA faces up to 48,000 Covid-19 deaths by November

SA’s Covid-19 deaths are projected to reach up to 48,000 by November and the country could run out of ICU beds as early as June, according to the most pessimistic projections from the modelling consortium advising the government.

Its optimistic scenario projects there will be 40,000 deaths by November, with the country’s ICU bed capacity, which stands at 3,300, exhausted in July.

Until now the government has refused to disclose any details of the epidemic models that have guided its decisions and went as far as requiring experts to sign nondisclosure agreements.

The data was provided by the consortium at a briefing hosted by health minister Zweli Mkhize on Tuesday evening, and follows growing pressure on the government to release details of the models it has used to guide its response to the Covid-19 pandemic, which included imposing one of world’s most stringent lockdowns on March 27, less than two weeks after confirming the country’s first case.

The epidemic and the lockdown are expected to have a devastating effect on the economy. The SA Reserve Bank projects that the economy will shrink 6.1% over 2020 while some have said it could be double digits.

Business for SA estimates that job losses could reach 2-million.

Unlike many countries in Europe and Asia that began easing their lockdowns when infections slowed, the government is planning to ease restrictions as transmission accelerates in SA.

As of Tuesday there had been 17,200 confirmed cases of the disease, an increase of 767 on the day before, and 312 deaths.

Mkhize said the lockdown had served its purpose, in slowing transmission and buying critical time to prepare the health system, but SA could not avoid a large number of cases.

The lockdown had enabled the government to ramp up community testing and prepare other mitigation measures, such as the preparation of isolation and quarantine facilities.

The modelling consortium, which is being co-ordinated by scientists at the National Institutes for Communicable Diseases, includes experts from the South African Centre for Epidemiological Modelling and Analysis at Stellenbosch University, the Modelling and Simulation Hub, Africa (Masha) at the University of Cape Town, and the Health Economics and Epidemiology Research Office at Wits.

Masha’s Sheetal Silal provided the projections for two scenarios and their key assumptions. Under the optimistic scenario, the hard lockdown reduced transmissibility of the coronavirus by 60%, the level 4 lockdown to May 31 reduced it by 35% and social distancing measures after that cut it by 20%. Under the pessimistic scenario, the hard lockdown reduced transmissibility by 40%, level 4 reduced it by 25% and social distancing by 10%.

She emphasised that there was considerable uncertainty about how the epidemic would play out in SA over the next six to eight months, and said the model was adjusted weekly as more information and data became available.

The model projects there will be 30,433 confirmed cases by the end of May, but the figure could be as low as 18,710 or as high as 54,540, she said, to illustrate the range of uncertainty.

While SA appeared to have sufficient non-ICU hospital beds, these would not be sufficient when SA’s ICU bed capacity was breached, she said.

When asked about ending the lockdown, she said: "It is not up to modellers to make such a decision. It is an economic decision and a social decision that requires consultation with all aspects of government."

Hero’s Gesine Meyer-Rath said ICU capacity was often breached in the public sector, and SA needed to increase ICU beds by a factor of 10.

Two thirds of SA’s ICU beds are in the private sector.