Medical Research Council: Covid-19 death toll three times more than official figures

The coronavirus pandemic has led to almost 11,000 fatalities in SA, more than triple the official death count, according to the latest analysis from the Medical Research Council (MRC).

The excess deaths reported by the MRC include those directly attributable to Covid-19 and those that occurred from other natural causes that could not be treated or prevented because people were afraid to seek care, or because there were constraints on health services.

Calculating these excess deaths provides an insight into the impact of the disease, which was first detected in SA in early March. Natural deaths are those caused by a disease or condition such as cancer, while non-natural deaths are due to causes such as traffic accidents or homicide.

The MRC estimates in its latest weekly death report that there were 10,994 more natural deaths between May 6 and July 7 in people over the age of one year than it would have expected had there been no coronavirus. The official death toll from Covid-19, as reported by health minister Zweli Mkhize stood at 3,502 on July 7.

The gap is not unique to SA: around the world, official Covid-19 death reports generally underestimate the true extent of the disease as they only reflect deaths occurring in facilities where patients have been tested.

Western Cape recorded the most excess deaths (3,694), followed by Eastern Cape (3,299) and Gauteng (2,770). Among the metros, the greatest number of excess natural deaths was seen in Cape Town (2,923), followed by Johannesburg (1,120), Ekhurhuleni (780), Nelson Mandela Bay (773), Buffalo City (497) and Tshwane (326).

Many countries are tracking excess Covid-19 deaths by comparing the number of natural deaths in a given time period to a recent historical average. However, the MRC said it had used a lower baseline for comparison than the historical average to take account of the marked decline in deaths observed before Covid-19 fatalities were significant. Most other countries tracking excess deaths imposed lockdowns after their Covid-19 death rates had risen significantly, said UCT demographer and report co-author Rob Dorrington

“We entered a very severe lockdown relatively early in the epidemic, which resulted in a decline in both unnatural and natural deaths. Thus instead of being at, or close to, the expected numbers of deaths when Covid-19 deaths started rising rapidly, the numbers of all-cause deaths were significantly below the expected number,” he said.

“Using the standard approach would have produced excess deaths below the confirmed number of Covid-19 deaths for several weeks before Covid-19 deaths made up the shortfall,” he said.

The MRC’s analysis used death records from the national population register, maintained by the department of home affairs, which only covers people with an SA identity number. The MRC adjusted these numbers to allow for deaths not recorded. The report excludes deaths below the age of one year, because babies that die before their births are registered with home affairs are not recorded in the population register. Home affairs offices were closed during lockdown level 5 and those in hospitals remain closed.

kahnt@businesslive.co.za