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Analysis: Up to 80% of South Africans Have Had COVID-19

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An analysis of COVID-19’s impact on South Africa suggests nearly 4 of every 5 people in the country may have already contracted the disease, whether they know it or not.

The report by South Africa’s Discovery Health insurance company came to that conclusion by looking at COVID’s overall fatality rate and South Africa’s daily estimate of excess deaths.

“When we do those numbers, what we get is between 42 and 48 million in South Africa,” Discovery Health’s chief actuary Emile Stipp told Bloomberg. South Africa’s population is about 60 million.

Excess deaths are the number of deaths above the historical norm. In terms of COVID-19, excess deaths account for deaths caused by the virus and deaths caused indirectly — by delays caused by overwhelmed hospitals, for example.

Of more than 100 countries represented in the World Mortality Dataset, South Africa’s excess-deaths rate ranks among the highest.

The South African Medical Research Council (SAMRC) tracks COVID-19 deaths across the country. The group’s count starts in May 2020 when the pandemic was first reported in South Africa.

Since then, the council estimates, South Africa has reported more than 244,800 deaths above normal. As in other countries, the excess death count is much higher than official estimates of deaths directly connected to COVID-19. According to SAMRC and the University of Cape Town, COVID-19 accounts for 85-90% of South Africa’s excess deaths.

Stipp based his analysis on 90% of excess deaths being from COVID-19. The analysis then applied the international fatality rate for COVID-19 to that number.

The estimate is a range, Stipp told South Africa’s BizTech, because “we can’t be certain about everybody, because not everybody gets tested.”

South Africa is experiencing its third wave of COVID-19 infections, this one driven by the delta variant. That wave, which hit hardest in Gauteng and North West provinces, peaked in July and continues to wane.

At the peak of South Africa’s second wave of infections in January, for example, the council reported more than 16,000 excess deaths on January 10. That was four times the official count of COVID-19 deaths for the same day.

Despite such a large portion of South Africa’s population being exposed to COVID-19, the 20-30% of the country that remains unexposed presents ample opportunity for the virus to become a chronic health concern, Stipp said.

“Herd immunity is something that we must all forget now,” he said. “It’s not going to happen. COVID is becoming endemic.”

Odds are the virus will continue to spread through the population, mutating and creating new variants as it goes. Anyone relying on natural immunity for protection has a 25% chance of developing a life-threatening case of COVID-19, Stipp said.

A recent study at the University of Cambridge in the United Kingdom concluded that the delta variant is twice as likely to send someone to the hospital as is the alpha variant.

Because of variants, South Africa has seen a small number of people who have had COVID twice. A few have even had it three times due to the rise of different strains.

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