As South Africa Reopens, Scientists Warn Against Complacency

By ADF On Oct 27, 2020

Mourners attend funerals at Olifantsvlei Cemetery in Soweto, South Africa. A study of excess deaths suggests that COVID-19 has taken a much higher toll on South Africa than official tallies indicate. AFP/GETTY IMAGES

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South Africa was hit hard by COVID-19 recording the highest number of cases and deaths on the continent.

As of mid-October, the nation reported nearly 704,000 cases. That’s 45% of the continent’s total caseload of 1.6 million. With more than 18,400 reported deaths, South Africa also leads the continent in that regard as well, according to the Africa Centres for Disease Control and Prevention.

That said, compared to other nations of similar size — Italy with 36,600 deaths or France with nearly 33,500 deaths, for example — South Africa’s experience with COVID-19 has been drastically different. That’s despite having a large number of citizens with other ailments such as HIV, tuberculosis and diabetes, all of which can make people more likely to die from COVID-19.

Public health officials continue to speculate about why South Africa has seen fewer deaths than some other countries. Could it be the relative youth of the population, which has a median age of 27.6 years? Maybe early lockdowns or the product of experience with past epidemics? Was the continent’s best medical establishment better prepared to treat patients?

“A possible explanation could be that there has been underreporting and undertesting on the African continent due to severe limitations of available resources,” Professor Salim Abdool Karim, an epidemiologist at the South Africa Medical Research Council and an advisor to the South African government, told ADF. “However, admissions in hospitals with acute respiratory illnesses across countries in Africa do not correlate with this hypothesis.”

South Africa’s Western Cape province was among the hardest hit by COVID-19 but also has some of the most complete records of excess deaths, which suggest COVID-19’s impact has been worse than the official tally. WESTERN CAPE GOVERNMENT

University of Cape Town Professor Emeritus Jonny Myers argues that, although South Africa is recovering, it may have been hit harder by the virus than many believe. His research suggests that South Africa’s COVID-19 death count is worse than the official tally. Myers is a public health specialist and a former director of the Centre for Environmental and Occupational Health Research at the university’s Department of Public Health and Family Medicine.

How does he reach his conclusion? By looking at South Africa’s excess deaths.

Excess deaths — the number of deaths above normal for a given time of year — lurk in the background of any COVID-19 discussion. They’re the shadow that is cast over the official number rooted in death certificates and other government documents.

“They represent a gold standard of measurement for COVID-19 deaths and constitute an upper limit on the real number of COVID-19 deaths during the epidemic period,” Myers wrote in an article published in South Africa’s Daily Maverick, an online newspaper.

They’re also difficult to calculate and require a depth of record keeping few other African countries can manage, Myers told ADF.

According to weekly numbers reported by the South Africa Medical Research Council, as of early October, South Africa has seen 45,701 excess deaths. The scale of excess deaths suggests South Africa has not gotten off lightly when it comes to the pandemic, Myers argues.

Karim is less certain. He points out that excess deaths have declined steadily from their peak in July. Although Myers contends that most excess deaths are likely connected to COVID-19, Karim has a different take.

“It would be unwise to speculate at this stage,” he told ADF. “We do not know. For the past two weeks, the excess deaths have reduced to almost none, so we have minimal number of cases.”

As the Southern Hemisphere moves into late spring and summer, Karim remains cautiously optimistic that South Africa may see its COVID-19 deaths decline further.

“We do have a young population, and I remain hopeful that South Africans will behave responsibly and diligently observe mask-wearing, social distancing and hand-washing,” Karim said. “It is about embracing the new normal to prevent a serious second surge. However, complacency can lead to a second surge.”