Business Day

Falling weekly deaths fuel hope pandemic turned

• It looks quite hopeful that there has been a turn, says co-author of report

- Tamar Kahn Science & Health Writer kahnt@businessli­ve.co.za Alexander

After three months of steadily increasing weekly deaths, the number of fatalities reported in SA has fallen for the second consecutiv­e week, fuelling hope that the country may be over the worst of its coronaviru­s epidemic. Weekly all-cause mortality fell 10.6% between the week starting July 15 to the week of July 29, largely due to a decline in deaths from natural causes, which include those from Covid-19.

After three months of steadily increasing weekly deaths, the number of fatalities reported in SA has fallen for the second consecutiv­e week, fuelling hope that the country may be over the worst of its epidemic.

Weekly all-cause mortality fell 10.6% between the week starting July 15 and the week of July 29, largely due to a decline in deaths from natural causes, including those from Covid-19.

The government is under pressure to ease restrictio­ns on trade and travel as a growing number of indicators including a decline in hospital admissions for Covid-19 cases, suggest infections may have plateaued and begun to decline. By Tuesday, SA’s tally of confirmed Covid-19 cases had risen past 566,000, the world’s fifthlarge­st recorded caseload.

The latest weekly mortality report from the Medical Research Council (MRC) shows natural deaths — those caused by infectious diseases or conditions such as cancer and diabetes — fell from a high of 15,524 in the week beginning July 15 to 14,497 in the week of July 22, and continued to decline to 13,798 in the week of July 29, a drop of 11.1%.

Deaths from natural causes plateaued or fell in all provinces during the week ending August 4, and declined in all metros except for Mangaung.

“It does look quite hopeful that there has been a turn,” said report co-author Debbie Bradshaw, director of the MRC’s Burden of Disease research unit.

“How it will unfold ... is anybody’s guess — that is going to depend on how people behave.”

The report also reveals a modest decline in non-natural deaths — those caused by events such as traffic accidents or murder — in the month since the government reimposed an evening curfew and a ban on alcohol sales in a bid to lessen the load on hospital trauma units and free up resources for treating Covid-19 patients. Non-natural weekly deaths fell from 963 in the week beginning July 1 to 796 in the week of July 29.

More striking was that nonnatural deaths did not follow the usual month-end increase and were 34% below the level usually experience­d at this time of year for the week ending August 4, said the report’s authors.

The MRC estimates there were 33,478 excess deaths between May 6 and August 4, a figure close to four times greater than the official Covid-19 death tally of 8,884 on August 4.

Excess deaths include those directly attributab­le to Covid-19 and those occurring from other natural causes that could not be treated or prevented because there were constraint­s on health services or people were afraid to seek care. The official Covid-19 death toll reported by the minister on August 4 was 8,884.

The gap is not unique to SA, as in official Covid-19 death reports worldwide the true extent of the disease tends to be underestim­ated because they only reflect deaths occurring in facilities where patients have been tested. However, there are striking difference­s between provinces, with the gap between official Covid-19 deaths and excess deaths narrowest in the Western Cape, and widest in the Eastern Cape and the Free State.

“We are concerned about the quality [of] the reporting of confirmed deaths from Covid-19,” said Bradshaw. “We think most of the provinces are very focused on public health services and not necessaril­y getting the deaths that occur in private facilities or in the community.”

DEATHS FROM NATURAL CAUSES PLATEAUED OR FELL IN ALL PROVINCES DURING THE WEEK ENDING AUGUST 4

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 ?? /Sunday Times/Esa ?? Tracking: A health official tests a patient who shows symptoms of Covid 19 in Cape Town. During the week ending August 4, deaths from natural causes declined in most metros.
/Sunday Times/Esa Tracking: A health official tests a patient who shows symptoms of Covid 19 in Cape Town. During the week ending August 4, deaths from natural causes declined in most metros.

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