COVID-19 and all-cause mortality in South Africa – the hidden deaths in the first four waves

• DOI: 10.17159/sajs.2022/13300
• Publication Date: 2022-05-26T18:03:36Z
• Authors: Debbie Bradshaw; Rob Dorrington; Ria Laubscher; Pamela Groenewald; Tom Moultrie
• Keywords: Death toll

Accurate statistics are essential for policy guidance and decisions. However, the reported number of cases COVID-19 deaths known to be biased due under-ascertainment SARS-CoV-2 incomplete reporting deaths. Making use death data from National Population Register has made it possible track in near-real time excess experienced South Africa. These reveal considerable provincial differences impact COVID-19, likely associated with population age structure density, patterns social mixing, prevalence comorbidities such as diabetes, hypertension, obesity. As waves unfolded, levels natural immunity together vaccination began reduce mortality. Mortality rates during second (Beta) wave were much higher than mortality third (Delta) wave, which either first or fourth (Omicron) waves. cumulative toll was a similar order magnitude that longer duration Delta wave. Near-real monitoring all-cause should refined provide more granular level information enable district-level support. In meanwhile, there is an urgent need re-engineer civil registration vital system timely access cause public health actions. Significance: This study highlights Africa about three times causes 2020 2021 Although remains unknown, strong temporal correlation between within each province indicates majority COVID-19. Many countries have found difficult estimate deaths, identify report accurately, demonstrating value through demographic analysis obtained country’s Register. Open set: https://www.samrc.ac.za/sites/default/files/files/2022-02-09/Estimated%20deaths%20for%20SA%2007%20Feb%202022%20with%20adj2.xlsx