Excess deaths rise, starting in Covid hotspot Eastern Cape

There have been more than 52 740 excess deaths in the past five months. Excess deaths, which loosely translates deaths above the average rate, have declined since the peak in middle to late July, but experts fear that South Africa could see another spike following the resurgence of Covid-19 cases in three provinces. 

Although it is not clear whether the pandemic has directly increased the weekly excess death rate — because people may have not been tested and died without knowing they had Covid-19 — infectious disease specialist Dr Richard Lessells suspects the number of deaths will rocket because of the resurgence. 

“The decline in deaths from the peak in July was clearly good news, but essentially this followed what we would expect based on the trajectory of the epidemic [the fall in cases].” 

This may have had an unintended consequence. “Unfortunately then some complacency set in and there was a sense among some people that we were over the worst of the epidemic, rather than that we had just passed through the first phase.” 

“As a result, we are now seeing an increase in deaths again — most noticeably in Eastern Cape, which is the first province to experience a significant resurgence in infections. This is extremely worrying. The deaths in Nelson Mandela Bay are already at a higher level than at the peak in the first wave in July,” Lessells said. 

He added that if the country did not respond aggressively to the signs of a resurgence in Gauteng, KwaZulu-Natal and Western Cape, there would be an increase in deaths in the upcoming weeks and months. 

Health Minister Zweli Mkhize visited the Nelson Mandela Bay metro to warn about the spread of the coronavirus. Last week the Western Cape health department confirmed that there is a 73% increase in new Covid-19 cases and 28% in new Covid-19 deaths. 

Based on the data, it seems there is a correlation between the uptick in excess deaths, a resurgence of cases and the number of deaths caused by Covid-19. 

In mid-July there were 6 980 reported natural excess deaths versus 1 022 reported Covid-19 deaths in the same week. Covid-19 deaths peaked the following week with reported 1 889 deaths. 

Currently the cumulative number of confirmed Covid-19 cases is more than 790 000 and 21 500 Covid-19 related deaths. The South African Medical Research Council has reported more than 51 000 excess deaths since May to 17 November.

According to the report on weekly deaths in South Africa released last week, there has been a 6.1% increase in excess deaths nationally. Since the resurgence, the Eastern Cape has, at 13 602, the highest number of excess deaths, followed by Gauteng (12 730) and KwaZulu-Natal (7 795). Another emerging hotspot is the Western Cape, which has had 6 662 excess deaths. 

The Eastern Cape has more than 30% of the total number of new cases since the regulations intended to limit the spread of Covid-19 eased up from level two to level one lockdown. 

Lessells advised holidaymakers to comply with the regulations this festive season to avoid an uncontrollable spread of Covid-19

“The deaths are an inevitable result of allowing virus transmission to continue in our homes and communities. The most effective way to prevent deaths is to prevent infection and to break chains of transmission,” he said. 

“If we want to limit Covid-19 deaths, we need to get back to basics — we need to strengthen our systems for testing, tracing and isolation, then strengthen our cluster investigations.”

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