Eastern Cape Covid-19 deaths may be 8,000 — four times official number

As many as 8,000 people may already have died in the Eastern Cape as a result of Covid-19 — almost four times higher than the government’s official numbers.

While official statistics show that more than 2,200 people in the province have succumbed to the coronavirus to date, researchers have shown how the Eastern Cape, along with the rest of SA, exhibited a high “excess mortality” rate in June and July compared to death figures for the same period in 2018 and 2019.

Covid-19 is the only difference now in the country compared to previous years.

Buffalo City metro has contributed 949 excess deaths to the provincial tally during the period this year.

Excess deaths are the number of observed deaths higher than what would be expected under normal circumstances and based on past records of deaths. This is an important measure for public health specialists to check the impact of the Covid-19 crisis.

By Monday night, the Eastern Cape had recorded 2,266 deaths out of the countrywide total of 10,621 people who have died since the pandemic’s arrival in SA.

Published weekly death statistics show the province recorded 7,597 excess deaths as the pandemic started to peak during June and July.

The startling figures emanate from weekly research by a team drawn from the SA Medical Research Council (MRC) and the University of Cape Town's (UCT's) centre for actuarial research.

When the figures were released earlier this month, the focus was on the fall in the weekly number of deaths from Covid-19, with little examination of excess fatalities.

Many of the uncounted Covid-19 deaths would have been people who died at home. They may not have attended a hospital, they may have died on the way to hospital before being tested, or they may have been sent home by hospital staff because they were too sick for treatment.

MRC researchers led by Dr Pam Groenewald, who collaborated in the study with UCT, said in the latest edition of the SA Medical Journal: “It is essential to undertake proper counting of the deaths in order to plan and provide adequate public health strategies for dealing with the present crisis.”

Until testing is more widely available, death counting due to Covid-19 is “the only population-based measure of the epidemic”, the article argues.

Covid-19 has exposed the country’s death reporting system.

SA law requires that when someone dies, a doctor must complete a death report form. This is submitted to the department of home affairs, which records the death in the national population register.

However, the part of the form indicating the cause of death may only be opened by Stats SA, which collects the forms from home affairs throughout the year and reports the figures annually, along with the causes of death.

That process has meant that throughout the pandemic, the government has had to depend on death reporting through health-care workers in hospitals and clinics.

The Cape Town research team has examined weekly death statistics from the population register as collected by home affairs offices since January this year, part of a long-term programme started by the team in 2018.

Their research does not capture medical causes of death, apart from distinguishing between natural and unnatural causes.

The MRC said “the data is invaluable as it provides a near real-time count of the total numbers of deaths”.

They used figures from the previous two years to predict deaths for 2020 — a baseline to track Covid-19 deaths since the pandemic broke out.

For the first part of the outbreak, the weekly total deaths from natural causes tracked the baseline, dipping drastically when the lockdown was implemented, and then climbing rapidly from early May.

By the end of July, the national count of excess deaths was 28,329.

Eastern Cape health spokesperson Siyanda Manana said there was now no underreporting of deaths.

“It happened in the past but that has been sorted,” he said.

Manana said health minister Zweli Mkhize's directive that all sudden and home deaths be subjected to Covid-19 testing was being implemented throughout the province.

“Deaths are being recorded daily. The districts are adhering to daily reporting,” Manana said.

DA MPL Jane Cowley, who raised the alarm on the probable high number of excess deaths in the Eastern Cape, said on Monday that if the figures reported by the research team stood up, it could drive the province’s death toll to “well over 8,000”.

The MRC-UCT study states that not all the excess deaths will be related to Covid-19. Some will be “collateral deaths” due to the constraints on the health-care system as a result of the pandemic.

The week ending July 28 showed the first drop in the national count of natural deaths in three months, the first positive sign in the country’s fight against the pandemic.

On Tuesday, premier Oscar Mabuyane highlighted the recent fall-off in Covid-19 infections in the Eastern Cape and the high percentage of recoveries, also in line with national figures.

— Additional reporting by Nomazima Nkosi

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