Over 260,000 surplus deaths reported in South Africa since pandemic onset

SOUTH AFRICA – Over 260,000 more people have died in South Africa since May 2020 than expected. This is according to researchers at the Medical Research Council (MRC), who estimate that 85 to 95% of these “excess” deaths are directly from Covid.

This is nearly three times as high as the official Covid death toll published by the Minister of Health.

The problem with the official death toll is that it only includes confirmed Covid deaths in health facilities. People who die at home, in an institution like an old-age home, or before getting a Covid diagnosis, are left out of the official count.

There is now enough data to reach some interesting conclusions about how the pandemic has affected mortality.

The number of deaths in South Africa steeply rose in the late 1990s, peaking in 2004 to 2006 at about 650,000 per year. Life expectancy dropped dramatically, to about 54.

This was due to the AIDS epidemic. South Africa had (and still has) more people living with HIV than any other country in the world.

Antiretroviral medicines helped fix this dire situation. Millions of South Africans with HIV take these medicines daily and it helps them to live healthy lives with almost normal life expectancy. From 2007 to 2019 annual deaths declined and life expectancy steadily rose to about 65.

In 2020 and 2021 the number of deaths has risen dramatically. There are important differences between the way the HIV and Covid epidemics have affected South Africa.

AIDS has killed many, many more South Africans over a much longer period of time. In the mid-2000s it probably killed more people in the country annually than Covid is going to kill in 2021.

It also killed much younger people on average than Covid: 75% of Covid deaths in the country are among people over 60, while most people who died of AIDS in the 2000s were in their 20s to 40s.

AIDS still kills about 70,000 people in South Africa a year (about a quarter of its mid-2000s peak). On top of this there’s tuberculosis.

Because of the combined effect of these three epidemics, nearly as many people will die this year as in 2005 or 2006, the years with the most recorded South African deaths. 

The AIDS deaths are spread more or less uniformly over a year. But Covid comes in surges. Measured over the worst three to six-week periods (January 2021 and July 2021) the rate of Covid deaths has far exceeded AIDS deaths over any equivalent period of time.

Also, many more people contract Covid than HIV, and most people with Covid who end up in hospital survive, which was not the case for people with AIDS before antiretrovirals became widely available.

What this means is that for short bursts, Covid-19 has overwhelmed the health system far more than HIV ever did.

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