A third of adult South Africans have been infected with Covid-19, Discovery estimates

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  • One third of South African adults have likely already been infected with Sars-CoV-2, says Discovery.
  • People between 20 and 40 years old are most likely to have had the coronavirus, with lower prevalence among those in younger and older bands. 
  • Discovery thinks the real Covid-19 death toll is around 40,000, with another 11,000 people likely to die before the end of the year.
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Discovery Health says nearly one in four South Africans – and one third of adults – have likely been infected with the coronavirus, based on an actuarial analysis of confirmed infections, recorded deaths, and the number of excess deaths recorded during the pandemic.

The health insurer’s actuarial "extrapolation” of the official infection rates and death toll, as well as the excess deaths reported by the South African Medical Research Council (SAMRC) arrived at a likely total average infection rate for the population, including children, of 22% – or 13.1 million people. 

The official death toll reached 15,168 on Wednesday, but given the high number of excess deaths in the country, Discovery estimates that the real number of Covid-19 deaths are around 40,000. It expects 11,000 more people to die before the end of the year.

Excess deaths versus the official death toll. Source: Discovery

This is line with the new “best case” scenario of the Actuarial Society of South Africa (ASSA), which sees another 12,000 deaths before the end of 2020.

Government’s swift action to implement a lockdown on 27 March probably saved 16,000 lives this year, Discovery reckons.

“There is no doubt that our early-onset lockdown delayed the country’s Covid-19 peak, gave us time to learn from globally-emergent treatment advances and availed capacity within our healthcare system to deal with the pandemic,” Ryan Noach, CEO of Discovery Health, said at a briefing on Thursday.

“However, our positive reflection on the epidemiological and clinical aspects of the lockdown does not in any way detract from the very challenging economic impacts of the lockdown.”

Discovery says the fact that South Africa implemented its lockdown just three weeks after its first confirmed Covid-19 case on 5 March, resulted in better “epidemiological outcomes” and significantly reduced the number of infections and deaths due to the Sars-CoV-2 virus. By contrast, Discovery says that the UK waited 55 days, and the US 63 days before implementing lockdown measures – and in neither case were those as stringent as in South Africa.

The swift lockdown gave South Africa time to learn from the treatment lessons of other countries, which resulted in an estimated 25% “mortality improvement”. This means that Covid-19 patients are now much less likely to die from the disease. 

At the start of the pandemic, 80% of ICU patients with Covid-19 succumbed to the disease, dropping to 60% by July and August.

Percentage of Covid patients admitted to ICU who died. Source: Discovery

This mortality improvement has already saved 10,000 lives and will save a further 6,000 by the end of next year, says Discovery.

“It is unequivocal that lockdown saved lives in respect of Covid-19,” says Noach. “We have achieved lower infection fatality rates when compared with other countries globally. The primary aim of our national lockdown – to save lives - has been achieved.”

Discovery’s analysis also found that infection rates differed widely between age groups, with working professionals between the ages of 20 and 40 most likely to be infected (at a 2.2% infection rate) due to their higher mobility and increased economic activity. Those aged between 40 and 60 had a 2% infection rate, while those aged 60 and older had a 1.3% infection rate, most likely due to efforts to curtail social interaction.

Children and young people up to age 20 had a 0.4% infection rate.

Infection rates by age. Source: Discovery

Discovery Health has 3.5 million members, or about 6% of South Africa’s population, of which 79,787 have tested positive for the virus. A total of 496,255 Discovery members, or 14% of the total, have been tested.

Nevertheless, advanced disease risk modelling of Discovery’s member base showed that people aged 60 and older have between 22% and 34% elevated risk of being admitted to hospital after contracting Covid-19, when compared to people aged 40.

Average length of stay of COVID admissions (Discovery members). Source: Discovery

Chronic conditions such as diabetes, hypertension, and hypercholesterolemia increased the risk of Covid-19 related hospitalisation by 27%, 11% and 7% respectively.

The higher the number of chronic conditions a person has the higher their Covid-19 hospitalisation risk, with Discovery members experiencing an elevated risk of admission of between 20% for one condition, and 86% for six or more chronic conditions.

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