Excess deaths South Africa Covid-19
(Photo by Alet Pretorius/Gallo Images via Getty Images)
  • South Africa's official Covid-19 death toll stands at more than 75,000, but the real number could be around three times higher.
  • This is because excess deaths, defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions, exceed 220,000.
  • This represents 374 excess deaths for every 100,000 people in South Africa.
  • Making it one of the hardest hit countries in the world, according to the World Mortality Dataset which tracks deaths during the pandemic.
  • For more stories go to www.BusinessInsider.co.za.

It's estimated that South Africa has suffered 220,000 excess deaths – roughly three times the total number of confirmed Covid-19 fatalities – since May 2020.

Excess deaths are defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions, according to the World Health Organisation (WHO). Within the context of the Covid-19 pandemic, excess mortality accounts for both the total number of deaths directly attributed to the virus as well as the pandemic's indirect impact.

The South African Medical Research Council (SAMRC) tracks local excess deaths and has been publishing weekly reports on fatalities during the pandemic. These reports compare weekly deaths recorded on the National Population Register with forecasts based on historical data from 2014 to 2019.

The discrepancy in confirmed Covid-19 deaths and excess natural deaths is attributed to underreporting of the underlying cause of death, especially in cases of home-based fatalities, according to a study conducted by the SAMRC and the University of Cape Town's (UCT) Centre for Actuarial Research.

Collateral deaths caused by the strain on medical resources during particularly devastating waves of Covid-19 infections are also considered.

It's estimated that between 85% and 95% of excess natural deaths are attributable to Covid-19, with the remainder a result of collateral causes, according to the report published by the SAMRC and UCT in February.

Of the 222,521 excesses deaths recorded by the SAMRC between May 2020 and July 2021, more than half have occurred in the past seven months. This represents 374 excess deaths for every 100,000 people in South Africa.

Excess deaths South Africa Covid-19
Excess death data from the South African Medical Research Council.

And while there is no global standard for estimating excess deaths, the World Mortality Dataset tracks deaths from all causes across 103 countries to better understand the true cost to human life resulting from the Covid-19 pandemic. Large parts of Asia and Africa are not represented due to a lack of information, according to the dataset's developers, Ariel Karlinsky and Dmitry Kobak.

But of the more than 100 countries represented, South Africa's excess date rate ranks among some of the worst in the World Mortality Dataset which sources its information directly from the SAMRC.

The slightly delayed dataset lists South Africa's excess mortalities as 210,000. This represents a rate of 42% – as the percentage increase over the baseline of forecasted deaths – as the eighth highest in the world.

Excess deaths South Africa Covid-19
Top-10 countries in the World Mortality Dataset according to different metrics (only countries with over 500,000 population are shown). Last updated 9 August 2021.

In terms of the number of excess deaths per 100,000 people per year, South Africa's total – as of July – of 350 places it as the ninth highest recorded on the World Mortality Dataset.

By comparison, while the United States has the highest number of excess deaths – estimated at 650,000 – this is more closely aligned to the country's actual Covid-19 death toll of 618,000, which in turn represents 200 deaths per 100,000 people.

Developing nations in South America and Eastern Europe record the highest rates of excess deaths as a percentage increase above the forecast and per 100,000 people. Scandinavian countries and island nations have of the lowest excess death estimates.

(Compiled by Luke Daniel)

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