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  • The Actuarial Society of South Africa (ASSA) has updated its model of expected deaths in South Africa due to Covid-19.
  • Under its most optimistic scenario in April, ASSA expected more than 48,000 South Africans would die from Covid-19.
  • It is now painting a more positive picture - though thousands could still die.
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The Actuarial Society of South Africa (ASSA) has just released an updated model of how many people may die from Covid-19 in South Africa – and it paints a much more optimistic picture than a couple of months ago.

At the end of April, ASSA warned that according to its projections 48,000 South Africans would die from Covid-19 by end-August – “if government does not maintain a strict approach to flattening the curve”.

In the end, South African continued with a stringent lockdown for many months, and deaths were still below 15,000 by Monday this week. This is the thirteenth highest death toll in the world, but adjusted for population size, South Africa is in the 23rd position. Fewer than 260 South African per million have died, far below countries like the UK (612 per million) and US (570 per million).

In April, ASSA’s “most optimistic scenario” held that 48,300 people would die, in total, in South Africa. That assumed government interventions would succeed, with a reduction in the reproduction numbers to 1.5, meaning the average coronavirus carrier would infect only 1.5 other people.

This week an updated version of ASSA’s Covid-19 model, which takes into account new research, as well as the effect the lockdown had on the spread of the coronavirus and mortality rates, was released.

While 30 different scenarios were modelled, the organisation highlighted two scenarios.

The first assumes low infection rates due to the lockdown, and that mortality per million peaks at 481. The model includes that 75% of those infected with Covid-19 remains asymptomatic. Under this best-case scenario, South Africa would have 27,000 dead by the end of the year.

"Of the published scenarios produced that is the lowest number," says Barry Childs, chair of ASSA's Healthcare Committee. "It is possible to produce lower numbers using the model, but the need to make allowance for some portion of excess deaths being due to Covid-19 makes lower numbers unlikely."

In the second scenario, only 35% of those who do get infected are asymptomatic. There are moderate levels of interactions between infected and uninfected people, and local mortality per million spikes to 876 – which is currently among the highest in the world – leaving 50,000 dead by year-end.

Lusani Mulaudzi, president of ASSA, says one of the key changes in its models was around the levels of susceptibility to the coronavirus. While the original version assumed that everyone was equally at risk of contracting the virus and developing Covid-19, the revised version of the model allows for different contact and infection rates.

“The reality is that not everyone comes into contact with the same number of people, and not everyone is equally susceptible to becoming ill after coming into contact with the virus.”

Also, the first ASSA model assumed that 75% of the population would remain asymptomatic, but the updated version introduces a range of percentages of the population contracting the coronavirus without developing symptoms.

But ASSA warns that while its new model is fitted to death data published daily by the National Institute for Communicable Diseases (NICD), the official death count is most likely understated.

By last month, the South African Medical Research Council recorded nearly 40,000 “excess deaths” (the number of people who died over and above what was expected) in the country. These fatalities are not officially recorded as being due to Covid-19.

Mulaudzi points out that the true number of deaths probably lies between the NICD figures and the reported excess deaths. He says future work on the model will look at using adjusted death rates.

The article has been updated with Barry Childs' comments.

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