COVID deaths in South Africa: 99 days since South Africa’s first death

Wyk, Victoria Pillay-van; Bradshaw, Debbie; Groenewald, Pam; Seocharan, Ishen; Manda, Samuel; Roomaney, R A; Awotiwon, O F; Nkwenika, Tshifhiwa; Gray, Glenda; Buthelezi, Sizakele; Mkhize, Z L

doi:10.7196/samj.2020.v110i11.15249

Cited by 29 publications

(36 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This drop in the number of natural deaths resulted in the development of the adjustment to the base to calculate the excess natural deaths. The 60 -69-year-olds were most affected at the peak of the surge, accounting for 28% of the excess natural deaths, the highest proportion of all 10-year age groups, and similar to the proportion of confirmed COVID-19 deaths in the first months of the pandemic (26%), [23] as well as deaths reported on the hospital surveillance system by the end of 2020 (27%). [24] It is possible that excess deaths due to COVID-19 occurred earlier in this age group than in other age groups, obscuring any drop in the number of deaths resulting from lockdown.…”

Section: Discussionmentioning

confidence: 85%

“…Government is urged to improve the cause-of-death information system going forward so that the current and long-term impact of the pandemic can be assessed more fully and information to prioritise responses can become available. [23] In particular, it is essential to ensure that the NDoH has access to cause-of-death information at the time of death registration to inform public health actions. [29] Declaration.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tracking mortality in near to real time provides essential information about the impact of the COVID-19 pandemic in South Africa in 2020

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background. Producing timely and accurate estimates of the impact of COVID-19 on mortality is challenging for most countries, but impossible for South Africa (SA) from cause-of-death statistics. Objectives. To quantify the excess deaths and likely magnitude of COVID-19 in SA in 2020 and draw conclusions on monitoring the epidemic in 2021. Methods. Basic details of deaths registered on the National Population Register by the Department of Home Affairs (DoHA) are provided to the South African Medical Research Council weekly. Adjustments are made to the numbers of weekly deaths to account for non-registration on the population register, as well as late registration of death with the DoHA. The weekly number of deaths is compared with the number predicted based on the Holt-Winters time-series analysis of past deaths for provinces and metropolitan areas. Excess deaths were calculated for all-causes deaths and natural deaths, using the predicted deaths as a baseline. In addition, an adjustment was made to the baseline for natural deaths to account for the drop in natural deaths due to lockdown. Results. We estimated that just over 550 000 deaths occurred among persons aged ≥1 year during 2020, 13% higher than the 485 000 predicted before the pandemic. A pronounced increase in weekly deaths from natural causes peaked in the middle of July across all ages except <20 years, and across all provinces with slightly different timing. During December, it became clear that SA was experiencing a second wave of COVID-19 that would exceed the death toll of the first wave. In 2020, there were 70 000 -76 000 excess deaths from natural causes, depending on the base. Using the adjusted base, the excess death rate from natural causes was 122 per 100 000 population, with a male-to-female ratio of 0.78. Deaths from unnatural causes halved for both males and females during the stringent lockdown level 5. The numbers reverted towards the predicted number with some fluctuations as lockdown restrictions varied. Just under 5 000 unnatural deaths were averted. Conclusions. Tracking the weekly numbers of deaths in near to real time has provided important information about the spatiotemporal impact of the pandemic and highlights that the ~28 000 reported COVID-19 deaths during 2020 substantially understate the death toll from COVID-19. There is an urgent need to re-engineer the system of collecting and processing cause-of-death information so that it can be accessed in a timely way to inform public health actions.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Tracking mortality in near to real time provides essential information about the impact of the COVID-19 pandemic in South Africa in 2020

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…[3] Recent US database studies found, in their population, higher COVID-19 mortality rates among people with psychiatric [11,12] or substance use disorders [13] compared with those without such disorders. As with the study by Pillay-van Wyk et al, [2] their findings are dependent on accurate death records. While such accuracy is lacking for most conditions in SA, it is particularly so for mental disorders.…”

mentioning

confidence: 76%

“…

Mental illness: South Africa's blind spotTo the Editor: The articles by Odendaal et al [1] and Pillay-van Wyk et al [2] indicate poor recognition of mental illness and its complex interplay with physical health in South African (SA) research. While Odendaal et al [1] screened for depression in pregnant women, the relationship between mental illness and persistent smoking was not explored and the possible need to tailor interventions to perceptual, cognitive or personality functioning was not discussed.

…”

mentioning

confidence: 99%

“…While Odendaal et al [1] screened for depression in pregnant women, the relationship between mental illness and persistent smoking was not explored and the possible need to tailor interventions to perceptual, cognitive or personality functioning was not discussed. Pillay-van Wyk et al [2] include mental illness among 'other' comorbidities in COVID-19 deaths, but do not mention substance use. Furthermore, they do not discuss the low prevalence of these comorbidities among COVID-19 deaths, although it is an unexpected finding given the excess mortality associated with mental disorders.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Mental illness: South Africa’s blind spot

Robertson

2021

S Afr Med J

View full text Add to dashboard Cite

Mental illness: South Africa's blind spotTo the Editor: The articles by Odendaal et al. [1] and Pillay-van Wyk et al. [2] indicate poor recognition of mental illness and its complex interplay with physical health in South African (SA) research. While Odendaal et al. [1] screened for depression in pregnant women, the relationship between mental illness and persistent smoking was not explored and the possible need to tailor interventions to perceptual, cognitive or personality functioning was not discussed. Pillay-van Wyk et al. [2] include mental illness among 'other' comorbidities in COVID-19 deaths, but do not mention substance use. Furthermore, they do not discuss the low prevalence of these comorbidities among COVID-19 deaths, although it is an unexpected finding given the excess mortality associated with mental disorders. [3] In pregnancy, mental disorders are associated with preterm delivery, low birth weight, hypertension, gestational diabetes and neonatal morbidity. [4][5][6] The extent to which these outcomes are mediated by smoking and/or social deprivation is unknown. Smoking is more prevalent among people with mental illness (PWMI) than in the general population, with more intense addiction and reduced response to population-level interventions. [7,8] Mental illness is also associated with social deprivation. The association between persistent smoking and social deprivation found by Odendaal et al. [1] is similar to that found in Canada among PWMI, [9] and is consistent with the well-documented mental health/poverty cycle [10] (related to social exclusion as well as social and/or occupational impairment).While mental healthcare may improve socioeconomic outcomes among PWMI, [10] it alone does not reduce smoking. Neither does education. However, behavioural and pharmacological interventions may. Prochaska et al. [8] discuss the application of the Host-Agent-Vector-Environment (HAVE) public health model to smoking cessation among PWMI. The four domains of this application are: • 'Host -tobacco user characteristics (e.g. biobehavioural, social/ cognitive, mental health). • Agent -tobacco product characteristics (e.g. nicotine content, delivery, flavourings). • Vector -tobacco industry efforts (e.g. research, develop ment, advertising, distribution). • Environment -broader community and policy structures (e.g. taxation, smoking bans, insurance coverage, retailers). ' [8] This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

show abstract

Risk Factors for COVID-19 Mortality Among People Living with HIV: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

People living with HIV (PLWH) are particularly vulnerable to worsened outcomes of COVID-19. Therefore, the purpose of this work was to provide a scoping review of the literature to assess the risk factors for COVID-19 mortality among PLWH. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. Articles were eligible for inclusion if they were in English, included PLWH who died after COVID-19 infection, and described risk factors for mortality. Results were descriptively synthesized and pooled thereafter. Study quality was assessed using the Joanna Brigg Institute’s critical appraisal tools. 20 studies were eligible for inclusion, with the pooled death rate being 11.7%. Age was a major risk factor, especially after 50 (23.2%) and after 70 (41.8%), and males had a death rate nearly double that of females. As total comorbidities increased, the death rate also greatly increased; among those with comorbidities, the highest fatality rates were those with cardiovascular disease (30.2%), chronic kidney disease (23.5%), obesity (22.4%), and diabetes (18.4%). Other risk factors for mortality among PLWH included having a Black racial background, being an injection drug user, being a smoker, and having a CD4 cell count below 200. There is a need to better study confounding factors, and to understand how vaccination influences mortality risk. Overall, the findings highlight a need to ensure that focus is placed on the varying demographics of PLWH amidst COVID-19 control efforts.

show abstract

COVID deaths in South Africa: 99 days since South Africa’s first death

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 29 publications

References 5 publications

Tracking mortality in near to real time provides essential information about the impact of the COVID-19 pandemic in South Africa in 2020

Tracking mortality in near to real time provides essential information about the impact of the COVID-19 pandemic in South Africa in 2020

Mental illness: South Africa’s blind spot

Risk Factors for COVID-19 Mortality Among People Living with HIV: A Scoping Review

Contact Info

Product

Resources

About