South Africa’s Covid-19 cases may be at 12 million

A medical expert is questioning the accuracy of South Africa’s Covid-19 statistics, claiming that studies pointed to coronavirus-related deaths being under-reported.

According to Dr Gilles van Cutsem of Doctors Without Borders, many people were dying of Covid-19 without being tested for the virus, casting doubts on the correctness of the numbers provided daily by the department of health.

Van Cutsem explained: “It is very difficult to estimate the exact number of cases and mortality, because only a fraction of cases are reported. Accurate reporting of deaths can only be done after several days, as deaths are not always reported immediately.

“There is work underway to put together data from all the serosurveys [blood serum tests done in a group of individuals to determine seroprevalence] important for giving an estimate of the real number of people who have been infected. The World Health Organisation has cited a global estimate of less than 10% of the world population.

“A recent serosurvey in the Western Cape found that 40% of the population sampled had been infected, estimating this to be in the upper bounds of possible prevalence. The minister of health has cited 20% as a credible estimate of people who have had Covid-19 in South Africa, translating to a total of 12 million cases, compared to the 696,000 reported.”

Asked if he agreed there was statistical under-reporting by government, health spokesperson Dr Lwazi Manzi referred The Citizen to a statement issued last week by Minister of Health Dr Zweli Mkhize, who noted there had been a “noticeable increase in the number of deaths recently which caused us concern as we have received reports from the Medical Research Council (MRC) that there have been no excess deaths for three weeks in a row”.

“We, therefore, consulted the provinces to ascertain the reason for the increased numbers.

“We have received reports that the provinces are implementing the recommendations of the MRC to reconcile the data with home affairs deaths data. In addition, provinces are auditing the deaths data, either by mining data from the DATCOV surveillance reports [a hospital monitoring system] and identifying unreported deaths, or auditing the facilities on the ground.

“We welcome this robust refinement of data collation as it reassures us that, moving forward, we exercise precision in epidemiological surveillance.”

Referring to government’s extension of the national state of disaster for another month, Van Cutsem cited a “need to ethically and legally balance public health with civil liberties”. With some people not adhering to health protocols, he warned “a second wave” was “definitely still a possibility if people decrease the application of prevention measures”.

“During the European summer holidays, we saw the reopening of night clubs and bars, which saw a multiple congregation of people, superspreader events which facilitated a second wave of community transmission,” he said.

Tygerberg Hospital infectious disease specialist and University of Stellenbosch academic Dr Jantjie Taljaard, who has been at the coalface of this pandemic, said government’s state of disaster extension was “understandable, because it is difficult to predict what is going to happen in the next month or two”.

In the absence of a vaccine, Taljaard said an increase in numbers of those infected was “inevitable” in SA. “Had government stopped the state of disaster now, to reinstate it a month or two later would be very disruptive.”

While a second wave of infections was possible, Wits University infectious disease specialist Dr Jeremy Nel said: “The second wave is unlikely to be anywhere near as big as the first wave. The limited data South Africans have suggests a large proportion of South Africans have already been infected. In the Western Cape, the proportion of people attending clinics with evidence of infection was about 40%. To the extent these numbers are representative of those elsewhere in the country, a large second wave is very unlikely in the short-term.

“If so many people were infected the first time around, there likely are not enough people still susceptible to the virus for there to be a big second wave – at least for as long as immunity lasts.”

– brians@citizen.co.za

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