Is South Africa Underreporting Coronavirus Deaths?South Africa's coronavirus death tally is suspiciously low [Image: Oladimeji Olaoluwa]

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Is South Africa Underreporting Coronavirus Deaths?

South Africa has more confirmed cases of coronavirus than places like Germany, the Netherlands, the UK and Canada, but is somehow reporting fewer deaths than all of them. Could this be a coincidence?

The coronavirus pandemic has spiralled out of control in South Africa, which is now reporting the 5th most cases in the world. However, their death tally seems oddly low and it should be raising a lot of questions.

According to Johns Hopkins University data, South Africa currently has 394,948 confirmed cases of coronavirus and 5,940 deaths, the 18th highest tally in the world. At first, it seems somewhat insignificant, because that would make South Africa’s mortality rate stand at 1.5%, which is right in the middle of the 1-2% bracket, which most news outlets would have you believe is pretty average. However, aside from that often cited 1-2% mortality rate being potentially misleading, we need to address the real elephant in the room: South Africa has more confirmed coronavirus cases (and we may never know how many there actually are) than countries like Italy, Spain, Germany, Canada, the UK, France and the Netherlands, but has reported fewer deaths.

How is it that South Africa, with a crumbling healthcare system that has been in crisis since long before the first patients were diagnosed with COVID-19, has been able to save more lives than Canada and other European nations, whose universal healthcare systems are the envy of the world?

An unlikely miracle

It is true that coronavirus hits older populations much harder, which is why Italy was so hard hit during the opening stages of the outbreak. The median age in South Africa is 27.1 years (26.9 for males, 27.3 for females), according to the CIA Factbook. Meanwhile the median ages in the UK, Canada, Germany and the Netherlands are 40.5, 42.2, 47.1 and 42.6, respectively.

So we could certainly attribute the discrepancies to age difference, but then we’d also have to address Iran, whose median age is far lower at 30.3, but has more than 100,000 fewer confirmed cases and almost triple the amount of deaths. Peru (median age 28 years) also has roughly 30,000 fewer cases and more than double the amount of deaths. But you can decide for yourself whether you think the age factor plays such a major role in the discrepancy between South Africa and other developing nations.

An article in Financial Times back in April suggested that the low median age on the African continent as a whole may be behind our resilience to the virus and relatively low infection count, but that was about resistance to contracting the virus, not surviving it. It had already suggested back then that it was too early to tell, and that it was a speculative assertion at best.

Others argue that, due to large parts of our populations having limited access to healthcare under normal circumstances, living in unsanitary conditions and all-in-all being exposed to diseases, deadly or otherwise, on a far more frequent basis than people living in the first world, we may have developed stronger immune systems that are more capable of withstanding this invisible enemy’s threat.

And, of course, there may still be some people such as President Ramaphosa, who will proudly suggest that the government’s response to the coronavirus outbreak was so good that we were simply better prepared than the rest of the world. Make of that what you will.

Major discrepancies

Earlier today, News24 reported on data released by researchers, which showed that there is a discrepancy of “an estimated 17 090 more natural deaths than expected between 6 May and 14 July”.

This means, not accounting for COVID-19, there were 17,000 more deaths between May and July than what would be expected from data trends. To get a full breakdown, the article is an excellent starting point, but it is important to note that excess mortality is very hard to quantify and modelling the data is complex, taking in a number of factors.

However, an excess of 17,000 is massive. Comparing that figure to the COVID-19 death toll, which is roughly a third of that, is also not a holistic way of looking at it. There are many coronavirus infected patients that may have died before reaching healthcare facilities, there are people who died from coronavirus, but whose deaths weren’t reported as such and there are people who died from non-COVID-19 related illnesses who were not able to receive adequate treatment due to over-capacitated hospitals.

Logical conclusions

Nonetheless, that discrepancy seems far too great to ignore.

President Ramaphosa’s and Health Minister Zweli Mkhize’s handling of the coronavirus outbreak has fallen far short of what can be considered acceptable, yet somehow just about right on point with what a rational South African could have expected from an ANC led government. And, given the president’s incredibly positive sentiments in his addresses to the country throughout the lockdown period, in spite of the clearly disastrous outcomes of our response to the coronavirus outbreak, would it be so far-fetched to suggest that the government is underreporting coronavirus deaths?

One cannot make an outright claims without evidence and there is a certain element of opinion being projected in the analysis – But the South African people can only apply the facts and use logic and reason to reach a conclusion about what is at play here.

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