The government’s swift action in imposing a hard lockdown within weeks of SA’s first coronavirus case will have averted 16,000 deaths by the end of the year, according to an analysis by SA’s biggest medical scheme administrator, Discovery Health.
Its modelling projects 51,000 deaths from Covid-19 by the end of the year, a figure that would have been 25% higher if there had not been such stringent measures to curb transmission of Covid-19. Its mortality estimates are broadly in line with the Actuarial Society of SA, which said earlier this week that its latest model projects between 27,000 and 50,000 deaths from Covid-19 this year.
The government has faced fierce criticism over the economic costs of the lockdown, which has seen businesses shuttered and massive job losses. SA’s GDP contracted 16.4% on a non-annualised basis in the second quarter, with the economy now stuck in its longest recession since the end of apartheid.
SA’s first case of Covid-19 was confirmed on March 5, and the country went into a hard lockdown three weeks later with all but essential workers ordered to remain at home except for vital trips to buy food or seek health care.
SA’s approach stood in sharp contrast to that of many European countries, such as Italy and the UK, which imposed lockdowns only when hospitals were already overwhelmed.
SA’s restrictions on people’s movement and mass gatherings helped slow the rate of infection and spread cases out over a longer period, buying time to ramp up health-care capacity and take advantage of developments in the treatment of patients, said Discovery Health chief actuary Emile Stipp.
"There are clear signs that SA has effectively navigated the peak of the pandemic with staggered hot-spot outbreaks resulting in longer, flatter regional peaks and lower infection fatality rates than the global experience," he said.
Analysis of claims data from members of Discovery Health’s client schemes, which include Discovery Health Medical Scheme, showed the mortality rate among Covid-19 patients admitted to an ICU had improved by 25% since the start of the pandemic, dropping from 80% to 60%, said Stipp.
SA was able to take advantage of improvements in care, such as putting patients on their stomachs and using high-flow nasal oxygen instead of mechanical ventilation.
Discovery Health CEO Ryan Noach acknowledged that the company’s analysis did not consider the economic effect of the lockdown or the cost of deferred health care.
The administrator has seen a 51% decline in claims from medical scheme members for mammograms between April and July compared with the corresponding period last year. There was a 42% drop in wellness tests that screen for lifestyle-related conditions such as diabetes and hypertension.
Discovery Health estimates that 13-million South Africans, or 22% of the population, have already been infected with Covid-19. Most of these people will have had very mild or asymptomatic infection.
These findings are broadly consistent with a recent seroprevalence survey conducted in the Western Cape, which found 37% of pregnant women and 40% of people with HIV using public sector clinics in Cape Town had antibodies to SARS-CoV-2, the virus that causes Covid-19.
The official tally of confirmed Covid-19 cases stood at more than 642,000 by Wednesday, but this figure is widely acknowledged to be an undercount, partly due to testing constraints.
Discovery Health’s analysis found Covid-19 transmission rates to be highest among the younger working population (aged 20 to 40), and among people working in the health-care and government sectors.
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