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According to the latest research by the South African Medical Research Council (SAMRC), South Africa’s death toll is at a much higher rate than expected as Covid-19 continues to spread at a significant pace in at least three provinces.

Professor Debbie Bradshaw, a co-author of the report, said the "timing and geographic pattern leaves no room to question whether this is associated with the Covid-19 epidemic".

Excess deaths between 6 May and 14 July topped 17,000, according the University of Cape Town's Centre for Actuarial Research.

"In the past weeks, the numbers have shown a relentless increase – by the second week of July, there were 59% more deaths from natural causes than would have been expected based on historical data. It also means that reported deaths have shown a pattern that is completely different to those indicated by historical trends," the SAMRC said in a statement on Wednesday.

"However, the weekly death reports have revealed a huge discrepancy between the country's confirmed Covid-19 deaths and the number of excess natural deaths," Bradshaw added.

According to the researchers, the excess deaths is calculated using the number of reported deaths from the National Population Register (NPR), which is maintained by the Department of Home Affairs. The team uses documented weighting methods to account for multiple variables that could affect the true number of deaths other than what is reported in the NPR data.

"Some analysts take the excess above the expected number based on historical data, while others take the number above a threshold such as the upper prediction bound i.e. significantly higher than expected," the SAMRC said in a statement on Wednesday.

"In general, these excess deaths are calculated using all-cause mortality. It is considered that excess deaths would comprise Covid-19 deaths that are confirmed, Covid-19 deaths that have not been confirmed, as well as other deaths that may arise from conditions that might normally have been diagnosed and treated had the public been willing and able to access health care."

Authors took note of the uncertainty about the exact number of excess deaths during an information sheet shared along with the latest report. They said the uncertainty came from having to estimate not only the actual number of deaths, but also the possibility of what would have happened without the Covid-19 pandemic.

"We have reported the challenges that we face and the method that we have used. Our estimate excess natural deaths could be revised should an improved method be identified. However, given the timing and geographic spread of the increases seen in the natural deaths, there can be no doubt that the bulk of the increase is related directly or indirectly to Covid-19."

SAMRC stated that they are still facing the challenge that "South Africa had a stringent lockdown in the very early stage of the epidemic and that unnatural deaths are a higher proportion of the all-cause mortality [and were impacted very significantly by the stringent lockdown], the SAMRC-UCT team thought it was necessary to use a different approach".

The SAMRC explained in their statement that; "to quantify the impact of the Covid-19 epidemic on South African deaths, it was decided to focus on deaths from natural causes and remove the impact of changes in the unnatural deaths."

The team thought it best to consider the fact that the lockdown had reduced the number of natural deaths, and thereof a baseline was chosen that was consistent with the level that the number of natural deaths was tracking prior to the uptick in the trend.

Bradshaw also added the weekly death reports have contributed important information to complement other data on the unfolding of the epidemic.

"The report was able to confirm that no epidemics had occurred prior to the first Covid-19 cases identified by the National Institute for Communicable Diseases (NICD) and the country's first death announced by Health Minister Dr Zweli Mkhize in March. It was through these reports that the early growth of the epidemic in Cape Town and the Western Cape was confirmed, followed by the spread in Nelson Mandela Bay and the Eastern Cape."

As of 14 July, the number of deaths from unnatural causes such as car accidents and murders was 20% below expected totals.

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