South Africa could see 40 000 Covid-19 deaths by November

Covid-19 could claim up to 40 000 lives in South Africa, according to experts. 

By Laura Lopez, Johannesburg

South Africa is likely to see about 40 000 deaths from Covid-19 by November, according to mathematical modelling released late on Tuesday.

And the country will quickly run out of hospital beds to treat patients.

Scientists now predict that the country will reach the 30 000 mark in diagnosed Covid-19 cases by the end of the month.

South Africa had recorded its first case of the new coronavirus on March 5. It was only a matter of days before journalists and the public alike began to clamour for the mathematical modelling the government was using to prepare for an uncertain future with a virus that globally was just months’ old. 

On Tuesday evening, Health Minister Zweli Mkhize — together with researchers — finally released the sobering projections compiled by teams from the University of Cape Town (UCT), University of the Witwatersrand and Stellenbosch University. 

Health economists and epidemiologists have partnered to produce predictions about the epidemic’s course and cost in the past six weeks. Modellers have projected best-case and worst-case scenarios that are now being used by national and provincial government departments for planning, including budgeting and the procurement of essential medical supplies. 

Even in an optimistic course of events, the country faces tens of thousands of deaths in the coming months as the epidemic peaks in July or August, scientists revealed. Pessimistic projections, meanwhile, place the death toll closer to 50 000.

But, regardless of whether the country follows the best-case or worst-case projections, one thing is sure: South Africa’s roughly 3 300 hospital beds in intensive care units (ICUs) in the public and private sector combined are not going to be enough. 

“Whether we are going to follow the optimistic trajectory of the epidemic or the pessimistic trajectory of the epidemic, the threshold of ICU beds [that we have] is going to be exceeded,” UCT senior lecturer in statistical sciences and modeller Sheetal Silal said. 

Our ICU beds could be overwhelmed as soon as early June — and that this is particularly likely in the Western Cape. 

When this happens, patients in need of ICU beds will have to be accommodated in other wards, and Silal warned this surge in needed beds was likely to outstrip the country’s capacity.

Two-thirds of the country’s ICU beds are in the private sector, explained health economist Gesine Meyer-Rath from the Health Economics and Epidemiology Research Office at Wits.

The government has already been in talks with private hospital groups to be able to pool hospital-bed capacity during the outbreak. This would allow it to place patients without medical aid in private beds if needs be. However, details about what the private sector is expected to charge the government for this plan have not been made public.

In March, several major hospital groups in KwaZulu-Natal, including Netcare, Mediclinic and Akeso, pledged to donate beds to the national response free of charge.

But, because the need for beds outstrips supply, healthcare workers are likely to be forced into making tough triage decisions about allocating beds and other essential equipment. 

The South African Medical Association and other professional bodies have already issued guidelines about how to triage patients. Wary of leaving doctors and nurses to shoulder the burden of making life or death choices about the rationing of care during the outbreak, private and public hospitals are working to revitalise the hospital ethics boards that should be making these kinds of calls.