In the context of the emerging COVID-19 pandemic, it has become essential to track the weekly number of deaths that occur. Deaths recorded on the National Population Register are provided to the SAMRC on a weekly basis. These have been scaled up to estimate the actual number of deaths by accounting for the people who are not on the population register and the under-registration of deaths. The methodology for the adjustment and predicted values have been changed to enable monitoring in 2021 and the reporting week has been changed to an ‘epi-week’ that runs from Sunday to Saturday. The estimated numbers are compared with the number that would be expected based on the historical data from 2014-2019 (see Methodological Note for more details). The number of deaths of persons 1-year and older are reported because birth registration was put on hold during lockdown stage 5 affecting the number of infant deaths recorded on this system. The start date of each week is represented on the graph.
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Estimated number of excess natural deaths and death rates by province and metro, South Africa 2020/2021 (all ages)
One approach to aid understanding of the emerging COVID-19 mortality is to compare the estimated weekly excess deaths with the number of COVID-19 deaths reported by the Minister of Health as shown in the figure below. This comparison is hampered to some degree by the fact that the excess deaths are classified by week in which the death occurred; the reported COVID-19 deaths are classified by date the numbers are reported to the Department. If all excess natural deaths were due to COVID-19, and all COVID-19 deaths were perfectly identified and reported, the two series would be identical. The number of estimated excess deaths has begun to decrease, consistent with the trend in the number of confirmed COVID-19 deaths. Although more data are needed on the underlying causes of death, this observation is strongly supportive that a significant proportion of the current excess mortality being observed in South Africa is likely to be attributable to COVID-19.
The P-Score is another measure frequently used to describe excess mortality on a weekly basis. It is the percentage change in the number of deaths from the expected number for that week. Negative values below 0% reflect a deficit in deaths while positive values reflect an increase. This graph shows the percentage change between the estimated number of deaths from natural causes and the predicted number based on the historical data.