COVID deaths among older persons in South Africa have been significantly underestimated

By Gabrielle Kelly, The Samson Institute for Ageing Research, South Africa

South Africa has experienced the highest burden of COVID-19 mortality in Africa, with 41 797 deaths officially reported as of 27 January 2021. However, the 112,280 excess deaths reported since May 2020 in the South African Medical Research Council (SA MRC) Report on Weekly Deaths demonstrate that the impact of the pandemic has been far greater than official COVID-19 statistics indicate.

National COVID-19 mortality data disaggregated by age is not publicly available past June 2020. However, the SA MRC report indicates that between 2 May 2020 and 16 January 2021, there were almost 84,906 excess natural deaths among persons older than 60. A significant proportion of these deaths are likely to be directly attributable to COVID-19 or the combined effects of decreased access to health care and decline in physical function, cognitive decline and mental health due to social isolation and inactivity brought about by lockdown and social distancing requirements.

Infection and mortality rates are likely to be highest among persons residing in long-term care facilities and, according to Cowper et al (2020), NICD sentinel surveillance and long-term care facilities showed infection rates of around 10% among residents and 12% among staff in the first wave of the pandemic (rates which are likely higher in the more aggressive second wave).

Given these devastating direct and indirect impact of COVID on older persons, there is an urgent need to pay attention to policies and practices for managing COVID-19 among this population group, and in LTC facilities in particular.