[imagesource: Brendan Magaar/African News Agency]

Whilst South Africa’s confirmed COVID-19 numbers continue to spike, it is worth making one or two important points.

Firstly, we passed the 300 000 confirmed cases mark yesterday, adding 12 757 new infections, with the death toll rising to 4 453.

However, the number of active cases (total confirmed cases, 311 049, minus deaths, and recoveries, which is 160 693) is 145 903, which, whilst still far higher than we would have hoped for, does make for slightly better reading.

Still, we now rank eighth in the world for confirmed cases, and our healthcare system is collapsing in certain parts of the country, so let’s not forget we’re deep in the dwang.

To further drive home the point, News24 reports that we are now recording new COVID-19 cases every day “at a rate higher than any other country in the world when reported COVID-19 infections are compared by population size”.

That’s using data for the week ending July 13, when we recorded 19,6 cases per 100 000 citizens.

News24’s graphics, designed by Rudi Louw, put that into perspective:

Only Peru has ever recorded a higher infection rate per 100 000 citizens, and their graph is now on a downward trajectory, whereas ours still shows a steep incline.

It is true that we are testing more than some other countries, which explains the higher confirmed cases number, but not all:

News24 has more informative graphics here, but let’s finish with one that illustrates how our mortality rate (deaths per 100 000 citizens) is significantly lower than many other countries:

So, what are the possible reasons behind why our mortality rate is so much lower than countries with healthcare systems that aren’t falling apart at the seams?

The explanations offered by scientists as to why the death rate is so low compared with European countries has varied – but a leading theory is that Covid-19 is yet to spread to vulnerable communities where access to healthcare and living conditions do not provide opportunity for social distancing.

South Africa also has a comparatively young population, and death trends observed in other countries and here show older people are at higher risk of falling seriously ill from the Covid-19 disease.

The first explanation seems a bit off to me, and is based in part off a Daily Maverick article from back in April, when the pandemic was still in first gear here in South Africa.

Earlier this month, epidemiologist Professor Andrew Boulle looked at Cape Town’s COVID-19 mortality rate, and in particular certain poverty-stricken areas of the city.

The numbers painted a grim picture, with Boulle stating that “if the Western Cape were a country and we compared it to other countries, at this point globally we might be one of the countries with the highest daily mortality rates”.

The Daily Maverick’s breakdown of South Africa’s population age demographics, though, remains important:

Another factor that may explain differing CFRs [case fatality rates] across countries is the proportion of the population above, say, age 55. In SA that proportion is 13%. In the UK it is 31%. The higher proportion of older people will result in more deaths for the same number of infections.

Dr Max Price, the former vice-chancellor of the University of Cape Town and a medical doctor, wasn’t convinced that was the sole reason, and also raised the issue of BCG, the anti-TB vaccine:

The theory is that South Africa, and many other developing countries and also Portugal, have high BCG vaccination levels and low Covid-19 infection and death rates, whereas the reverse is true for the US and many European countries including Portugal’s neighbour, Spain. However, the data to support this is suspect.

At present, both the TB BCG vaccine and the ChAdOx1 nCoV-19 vaccine are in Phase II clinical trials in South Africa.

You can read Price’s full article here.

Whilst there are many theories around our low mortality rate, uncertainties remain, and concrete evidence is hard to come by at this point.

Whatever the reason, long may it continue, because the number of new infections daily is a reminder that we are only now starting to see the extent of the pandemic’s spread.

[sources:news24&dailymaverick]