Official figures say there have been 55,000 covid deaths in South Africa since March 27th last year. That puts the country’s death rate at 92.7 per 100,000 people, the highest in sub-Saharan Africa. It is also a significant underestimate—as, it seems safe to infer, are all the other African data on the disease.
Over the year to May 8th the country recorded 158,499 excess deaths—that is, deaths above the number that would be expected on past trends, given demographic changes. Public-health officials feel confident that 85-95% of those deaths were caused by sars-cov-2, the covid-19 virus, almost three times the official number. The discrepancy is the result of the fact that, for a death to be registered as caused by covid-19, the deceased needs to have had a covid test and been recorded as having died from the disease. Although South Africa does a lot of testing compared with neighbouring countries, its overall rate is still low. And the cause of death is unevenly recorded for those who die at home.
South Africa is not particularly unusual in its levels of testing or in missing deaths outside the medical system. Excess mortality has outstripped deaths officially reported as due to covid-19, at least at some points in the course of the epidemic, in most if not all of the world. According to the most recent data, America’s excess deaths were 7.1% higher than its official covid-19 deaths between early March 2020 and mid-April 2021.
