Excess Deaths Reveal Vulnerabilities Driving the COVID-19 Burden in South African Provinces

Photo: World Bank Photo Collection

Connecting Observed Data to Vulnerability

South Africa is the only African country currently reporting excess deaths across its provinces. To understand why some provinces have suffered more than others and assess which ones are being hit hard during the second wave of the pandemic, we examined relationships between the South African Medical Research Council’s (SAMRC) reported excess deaths per 100K and province-level vulnerability from the Africa CCVI. The Africa CCVI ranks 48 countries on seven types of vulnerabilities, shown here for South Africa:

Identifying Vulnerable Regions

The Africa CCVI does not predict how and where the virus will spread. Rather, it aims to capture the impact of the pandemic on regions when it does reach those areas. As such, there may be regions that are vulnerable that have been spared in the first wave. They should not fall off our radar when we plan ahead. In Figure 4, we highlight South African provinces that are vulnerable due to old age and fragility. Among those that did not experience the greatest number of excess deaths in the first wave, Limpopo is the most age-vulnerable, and Gauteng and Mpumalanga are the most fragile.

Using Our Insights to Target the Response

With the second wave of COVID-19 in full force, South Africa in particular is suffering immensely. The new coronavirus variant has resulted in an overwhelming surge of cases, scaring countries globally and pressuring policy-makers who are afraid of the negative economic impacts of another stringent lockdown. In addition, the race for the acquisition of COVID-19 vaccines could result in Africa not receiving an adequate amount of doses soon enough to meet this rapid spread. As the intensity of the second wave inevitably extends beyond South Africa, and with governments hesitant to institute strict policies, the consequences could be detrimental.

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