A spike of people dying from “natural causes” has prompted fears one country’s actual coronavirus death toll is much higher than figures indicate.
South Africa, the worst affected country in Africa, witnessed some 17,000 extra deaths from natural causes or 59 per cent more than would normally be expected between early May and mid-July, scientists said, suggesting many more people are dying of COVID-19 than shown in official figures.
New data by the South African Medical Research Council (SAMRC), released overnight, showed that just in the week to July 14 there was an excess of 5,022 deaths by natural causes, about half more than usual.
Africa's most industrialised nation is in the middle of a runaway epidemic of the coronavirus, with cases increasing by more than 10,000 each day, or more than 400,000 in total.
Its recorded death toll is low, with just over 6000 deaths.
Debbie Bradshaw, chief specialist scientist at the government-funded research council, said the figures revealed "a huge discrepancy" between the confirmed COVID-19 death toll and the excess natural deaths.
Richard Lessells, an infectious disease specialist at the KwaZulu-Natal Research Innovation and Sequencing Platform in eastern South Africa, said the figures were not surprising because the same pattern could be seen in other countries.
It could partly reflect other knock-on effects in the health system, such as "if I have a stroke at home and my family decide they don't want to take me to hospital because it's too risky and I die at home."
Planning funerals a ‘nightmare’ for families
Under new regulations, mourners have a maximum of two hours to collect the body and bury it to avoid congestion at graveyards and limit the spread of COVID-19.
The change has been deeply traumatic in South Africa, where family honour, dignity and the instinct to renew human bonds make funerals long and elaborate affairs.
The time between death and burial is traditionally a week or more, so that mourners can travel from different parts of the country or from abroad, to come and collectively grieve.
Today, the remains of a coronavirus victim are interred within three days - and disposal is swift, clinical and mindful of social distancing.
Modise Motlhabane was still in his early 40s when he became the latest of South Africa's mounting fatalities from coronavirus.
"It was too quick," said Charles Motlhabane, 32, after the burial of his older brother.
Organising the funeral was "a nightmare," he said.
On the way to the cemetery, the hearse drove briefly by the family home in Soweto.
It parked on a narrow street while mourners gathered from metres away, and a priest shouted out a prayer. The vigil lasted just 10 minutes before the hearse moved on.
Clinical psychologist Thandeka Mvakali said denial of traditional mourning rituals would wreak an emotional toll for many.
"People's grieving could be complicated by the inability to do a grand and beautiful send off, (and) that could come with feelings of guilt that my loved one deserved more than this," Mvakali said.
Final rites are "all about reaching closure," which includes details such as flowers and personal mementoes, she said.
A coronavirus ‘storm’
South Africa is among the top five countries in the world in terms of confirmed cases, with more than 400,000 infections reported to date.
It is now in the midst of the long-forecast coronavirus "storm".
On Wednesday the virus death toll jumped by a record 572 over the previous 24 hours, taking the total of fatalities to 5940.
But experts suggest this could be an understatement.
The South African Medical Research Council (SAMRC) reported on Wednesday a 60 per cent increase in overall numbers of "natural" deaths in recent weeks.
"The weekly death reports have revealed a huge discrepancy between the country's confirmed COVID-19 deaths and number of excess natural deaths," said its lead author, Professor Debbie Bradshaw.
Epicentre has the capacity to bury one million
Police have been deployed at the entrance of cemeteries to ensure an orderly traffic flow and control the numbers of mourners entering, and funeral parlours say they are nearly bursting at the seams.
At AVBOB Funeral Service in Soweto, branch manager Gladwin Madlala was busy attending to a handful of mourners that had come to view a body.
"Normally this time (of the year) we are having plus or minus 16 to 18 bodies in the fridge. But currently we are sitting with more than 30," he said.
"At some point about a week ago, we were sitting at our full capacity, which is 44 bodies in the fridge. In fact it has doubled."
Johannesburg, currently the virus epicentre in South Africa, has a capacity to bury around a million people.
Reggie Moloi, the City of Johannesburg's cemeteries manager, told AFP that COVID-19 deaths for the whole of the month of April tallied six.
In the first three weeks of July alone, they were 252.
"Our curve really went up," he said.
The nationwide toll could be between 40,000 and 50,000 by the end of 2020, according to projections.
"The surge is upon us," Health Minister Zweli Mkhize said on Thursday in badly-hit Eastern Cape province.
"This month, numbers have increased and next month we expect the numbers to be higher as well."
with Reuters and AFP
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