A team consisting of some of South Africa’s leading healthcare actuaries have developed a new model to assist in understanding the potential impact of Coivd-19 on the South African healthcare system and the mortality rate.
The model will be made available selectively to other interested parties such as government, the Actuarial Society of South Africa (ASSA) said.
Lusani Mulaudzi, healthcare actuary and president of ASSA, said the model is based on the key mechanisms of a pandemic, namely susceptibility, exposure, infection and recovery (SEIR).
He added that the model’s baseline assumptions were informed by an extensive scientific literature review conducted by the ASSA Covid-19 task team.
Mulaudzi stressed that the projections are solely based on assumptions, since South Africa has only two months of data to work with.
“Society, and indeed the actuarial profession has not had the time to come to terms with all the dynamics of this disease with the evidence, science, and opinions on the disease changing rapidly. There is much about this coronavirus that remains unknown and new evidence emerges daily.”
He said that the ASSA Covi-19 task team will update the assumptions regularly as more data becomes available.
A peak in August or September
Mulaudzi said the ASSA model confirms current government assumptions that infections are likely to increase significantly without appropriate interventions.
“Conservative modelling indicates that the peak is only likely to be reached between August and September this year, depending on the effectiveness of lockdown and other non-pharmaceutical interventions.
“Deaths may exceed 48,000 within the next four months if government does not maintain a strict approach to flattening the curve.”
Mulaudzi said that the model’s baseline scenario assumes that one infected person is likely to infect three others (a reproduction number (R0) of three), and that 75% of infected people present as asymptomatic.
He said the most optimistic scenario assumes that the lockdown initiative reduces the reproduction number to 1.5 and that non-pharmaceutical interventions (NPIs) after the strict lockdown period result in a reproduction number of 2.1.
In this scenario, hospital bed usage would peak at 70,000 between August and September this year and requirements for ICU beds at just over 10,000. Expected cumulative deaths stop short at just over 48,300.
“We have to caution that the projected mortality figures are sensitive to the mortality assumptions made. Views on the Covid-19 impact on mortality rates still vary widely and as more data becomes available we may find that the actual mortality figures are significantly different to what has been projected.
“As we update the ASSA Covid-19 Model, we will include new scenarios assuming different mortality rates.”
Infection in SA
On Wednesday evening, health minister Dr Zweli Mkhize confirmed that there are now 5,350 positive Covid-19 cases in South Africa – a rise of 354 cases since the last reporting period.
This is the highest number of cases in a 24-hour cycle recorded to date, representing a 73% increase relative to the day before.
Mkhize also reported that the number of deaths from the coronavirus now stands at 103, with 2,073 recoveries.
Bloomberg reported that children contract the coronavirus less often and with less severity than the general population, and there doesn’t appear to be cases of a child passing Covid-19 to an adult, citing a new report.
Many infected children may stay asymptomatic, but cases of them becoming critically ill with Covid-19 remain rare, according to an analysis of global virus studies compiled by the Don’t Forget the Bubbles pediatric blog.
Among the study’s findings are:
- A China/World Health Organization joint commision couldn’t find a single case of a child passing the virus to an adult.
- Low case rates among children may be due more to higher numbers remaining asymptomatic, rather than a lower infection rate.
- Analysis of Chinese data in confirmed and suspected cases showed that 32% of affected children aged 6-10 years were asymptomatic.
- Precise details regarding pediatric transmission remain unclear.
- To date, only a handful of coronavirus deaths have been reported in children.
- Very few newborns or infants contract Covid-19 and generally they do well in overcoming the virus.
Meanwhile, separate research conducted in the UK pointed to higher mortality rates among men and obese people. They also found that mortality was high in patients in general wards who were not admitted to intensive care units.