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FACT CHECK: SA COVID-19 death rate among the lowest, but not the world’s lowest

Researched and written by Keegan Leech

“South Africa has the fifth highest number of confirmed corona cases in the whole world,” President Cyril Ramaphosa said in a televised update on the coronavirus crisis on 23 July.

But, he added, the country “continues to have one of the lowest case fatality rates in the world”.

Within hours, summaries of his speech began appearing on Facebook.

“SA has the lowest death rate in the world,” one user wrote. “THE COUNTRY WITH MOST INFECTION BUT LOWEST DEATH RATE,” another said, in a post that has since been deleted.

How deadly has COVID-19 been in South Africa? Is the country’s death rate really the world’s lowest?

Not what Ramaphosa said

“Case fatality rate” is a more specific term for what is otherwise known as the “death rate” – the number of people infected with the coronavirus who die of COVID-19 complications.

Ramaphosa said South Africa’s death rate was one of the lowest in the world – not the lowest. And the claim isn’t supported by other sources.

According to the World Health Organization’s COVID-19 situation report for 22 July, the most recent at the time of Ramaphosa’s address, South Africa had the world’s fifth highest number of total infections, with 381,798 cases.

The United States had the most, followed by Brazil, India, Russia and South Africa. On 28 July the five countries were in the same position.

The 22 July report records 5,368 COVID-19 deaths in South Africa, meaning that roughly 1.4% of known cases resulted in death. This is the lowest death rate among the 10 countries with the most cases, but not the lowest in the world. Singapore, for instance, has reported a death rate of only around 0.06%.

Countries with 10 highest total COVID-19 cases as of 22 July 2020

A data visualisation maintained by the Reuters news agency gives estimates of both the death rate and recovery rate for countries and territories across the world.

Questions about the death rate

But South Africa’s low death rate raises questions. One of them is whether the rate is accurate, a question asked by the South African Medical Research Council (SAMRC), which regularly releases reports on weekly deaths in the country.

Recent reports, the SAMRC says, show a far greater number of deaths due to “natural causes” than expected at this time of year. The council warns that this could indicate a much higher COVID-19 death toll than the one reported.

SAMRC warns that the roughly 17,000 “excess” deaths are not necessarily due to COVID-19, even if their “timing and geographic pattern” links them to the pandemic.

Professor Glenda Gray, CEO and president of the SAMRC, said the excess deaths may be “due to other diseases such as TB, HIV and non-communicable diseases, as health services are re-orientated to support this health crisis”.

In the unlikely scenario that all 17,000 excess deaths were caused by COVID-19, South Africa’s death rate would be closer to 5.6%. This would still be a far lower rate than in, say, the United Kingdom, but higher than in most countries with similar case numbers.

It is also uncertain whether death rates can be accurately measured during the pandemic. A number of journal articles have stressed that it is extremely difficult to calculate the true mortality rate of COVID-19 while the pandemic continues, suggesting that other indicators may be more reliable.

The latest data supports Ramaphosa’s statement about South Africa’s death rate, but the actual rate may be different. It is likely, as one expert told BBC News, that “we will only know the virus’s true impact in Africa in several years”.

This article appeared on AfricaCheck.org, a non-partisan organisation which promotes accuracy in public debate and the media. Follow them on Twitter: @AfricaCheck