Look, an elephant!

A lot of figures have been thrown around during the last few weeks with regards to the coronavirus outbreak – from the number of infections to the number of tests conducted, how many died, and predictions of the effect of the pandemic on different economic figures.

However, the steady increase in the death rate has been ignored.

According to statistics published by Worldometers, based on figures supplied by the World Health Organisation (WHO), the number of infections worldwide had increased to more than 1.8 million by Monday morning (April 13). Some 433 915 people had recovered, and recorded deaths reached 115 224.

These figures do not look alarming at first glance. More people die of normal flu worldwide every year, or in car accidents.

Read: Make-or-break moment in virus fight could happen this week

A Statistics SA analysis of causes of mortality in South Africa published in March shows that more than nearly 80 000 South Africans died from infectious and parasitic diseases during 2017 (the latest reliable figures available). Nearly 82 000 died from diseases of the circulatory system (mostly heart problems) and more than 51 000 died from external causes such as injuries, car accidents and violent deaths.

In total, 446 000 people died in SA in 2017 – without a daily update on every possible media platform and the banning of the sale of books, shoes and beer.

However, the deaths of 25 people from coronavirus in SA is different.

On Monday the global death rate due to Covid-19 was standing at 21%, compared to less than 2% when the virus hit a few months ago and people started counting.

A grim and steady increase

Worldometers has calculated the death rate since the beginning of the health crisis, and has recorded a grim and steady increase. It rose from 2% to 3% a week later, then 6%, increasing weekly all the way up to the current 21%.

Allow a quick analysis of the calculation to explain the high number. Worldometers calculates the death rate by dividing the number of deaths by the number of cases that had an outcome expressed as a percentage.

Thus, the number of deaths (95 766) divided by the number of people who recovered or died (356 986 + 95 766 = 452 752 outcomes)= 0.21 x 100 = 21%.

That is the correct calculation, and that is the correct figure. More than 20% of the people who got Covid-19 died.

Please allow a further explanation of the calculation (to satisfy the critics). Imagine a visit to the driving range by Roger, who decides to hit a few golf balls to improve his score. He collects a bucket of 50 balls and starts swinging.

After 10 shots, he stands back to consider his performance. He hit eight good shots, but the other two were bad. His failure rate is 20%, based on the 10 shots he played. Obviously, the denominator is the number of shots he played (eight good plus two bad) and not the total number of balls in the bucket.

The high death rate proves that the world – South Africa included – is facing a huge challenge from a highly contagious and deadly disease.

At present, Covid-19 is more deadly than a game of Russian roulette.

Your chances of dodging the single bullet in a five-shot revolver is in fact a touch better than your chances of surviving a coronavirus infection.

It is alarming that deaths are increasing day by day – the figures in this article needed to be updated before publication, and will be outdated by the time readers get to the bottom of the page. The good news is that by 20:00 on Monday evening the death rate had not increased in the five days since it hit 21%.

The WHO warns that the death rate changes as a virus develops and spreads.

This can be seen in the estimate of a death rate of 3.4% on March 3 compared to the current estimate of 21%. Worldometers explains that the final death rate can only be calculated once a virus has run its course, and might be much higher than initial estimates. “We shall remember that while the 2003 Sars epidemic was still ongoing, the WHO reported a fatality rate of 4% (or as low as 3%), whereas the final case fatality rate ended up being more than 9.6%,” according to a Worldometers article.

Variables

However, it is wrong to assume that 20% of SA’s population of around 56 million will die, or that one in five of the African continent’s population of 1.2 billion will. Ultimately, the grim number will depend on the number of infections and the death rate in different populations.

Infections and death rates could be higher in less-developed countries due to an average lower standard of living, inadequate nutrition (if not outright hunger and starvation), a lack of clean water and sanitation, present diseases and infections such as HIV and tuberculosis, inadequate healthcare, low literacy rates and limited access to information.

The WHO earlier noted its surprise that there seemed to be so few infections in Africa.

This in light of the fact that several infectious diseases in the past seemed to hit Africa hard. This is most likely due to a failure to collect statistics.

Information on the number of infections in SA and the rest of Africa are scarce and unreliable. By Monday evening, SA had recorded 2 272 infections (also using the Worldometers data to ensure figures are comparable) from just more that 80 000 tests. That equals an infection rate of less than 3%.

Context

But the 800 083 tests done by Monday morning are definitely not representative of a highly diverse population of more than 56 million people only a few weeks after the first recorded case.

The SA death rate is also low at the moment, at less than 6%. SA has seen 27 deaths and 410 recoveries with 1 835 infected people still sick.

From a statistical and mathematical point of view, trying to calculate the total number of potential deaths in SA based on assumptions of infection and mortality rates would be useless. It can return any number from 10 000 to 10 million. It would be pure speculation and irresponsible.

At present, the best defence seems to be to prevent infection. For now, the infection rate is key to the eventual outcome and probably enough reason to accept the extension of the lockdown in South Africa up to the end of April.