The authors of a study published in the ‘South African Journal of Science’ say understanding the relationship between race and other demographic characteristics with Covid-19 hospitalisation and mortality is important to address effectively the burden ...
Principal author Dr Waasila Jassat, a public health medicine specialist at the National Institute for Communicable Diseases says there is a “huge” difference in risk of Covid-19 mortality between provinces even after accounting for age, sex, comorbidities, and admission to either private or public hospitals.
“This South African data confirms black, coloured, and people of Indian descent had a higher mortality rate and that those using the public sector had a higher risk of dying as they had less access to ICU and ventilation which could be lifesaving for Covid-19 treatment,” she says.The researchers analysed data on Covid-19 admissions and deaths in South Africa between March 2020 and January 2022. The data is from Datcov — the active national Covid-19 surveillance programme.
Jassat says this result was “surprising” but explained that this may be due to more availability of beds in the private sector and a lower threshold for admitting Covid-19 patients. “Patients with milder symptoms may have been admitted to the private sector as a precaution. Whereas in the public sector, only the most severely ill got admitted, we know our excess mortality is three times higher than our reported Covid-19 mortality.
Jassat says the data shows a lower proportion of patients in the public sector were in ICU, ventilated, or treated with supplemental oxygen, which highlights the inequity of resources between the public and private sectors, including hospital beds, healthcare workers, and equipment such as ventilators and oxygen.
While it is well known that HIV and tuberculosis prevalence is highest among black Africans, Jassat says the South African Demographic and Health Survey has suggested a very high rate of hypertension, diabetes, obesity, and undiagnosed and poorly controlled disease for black African people putting them at higher risk of mortality.
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