World Health Organisation regional director for Africa Matshidiso Moeti. Picture: REUTERS/DENIS BALIBOUSE
World Health Organisation regional director for Africa Matshidiso Moeti. Picture: REUTERS/DENIS BALIBOUSE

Neglecting essential health services to combat the coronavirus pandemic could cause greater harm than the virus itself, the Africa head of the World Health Organisation (WHO) warned on Thursday, as the continent surges towards 1-million confirmed cases.          

“We are concerned that in the end we may see more damage from other illnesses and conditions than we see from Covid-19. Countries have to do both,” said the WHO’s regional director for Africa, Matshidiso Moeti.

The WHO had received reports of “significant declines” in access to treatment for HIV and tuberculosis, immunisation, family planning and antenatal services, she said.

SA, which with more than 471,000 reported coronavirus cases accounts for more than half the continent’s tally of almost 890,000, saw its weekly TB testing rates fall to half the usual volume during the hard lockdown imposed on March 27. At that stage, all but essential workers were confined to their homes except for trips to buy groceries or seek health care, and there were tight restrictions on public transport.

Moeti said the WHO recognised there was underreporting of Covid-19 cases and deaths in Africa, but did not believe this was happening on a massive scale.

“We think there is a certain level of underestimation, but we do not think there is a huge silent epidemic killing many people,” Moeti said.

Nevertheless, it was important to understand more about the excess deaths reported by the SA Medical Research Council (MRC), she said. The MRC’s weekly death reports have identified a steadily growing gap between the number of excess natural deaths and official Covid-19 death figures.

Natural deaths include those caused by diseases or conditions such as cancer and are tracked by many health authorities to identify trends and disease outbreaks.

Excess deaths usually refer to an increase in deaths above historic levels, or the difference between the number of recorded deaths and what might have been expected had Covid-19 not occurred.

The MRC has gone a step further and adjusted the baseline against which it has compared the number of reported natural deaths, to take account of a reduction in natural deaths observed during the early stages of the hard lockdown that put SA on an unusually low trajectory. Comparing reported deaths to historic trends would have underestimated the true effect of the pandemic, it said.

The MRC estimated there were 22,279 excess deaths between May 6 and July 21, a figure more than four times higher than the official Covid-19 death tally, which stood at 5,368 on July 21.

Moeti said disruption to essential health services, lockdown restrictions on people’s movement and public transport, and people’s fear of getting infected in health facilities could all contribute to increased deaths during the pandemic.

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