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- Health researchers fear a possible increase in deaths and health complications in SA.
- SA's burden of diseases is increasing due to delayed check-ups and treatments.
- But a sicker nation will cost the government more as economic productivity declines while healthcare costs escalate.
Covid-19 is starting to stabilise in many parts of the world, and the number of deaths in successive waves is likely to be much lower than in the past two years. But healthcare researchers predict that overall deaths will likely remain elevated in South Africa for some time.
Missed doctor's appointments, delayed annual check-ups and not adhering to treatment regimes among people with chronic conditions mean the management of some illnesses has suffered.
As a result, professionals at the inaugural SA Healthcare Industry Summit expect increased death rates in the country from other complications outside of Covid-19.
READ | A sicker nation: Covid-19 future health risks a threat to SA's prospects
Dr Fareed Abdullah, the director of the Office of Aids and TB Research at the South African Medical Research Council (SAMRC), said Covid-19 knocked both inpatient and outpatient visits in the public and private sector.
Cancer patients admitted for oncology treatment declined significantly compared to 2019. Even asthma admissions were nowhere near pre-pandemic levels. Only the delivery of babies kept pace with 2019 levels, Abdullah's research showed.
The next two years will be critical
"It's really important that we monitor the impact of that on mortality and morbidity," said Abdullah.
The Steve Biko Academic Hospital, where he works, has completed a study looking at death rates in the two years before Covid-19 and the past two years that the world lived with the virus.
"We are really interested to see what will happen over the next two years. Our hypothesis is that there will be an increase in deaths from untreated HIV, untreated tuberculosis, oncology. And a lot of those patients who needed care and surgery, the quality of their lives will be worse over the next two years," said Abdullah.
Barry Childs, the joint CEO of Insight Actuaries & Consultants, said South Africa was already on a back foot in terms of the health and wellness of its population before the pandemic struck. Lack of nutrition, exercise, and awareness fuelled non-communicable diseases such as diabetes.
The country is also not off the hook on other infectious diseases either. It still has the highest number of HIV and tuberculosis deaths globally.
A rise in mental health conditions during the lockdown further worsened the burden of diseases the country was already battling with, said Dr Samukeliso Dube, the general manager for medical advisory and health policy at the AfroCentric Group.
"There are some epidemiological shifts. The disease profiles are changing, and the burden of diseases in the country is changing," she said.
READ | A mental health tsunami is brewing in the workforce, and it's not just stress
Not enough resources
But while this burden of diseases is escalating, Childs' calculations showed that SA's public sector budgets only R4 500 per person per year, or R375 a month. Before people got sicker because of a lack of healthcare under Covid-19, about 450 000 people were dying in SA every year. Some 125 000 of those die because of HIV complications and TB, said Childs.
To channel money towards other priorities, government cut budgets of provincial health departments by R76 billion in the Medium-Term Expenditure Framework. This means between 2022 and 2024, provinces will have fewer resources to try to manage the needs of a sicker nation.
"We potentially have budget cuts to the provincial health departments at the same time that we expect a rebound in utilisation. The second point is that Covid-19 is not gone yet either," said Abdullah.
Stavros Nicolaou, the senior executive for strategic trade development at Aspen Pharmacare, said there's nothing worse than a deterioration of a country's health metrics when it is trying to recover its economic activity. He said SA's health indicators were already poor before Covid-19 almost brought some sectors of the economy on their knees. But the sicker the workforce gets, it will reduce productivity and stifle the economy more.
"We can never begin to forge any sort of economic reconstruction and recovery as a country unless we are able to address some of these health indicators. A healthy nation is a productive nation," said Nicolaou.
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