• V Pillay-van Wyk, D Bradshaw, P Groenewald, I Seocharan, S Manda, R A Roomaney, O Awotiwon, T Nkwenika, G Gray, S S Buthelezi, and Z L Mkhize.
• Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa. victoria.pillayvanwyk@mrc.ac.za.
• S. Afr. Med. J. 2020 Oct 1; 110 (11): 1093-1099.

BackgroundUnderstanding the pattern of deaths from COVID-19 in South Africa (SA) is critical to identifying individuals at high risk of dying from the disease. The Minister of Health set up a daily reporting mechanism to obtain timeous details of COVID-19 deaths from the provinces to track mortality patterns.ObjectivesTo provide an epidemiological analysis of the first COVID-19 deaths in SA.MethodsProvincial deaths data from 28 March to 3 July 2020 were cleaned, information on comorbidities was standardised, and data were aggregated into a single data set. Analysis was performed by age, sex, province, date of death and comorbidities.ResultsSA reported 3 088 deaths from COVID-19, i.e. an age-standardised death rate of 64.5 (95% confidence interval (CI) 62.3 - 66.8) deaths per million population. Most deaths occurred in Western Cape (65.5%) followed by Eastern Cape (16.8%) and Gauteng (11.3%). The median age of death was 61 years (interquartile range 52 - 71). Males had a 1.5 times higher death rate compared with females. Individuals with two or more comorbidities accounted for 58.6% (95% CI 56.6 - 60.5) of deaths. Hypertension and diabetes were the most common comorbidities reported, and HIV and tuberculosis were more common in individuals aged <50 years.ConclusionsData collection for COVID-19 deaths in provinces must be standardised. Even though the data had limitations, these findings can be used by the SA government to manage the pandemic and identify individuals who are at high risk of dying from COVID-19.

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