SARS CoV 2 Infection Fatality Rate Estimates for South Africa

Mhlanga, Laurette; Vermeulen, Marion; Grebe, Eduard; Welte, Alex

doi:10.21203/rs.3.rs-707813/v2

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…As soon as feasible after the omicron variant driven fourth wave in early 2022, 3395 residual specimens were randomly collected from consenting donors from all provinces presenting to donate blood at either of the South African Blood Services: the South African National Blood Service (SANBS), and the Western Cape Blood Service (WCBS) in mid-March 2022. This was carried out in accordance with previous arrangements and practices underlying our previous rounds of sampling [1,2,3], as approved by the SANBS Human Research Ethics Committee (HREC).…”

Section: Methodsmentioning

confidence: 99%

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Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa in March 2022

Bingham

Cable

Coleman

et al. 2022

Preprint

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In line with previous instalments of analysis from this ongoing study to monitor ‘Covid Seroprevalence’ among blood donors in South Africa, we report on an analysis of 3395 samples obtained in mid-March 2022 from all provinces of South Africa – a timepoint just after the fourth (primarily omicron) wave of infections. As in our previous analyses, we see no evidence of age and sex dependence of prevalence, but significant variation by race. Differences between provinces have largely disappeared, as prevalence appears to have saturated. In contrast to previous estimates from this study, which reported only prevalence of anti-nucleocapsid antibodies, this present work also reports results from testing for anti-spike antibodies. This addition allows us to categorise those donors whose only antibodies are from vaccination. Our race-weighted national extrapolation is that 98% of South Africans have some antibodies, noting that 10% have anti-spike antibodies but not anti-nucleocapsid antibodies - a reasonable proxy for having both 1) been vaccinated and 2) avoided infection.

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Section: Methodsmentioning

confidence: 99%

“…We have previously published estimates of the prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa, based on specimens collected from January to November 2021 [1,2], as well as estimates of fatality rates [3], based on these prevalence estimates and publicly available excess deaths estimates.…”

Section: Introductionmentioning

confidence: 99%

Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa in March 2022

Bingham

Cable

Coleman

et al. 2022

Preprint

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“…Some have highlighted collateral deaths of various kinds, and others have noted the reduction in other infection-related deaths during lockdown periods [24,25]. This estimated IFR shows the same exponential, escalation with age, over the full age range, as has been seen in other contexts, with much the same overall scale [27].…”

Section: Discussionmentioning

confidence: 60%

“…The (provincial) overall estimated IFR was highest in NC at 1.05% followed closely by the EC at 1.0% with North West the lowest at 0.33% [27] (Table 4). We also present, as a comparator for each province, what the provincial IFR would be, if the nationally estimated ‘age‐specific’ IFR is applied to the age structure of each provincial population.…”

Section: Resultsmentioning

confidence: 99%

The evolution and interpretation of seroprevalence of SARS‐CoV‐2 antibodies among South African blood donors from the Beta to Omicron variant‐driven waves

Vermeulen,

Mhlanga,

Sykes

et al. 2023

Vox Sanguinis

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Background and ObjectivesConfirmed COVID‐19 diagnoses underestimate the total number of infections. Blood donors can provide representative seroprevalence estimates, which can be leveraged into reasonable estimates of total infection counts and infection fatality rate (IFR).Materials and MethodsBlood donors who donated after each of three epidemic waves (Beta, Delta and first Omicron waves) were tested for anti‐SARS‐CoV‐2 nucleocapsid antibodies using the Roche Elecsys anti‐SARS‐CoV‐2 total immunoglobulin assay. Roche Elecsys anti‐spike antibody testing was done for the post‐Omicron sampling. Prevalence of antibodies was estimated by age, sex, race and province and compared to official case reporting. Province and age group‐specific IFRs were estimated using external excess mortality estimates.ResultsThe nationally weighted anti‐nucleocapsid seroprevalence estimates after the Beta, Delta and Omicron waves were 47% (46.2%–48.6%), 71% (68.8%–73.5%) and 87% (85.5%–88.4%), respectively. There was no variation by age and sex, but there were statistically and epidemiologically significant differences by province (except at the latest time point) and race. There was a 13‐fold higher seroprevalence than confirmed case counts at the first time point. Age‐dependent IFR roughly doubled for every 10 years of age increase over 6 decades from 0.014% in children to 6.793% in octogenarians.ConclusionDiscrepancies were found between seroprevalence and confirmed case counts. High seroprevalence rates found among Black African donors can be ascribed to historical inequities. Our IFR estimates were useful in refining previous large disagreements about the severity of the epidemic in South Africa. Blood donor‐based serosurveys provided a valuable and efficient way to provide near real‐time monitoring of the ongoing SARS‐CoV‐2 outbreak.

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“…We have previously published estimates of the prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa, based on specimens collected from January to May 2021 [1,2], as well as estimates of fatality rates, based on these prevalence estimates and publicly available excess deaths estimates [3].…”

Section: Introductionmentioning

confidence: 99%

Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in eight provinces of South Africa in November 2021

Cable

Coleman

Glatt

et al. 2022

Preprint

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In line with previous instalments of analysis from this ongoing study to monitor ‘Covid Seroprevalence’ among blood donors in South Africa, we report on analysis of 3395 samples obtained from 8 to 12 November 2021 in all provinces of South Africa except the Western Cape. As in our previous analyses, we see no evidence of age and sex dependence of prevalence, but substantial variation by province, and by race within each province, from which we generated provincial total point estimates (EC-74%; FS-75%; GP-68%; ZN-73%; LP-66; MP-73%; NC-63%; NW-81% ) and a ‘South Africa minus Western Cape’ national prevalence estimate of 71% (95%CI 69-74%). We note that sample collection occurred just before the omicron variant driven wave in South Africa, but otherwise present these results without significant interpretation.

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SARS CoV 2 Infection Fatality Rate Estimates for South Africa

Abstract: This is a brief report. The intention is simply to communicate findings and thereby trigger discussion and further work – not to provide a substantial contextual, comparative, or interpretive narrative.

Cited by 3 publications

References 4 publications

Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa in March 2022

Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa in March 2022

The evolution and interpretation of seroprevalence of SARS‐CoV‐2 antibodies among South African blood donors from the Beta to Omicron variant‐driven waves

Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in eight provinces of South Africa in November 2021

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