Second Covid wave in South Africa - More hospitalizations & Deaths. 
Case incidence, hospital admissions, and in-hospital mortality all increased during the second wave of COVID-19 in South Africa, when the Beta variant (B.1.351) was predominant, researchers found in a prospective cohort study.
Cases were up dramatically in the second wave compared to the first wave (240.4 per 100,000 people vs 136 per 100,000, respectively), as were hospital admissions (27.9 per 100,000 vs 16.1 per 100,000) and deaths (8.3 per 100,000 vs 3.6 per 100,000), reported Waasila Jassat, MD, from the National Institute for Communicable Diseases in Johannesburg, South Africa and colleagues.
South Africa has not yet had the same vaccine coverage as most of the rest of the world, largely due to vaccine supply, global vaccine availability, and vaccine nationalism.
During March 2020 to March 2021, researchers looked at patient admission data from 644 national hospitals to compare patient characteristics between the first COVID wave in July 2020 and the second wave in January 2021, when the Beta variant dominated the country.
Primary outcome was mortality risk factors, based on adjusted variables such as province, age, comorbidities, health sector, race, sex, and mode of admission. South African patients with laboratory-confirmed COVID-19 (RT-PCR or SARS-CoV-2 antigen test) were included, if they were admitted for at least one full day in a hospital.
Of 219,265 COVID-19 patients with an in-hospital outcome, 51,037 patients died with an in-hospital case-fatality risk of 23.28%. The peak of the first wave had a significantly lower case-fatality risk (21.80%, 95% CI 21.39-22.22) than the peak of the second wave (29.34%, 95% CI 28.95-29.74).
During the first wave, the average weekly hospital admission rate increased 20%, but increased 43% during the second wave (ratio of growth rate 1.19, 95% CI 1.18-1.20).
Compared to the first wave, risk factors for hospital admission in the second wave included being ages 40 to 64 (aOR 1.22, 95% CI 1.14-1.31), age 65 or older compared with age 40 and younger (aOR 1.38, 95% CI 1.25-1.52), being of mixed race compared to being white (aOR 1.21, 95% CI 1.06-1.38), admitted in the public sector (aOR 1.65, 95% CI 1.41-1.92), and high weekly hospital admissions (more than 8,000 admissions) versus low weekly admissions (less than 3,500 admissions) (aOR 2.31, 95% CI 1.81-2.95).
Risk of in-hospital fatality per case was 17.7% during low admission weeks, but rose to 26.9% during high admission weeks (aOR 1.24, 95% CI 1.17-1.32).
Case incidence, hospital admissions, and in-hospital mortality all increased during the second wave of COVID-19 in South Africa, when the Beta variant (B.1.351) was predominant, researchers found in a prospective cohort study.
Cases were up dramatically in the second wave compared to the first wave (240.4 per 100,000 people vs 136 per 100,000, respectively), as were hospital admissions (27.9 per 100,000 vs 16.1 per 100,000) and deaths (8.3 per 100,000 vs 3.6 per 100,000), reported Waasila Jassat, MD, from the National Institute for Communicable Diseases in Johannesburg, South Africa and colleagues.
South Africa has not yet had the same vaccine coverage as most of the rest of the world, largely due to vaccine supply, global vaccine availability, and vaccine nationalism.
During March 2020 to March 2021, researchers looked at patient admission data from 644 national hospitals to compare patient characteristics between the first COVID wave in July 2020 and the second wave in January 2021, when the Beta variant dominated the country.
Primary outcome was mortality risk factors, based on adjusted variables such as province, age, comorbidities, health sector, race, sex, and mode of admission. South African patients with laboratory-confirmed COVID-19 (RT-PCR or SARS-CoV-2 antigen test) were included, if they were admitted for at least one full day in a hospital.
Of 219,265 COVID-19 patients with an in-hospital outcome, 51,037 patients died with an in-hospital case-fatality risk of 23.28%. The peak of the first wave had a significantly lower case-fatality risk (21.80%, 95% CI 21.39-22.22) than the peak of the second wave (29.34%, 95% CI 28.95-29.74).
During the first wave, the average weekly hospital admission rate increased 20%, but increased 43% during the second wave (ratio of growth rate 1.19, 95% CI 1.18-1.20).
Compared to the first wave, risk factors for hospital admission in the second wave included being ages 40 to 64 (aOR 1.22, 95% CI 1.14-1.31), age 65 or older compared with age 40 and younger (aOR 1.38, 95% CI 1.25-1.52), being of mixed race compared to being white (aOR 1.21, 95% CI 1.06-1.38), admitted in the public sector (aOR 1.65, 95% CI 1.41-1.92), and high weekly hospital admissions (more than 8,000 admissions) versus low weekly admissions (less than 3,500 admissions) (aOR 2.31, 95% CI 1.81-2.95).
Risk of in-hospital fatality per case was 17.7% during low admission weeks, but rose to 26.9% during high admission weeks (aOR 1.24, 95% CI 1.17-1.32).
