Estimating cases for COVID-19 in South Africa
Short term Projections: June 2020
Report Update: 12 June 2020

FOR PUBLIC RELEASE
Prepared by MASHA, HE2RO, and SACEMA
on behalf of the South African COVID-19 Modelling Consortium

Please address all queries and comments to: Harry Moultrie at HarryM@nicd.ac.za

The projections in this report are intended for planning purposes by the South African government.

 Summary
The purpose of this report is to project estimated COVID-19 cases at national and provincial levels for the
next 4 weeks. A mathematical model was used to simulate the transmission of local and imported COVID-19
cases based on data regarding laboratory confirmed infections until 5 June 2020 using parameter estimates
jointly agreed upon by the SA COVID-19 Modelling Consortium.
The model projects that if testing patterns remain unchanged there may be more than 408,000 detected
cases by mid-July. However, prioritization of testing may result in a reduction in detected cases to
approximately 133,000. The cumulative number of deaths by mid-July is expected to be 7,440 (3,610 14,000). ICU and hospital bed numbers are to be interpreted with caution as use of hospital beds are
influenced by treatment practices, and admission to ICU is likely to be subject to criteria that change through
time and as a function of resources available. The model projections indicate that the demand for ICU beds
is likely to exceed available ICU beds in the Western Cape and Eastern Cape during the month of June
(including expanded capacity that has been made available in the Western Cape).
The models have been recalibrated based on updated data. This is an ongoing process as new testing and
hospital data become available.
Due to the rapidly changing nature of the outbreak globally and in South Africa, the projections will need to
be updated regularly and should be interpreted with caution. The models have been developed using data
that is subject to a high degree of uncertainty. Transmission has been modelled at national and provincial
levels resulting in model predictions providing broad-stroke national/provincial guidance rather than informing
strategy at a more granular level. All models are simplifications of reality that are designed to describe and
predict system behaviour and are justified by the assumptions and data with which they are developed.

Findings: Projected cases in the next four weeks
The model was calibrated to reported cumulative admissions and death data from 21 March to 5 June. Given
that, in the early stages of the epidemic, the disease had seeded differently in the provinces and in
communities with varying contact behaviour, the growth of the epidemic is different in each of the provinces.
Thus, to provide short term projections reflective of the admissions and deaths reported, the basic
reproductive number and the estimated decrease during lockdown were incorporated into the model. The
basic reproductive number (R0) and impact of the hard lockdown were informed by an analysis of laboratory
testing and confirmed cases conducted by the National Institute for Communicable Diseases1. The
reproductive numbers under Level four restrictions were varied in the model to reproduce trends in reported
deaths between provinces. As detection is a function of the number of tests conducted and testing strategy
(e.g. mass vs focal), inflation factors were adjusted to reproduce detected cases per province. As in previous
reports, severe and critical cases were assumed to receive a test, with only a proportion of mild cases being
tested.

2

 Table 1. Level description and estimated parameters
Scenario

Description

Estimated Impact on
Reproductive Number

Level five: National lockdown

Lockdown reduces transmissibility until
30 April

NICD analysis1

Level four restrictions

Level four restrictions reduce
transmissibility from 1 May to 31 May

Estimated through
calibration

Level three restrictions

Social distancing and other NPIs
reduce transmissibility - implemented
after 31 May and assumed to continue
thereafter

Global Intervention Impact
analysis*2

*A country-specific timeline of Covid-19 NPIs (household confinement, mask wearing, quarantine of known positives, school closures
and limiting social groups) was constructed including interventions implemented for a minimum of 5-days in the absence of any other
intervention (HopkinsIDD_hit-covid). The median effective reproduction number (Rt) was estimated for each intervention period using
country-specific confirmed case reports. The final dataset included 41 countries and US States and 74 intervention events. Using a
linear mixed effects model to account for country specific variations and household confinement as baseline, only social group limits
were significantly associated with interval specific Rt. In comparison to household confinement, there was a 10.2% (95% CI: 8.27%12.33%) increase in the estimated marginal mean Rt associated with social group limits.

Table 2 summarises the projected ranges of the number of cases, required hospital and ICU beds, and deaths
at a national level. It is important to realise that not all active cases will require healthcare. A substantial
proportion of infections (75%) are assumed to be asymptomatic or very mildly ill such that they would not
require an outpatient care visit and would be very unlikely to seek COVID testing. Approximately 96% of
active symptomatic cases are predicted to be mildly ill, with only a fraction of those seeking outpatient care
or COVID testing. Therefore, large case numbers do not necessarily present a large burden on the health
system. As has been the experience of many countries around the world, the vast majority of COVID-19
cases will show no or mild symptoms.
Previous projections from the NCEM have assumed that while all hospitalised cases will receive a laboratoryconfirmed diagnosis, only a fraction of mildly symptomatic cases will be detected. This fraction has been
based on inflation factors determined by reviewing the number of confirmed COVID-19 cases, evolution of
‘person under investigation’ (PUI) criteria for COVID-19 testing, the number of contacts identified and
proportion traced, and publications/reports on under-detection rates in other countries. Due to current
backlogs in testing, detection is modelled to decrease in mid-May to detect 1 in 5 mild cases. However, a
change in policy to prioritise testing of hospitalised patients, health care workers, elderly and individuals with
co-morbidities with respiratory symptoms, has been implemented in the Western Cape and may be extended
to other provinces. The Cumulative Detected Cases panel in Figure 1 shows both detected cases assuming
the current testing policy (blue) and detected cases projected under a limited policy of detecting only
hospitalised cases from mid-June. Projections of detected cases may deviate from observed detected cases
if the testing policy changes.
The projected beds in use and cumulative deaths are estimated under an assumption of unlimited capacity,
i.e. any patient who needs a bed is able to get one and no excess mortality results from hospital capacity
being breached. A separate analysis presented in this report projects the impact of capacity constraints on
bed usage and mortality. All figures in the report are rounded to the nearest 10 and 100.
3

 The uncertainty in the model output takes into account both process and parametric uncertainty. For each
scenario, we conduct 10,000 stochastic simulations, each one with parameters sampled from the ranges
provided in Table 13. We then construct 90% prediction intervals from the daily 5% and 95% quantiles of
these simulation runs. These prediction intervals are the uncertainty bands presented in the plots. Darker
internal bands represent the 50% prediction intervals.

4

 Figure 1. National projections

Table 2. National Projections
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current Detection

Limited Detection

2020-06-15

2,710,000
(1,390,000 5,030,000)

481,000
(243,000 917,000)

647,000
(292,000 1,310,000)

112,000
(49,500 - 234,000)

78,700
(41,600 - 147,000)

78,700
(41,600 - 147,000)

2020-06-22

4,170,000
(2,070,000 7,740,000)

746,000
(364,000 1,440,000)

998,000
(442,000 1,990,000)

175,000
(75,900 - 360,000)

121,000
(60,400 - 232,000)

85,900
(44,800 - 161,000)

2020-06-29

6,240,000
(3,050,000 11,500,000)

1,140,000
(541,000 2,200,000)

1,470,000
(659,000 2,890,000)

261,000
(114,000 526,000)

185,000
(89,500 - 358,000)

96,500
(49,600 - 182,000)

2020-07-06

9,080,000
(4,430,000 16,500,000)

1,690,000
(793,000 3,240,000)

2,080,000
(941,000 3,980,000)

371,000
(163,000 728,000)

278,000
(132,000 - 535,000)

112,000
(56,600 - 212,000)

2020-07-13

12,800,000
(6,290,000 21,900,000)

2,440,000
(1,140,000 4,530,000)

2,830,000
(1,310,000 4,910,000)

503,000
(227,000 922,000)

408,000
(193,000 - 775,000)

133,000
(66,500 - 251,000)

5

 Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

11,400
(5,840 - 21,700)

1,470
(750 - 2,810)

3,810
(1,750 - 7,770)

440
(200 - 910)

1,440
(780 - 2,660)

2020-06-22

17,800
(8,710 - 34,200)

2,270
(1,110 - 4,470)

6,030
(2,720 - 12,200)

690
(300 - 1,440)

2,210
(1,140 - 4,190)

2020-06-29

27,200
(12,900 - 52,600)

3,470
(1,650 - 6,920)

9,190
(4,140 - 18,400)

1,050
(460 - 2,170)

3,380
(1,680 - 6,450)

2020-07-06

40,700
(19,200 - 78,600)

5,220
(2,430 - 10,300)

13,400
(6,070 - 26,700)

1,530
(670 - 3,130)

5,090
(2,480 - 9,670)

2020-07-13

59,300
(28,000 - 114,000)

7,640
(3,540 - 14,900)

19,100
(8,690 - 37,000)

2,150
(960 - 4,260)

7,440
(3,610 - 14,000)

Note:
●

Hospital admissions and treatment pathways are based on national line list hospital data from the
public and private sector, and sourced from the National Institute for Communicable Diseases
DATCOV Platform. While this database contains a full hospital listing for the Western Cape, it is
incomplete in the public sector for all other provinces. All parameters derived from this database were
estimated from a patient cohort analysis. The cohort, constructed from the hospitalization data, was
right-censored 35 days prior to data export, and followed to present, allowing for sufficient time for
patients to experience an outcome (discharge or death). Where the sample of patients was too small
to reliably determine parameter values, estimates were based on the patient cohort analysis from
hospitals in all provinces.

●

Estimates of lengths of hospital stay, care pathways and outcomes derived from the DATCOV
Platform are not likely to be static over time. They will be influenced by evolving treatment practices,
and admission to ICU is likely to be subject to criteria that change through time and as a function of
resources available.

6

 Projections by Province

Figure 2: Eastern Cape

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed

   

 

 

 

 

 

 

 

 

   

6,000 
100.000
4.000
50.000 2.000
Jul
ICU beds needed Cumulative Deaths
1.200
900
2,000
600
1,000
300
Jul

Table 3: Eastern Cape
Eastern Cape
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current Detection

Limited
Detection

2020-06-15

330,000
(147,000 - 722,000)

56,300
(25,200 126,000)

80,400
(31,700 195,000)

13,900
(5,360 - 34,400)

9,000
(4,290 - 19,200)

9,000
(4,290 - 19,200)

2020-06-22

531,000
(225,000 1,190,000)

91,300
(38,500 212,000)

131,000
(49,400 325,000)

22,700
(8,350 - 57,700)

14,300
(6,350 - 32,200)

9,870
(4,620 - 21,300)

2020-06-29

840,000
(343,000 1,880,000)

147,000
(58,900 345,000)

207,000
(75,300 498,000)

36,100
(12,900 90,000)

22,800
(9,570 - 53,200)

11,300
(5,130 - 24,800)

2020-07-06

1,290,000
(517,000 2,710,000)

230,000
(89,500 527,000)

313,000
(114,000 685,000)

55,100
(19,300 127,000)

36,300
(14,500 - 84,200)

13,500
(5,920 - 29,900)

2020-07-13

1,880,000
(764,000 3,550,000)

348,000
(134,000 742,000)

441,000
(166,000 813,000)

78,400
(28,700 154,000)

56,100
(21,900 - 126,000)

16,600
(7,090 - 36,400)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative Deaths

2020-06-15

1,150
(530 - 2,520)

260
(120 - 550)

410
(170 - 950)

76
(31 - 180)

160
(80 - 340)

2020-06-22

1,860
(800 - 4,260)

410
(180 - 940)

670
(260 - 1,620)

120
(48 - 310)

260
(120 - 580)

2020-06-29

3,010
(1,220 - 7,090)

670
(270 - 1,560)

1,080
(400 - 2,680)

200
(74 - 510)

420
(180 - 970)

2020-07-06

4,790
(1,870 - 11,200)

1,070
(420 - 2,500)

1,700
(620 - 4,050)

320
(110 - 780)

680
(280 - 1,600)

2020-07-13

7,390
(2,820 - 16,500)

1,650
(630 - 3,730)

2,530
(920 - 5,460)

480
(170 - 1,090)

1,080
(420 - 2,520)

8

 Figure 3: Free State

2.500

2.000

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed

 

 

 

150

 

 

 

 

 

 

 

 

1.500
1.000
500
Jul
ICU beds needed Cumulative Deaths
Jul

Table 4: Free State
Free State
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited
Detection

2020-06-15

10,500
(6,070 - 18,800)

2,320
(1,350 - 4,090)

1,490
(630 - 3,300)

280
(120 - 640)

520
(310 - 880)

520
(310 - 880)

2020-06-22

12,700
(6,940 - 23,900)

2,780
(1,550 - 5,130)

1,790
(720 - 4,280)

340
(140 - 820)

620
(360 - 1,110)

550
(330 - 960)

2020-06-29

15,300
(7,930 - 30,500)

3,350
(1,770 - 6,520)

2,170
(820 - 5,520)

420
(150 - 1,050)

750
(410 - 1,400)

590
(350 - 1,060)

2020-07-06

18,500
(9,070 - 39,000)

4,010
(2,010 - 8,290)

2,630
(930 - 7,140)

500
(170 - 1,360)

900
(470 - 1,780)

650
(360 - 1,190)

2020-07-13

22,300
(10,400 - 50,200)

4,840
(2,280 - 10,600)

3,160
(1,050 - 9,230)

600
(200 - 1,740)

1,080
(540 - 2,260)

710
(390 - 1,350)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

160
(95 - 280)

<10
(<10 - 15)

28
(13 - 58)

<10
(<10 - <10)

18
(11 - 31)

2020-06-22

200
(110 - 360)

11
(<10 - 19)

33
(14 - 75)

<10
(<10 - <10)

22
(13 - 39)

2020-06-29

230
(130 - 450)

13
(<10 - 24)

40
(16 - 95)

<10
(<10 - <10)

27
(15 - 48)

2020-07-06

280
(140 - 570)

16
(<10 - 31)

49
(19 - 120)

<10
(<10 - <10)

32
(17 - 61)

2020-07-13

340
(160 - 730)

19
(<10 - 40)

59
(21 - 160)

<10
(<10 - <10)

38
(20 - 78)

10

 Figure 4: Gauteng

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed

 

   

 

 

 

 

 

 

 

   

300.000 1? 12,500
10,000
200,000
7,500
5,000
100,000
2,500
Jul
ICU beds needed Cumulative Deaths
2.000
1 000 1,500
1.000
500
500
Jul

Table 5: Gauteng
Gauteng
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current Detection

Limited Detection

2020-06-15

537,000
(255,000 1,130,000)

88,700
(42,900 - 185,000)

134,000
(54,400 316,000)

22,600
(9,050 - 54,300)

12,800
(6,610 - 25,300)

12,800
(6,610 - 25,300)

2020-06-22

951,000
(413,000 2,130,000)

155,000
(68,700 - 349,000)

248,000
(93,500 613,000)

42,000
(15,700 - 107,000)

21,600
(10,200 - 47,000)

13,800
(7,030 - 27,900)

2020-06-29

1,680,000
(681,000 3,800,000)

274,000
(113,000 - 643,000)

446,000
(160,000 1,110,000)

76,000
(26,800 - 194,000)

38,100
(16,500 - 87,200)

15,700
(7,740 - 32,600)

2020-07-06

2,870,000
(1,120,000 6,170,000)

478,000
(186,000 - 1,110,000)

763,000
(270,000 1,750,000)

131,000
(45,300 - 314,000)

67,100
(27,000 - 157,000)

19,100
(8,940 - 40,800)

2020-07-13

4,600,000
(1,820,000 8,730,000)

800,000
(305,000 - 1,730,000)

1,200,000
(439,000 2,290,000)

208,000
(74,700 - 425,000)

115,000
(44,500 - 262,000)

24,600
(10,900 - 52,700)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

1,290
(650 - 2,580)

180
(91 - 360)

490
(210 - 1,120)

51
(22 - 120)

88
(49 - 160)

2020-06-22

2,200
(1,010 - 4,830)

310
(140 - 670)

920
(370 - 2,190)

93
(38 - 230)

140
(71 - 280)

2020-06-29

3,870
(1,640 - 9,000)

540
(230 - 1,260)

1,680
(630 - 4,150)

170
(65 - 440)

240
(110 - 520)

2020-07-06

6,810
(2,690 16,100)

950
(380 - 2,270)

2,980
(1,070 - 7,310)

310
(110 - 780)

420
(180 - 960)

2020-07-13

11,700
(4,420 26,500)

1,630
(620 - 3,790)

5,050
(1,800 11,400)

520
(180 - 1,210)

730
(290 - 1,710)

12

 Figure 5: KwaZqu?Natal

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed

 

40.000 2.000

30,000 1.500

   

 

 

 

 

 

 

 

 

 

20,000 1,000

Jul
ICU beds needed Cumulative Deaths
400
600

300
200
100
Jul

Table 6: KwaZulu-Natal
KwaZulu-Natal
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited
Detection

2020-06-15

131,000
(69,500 - 251,000)

25,900
(14,100 48,500)

25,400
(10,700 - 57,500)

4,470
(1,860 - 10,300)

4,660
(2,690 - 8,240)

4,660
(2,690 - 8,240)

2020-06-22

183,000
(89,900 - 377,000)

35,700
(18,000 71,600)

36,800
(14,400 - 89,300)

6,500
(2,520 - 16,000)

6,260
(3,380 - 11,800)

4,890
(2,790 - 8,790)

2020-06-29

259,000
(118,000 - 566,000)

49,800
(23,400 107,000)

53,300
(19,400 - 137,000)

9,410
(3,410 - 24,500)

8,550
(4,270 - 17,600)

5,230
(2,920 - 9,630)

2020-07-06

367,000
(154,000 - 854,000)

70,000
(30,500 160,000)

76,700
(26,100 - 209,000)

13,600
(4,580 - 37,000)

11,900
(5,520 - 26,100)

5,720
(3,100 - 10,900)

2020-07-13

518,000
(203,000 1,270,000)

98,900
(40,000 241,000)

110,000
(35,200 - 309,000)

19,400
(6,150 - 55,500)

16,700
(7,190 - 39,100)

6,430
(3,340 - 12,900)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

530
(300 - 970)

120
(69 - 220)

170
(78 - 360)

30
(14 - 64)

77
(47 - 130)

2020-06-22

720
(380 - 1,420)

170
(87 - 320)

240
(100 - 550)

44
(19 - 98)

100
(58 - 190)

2020-06-29

1000
(480 - 2,110)

230
(110 - 480)

350
(140 - 850)

63
(25 - 150)

140
(74 - 270)

2020-07-06

1,400
(630 - 3,160)

320
(140 - 720)

510
(190 - 1,310)

91
(34 - 230)

190
(94 - 390)

2020-07-13

1,970
(820 - 4,760)

460
(190 - 1,080)

730
(260 - 1,970)

130
(46 - 350)

270
(120 - 590)

14

 Figure 6: Limpopo

8.000

6,000

4,000

2,000

ICU beds needed

100

75

25

 

Cases Detected (Limited testing in yellow)

 

 

 

 

 

 

 

Hospital non-ICU beds needed

500
400
300
200

100

 

 

 

 

Jul

Cumulative Deaths

 

150

100

Jul

Table 7: Limpopo
Limpopo
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited
Detection

2020-06-15

11,700
(5,330 - 26,100)

1,990
(930 - 4,410)

2,860
(1,130 - 7,180)

490
(190 - 1,250)

320
(160 - 670)

320
(160 - 670)

2020-06-22

19,500
(8,190 - 47,100)

3,290
(1,410 - 7,940)

4,890
(1,780 - 13,300)

850
(300 - 2,310)

510
(230 - 1,170)

360
(170 - 760)

2020-06-29

32,900
(12,600 - 86,300)

5,510
(2,150 - 14,400)

8,320
(2,800 - 24,500)

1,440
(480 - 4,280)

840
(350 - 2,090)

410
(190 - 930)

2020-07-06

55,400
(19,600 - 159,000)

9,310
(3,330 - 26,400)

14,200
(4,350 - 45,300)

2,460
(750 - 7,900)

1,400
(540 - 3,800)

510
(220 - 1,230)

2020-07-13

93,800
(30,400 - 288,000)

15,700
(5,160 - 48,200)

24,100
(6,900 - 82,700)

4,170
(1,180 - 14,600)

2,370
(820 - 6,900)

680
(280 - 1,790)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

44
(21 - 95)

<10
(<10 - 21)

15
(<10 - 37)

<10
(<10 - <10)

<10
(<10 - 13)

2020-06-22

72
(32 - 170)

16
(<10 - 37)

26
(10 - 67)

<10
(<10 - 13)

10
(<10 - 23)

2020-06-29

120
(49 - 310)

26
(11 - 66)

44
(16 - 120)

<10
(<10 - 24)

17
(<10 - 40)

2020-07-06

200
(75 - 560)

44
(16 - 120)

76
(25 - 230)

15
(<10 - 44)

28
(11 - 72)

2020-07-13

340
(120 - 1,020)

74
(26 - 220)

130
(39 - 420)

25
(<10 - 81)

48
(18 - 130)

16

 Figure 7: Mpumalanga

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed

 

 

4,000 80

3.000 60

 

 

 

 

 

 

 

 

 

 

 

2,000 40
1,000 Jul
ICU beds needed Cumulative Deaths
Jul

Table 8: Mpumalanga
Mpumalanga
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited
Detection

2020-06-15

10,300
(5,010 - 21,700)

1,920
(950 - 4,000)

2,200
(890 - 5,340)

380
(150 - 940)

320
(170 - 640)

320
(170 - 640)

2020-06-22

15,100
(6,810 - 34,100)

2,790
(1,290 - 6,250)

3,290
(1,240 - 8,590)

570
(210 - 1,510)

460
(230 - 960)

340
(180 - 660)

2020-06-29

22,300
(9,330 - 54,300)

4,090
(1,750 - 9,900)

4,940
(1,720 - 13,900)

850
(290 - 2,420)

660
(300 - 1,490)

350
(180 - 710)

2020-07-06

33,000
(12,800 - 86,800)

6,050
(2,400 - 15,700)

7,370
(2,390 - 22,200)

1,270
(410 - 3,860)

960
(400 - 2,340)

380
(190 - 780)

2020-07-13

48,900
(17,600 - 139,000)

8,960
(3,300 - 25,000)

11,000
(3,340 - 35,500)

1,900
(570 - 6,170)

1,410
(550 - 3,720)

410
(200 - 900)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

15
(<10 - 31)

10
(<10 - 20)

<10
(<10 - 11)

<10
(<10 - <10)

<10
(<10 - <10)

2020-06-22

22
(10 - 48)

15
(<10 - 32)

<10
(<10 - 18)

<10
(<10 - <10)

<10
(<10 - 13)

2020-06-29

32
(14 - 75)

21
(<10 - 50)

11
(<10 - 29)

<10
(<10 - 16)

<10
(<10 - 21)

2020-07-06

47
(19 - 120)

31
(13 - 79)

16
(<10 - 46)

<10
(<10 - 25)

14
(<10 - 32)

2020-07-13

70
(27 - 190)

46
(18 - 120)

24
(<10 - 74)

13
(<10 - 40)

20
(<10 - 51)

18

 Figure 8: Northern Cape

2.000

1.500

1,000

Cases Detected (Limited testing in yellow)

 

 

 

 

 

ICU beds needed

 

15.0

10.0

5.0

0.0

 

 

 

Hospital non-ICU beds needed

 

Jul

Cumulative Deaths

 

Jul

Table 9: Northern Cape
Northern Cape
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited
Detection

2020-06-15

5,020
(2,470 - 10,600)

940
(470 - 1,960)

1,070
(440 - 2,580)

190
(76 - 460)

170
(90 - 330)

170
(90 - 330)

2020-06-22

7,350
(3,360 - 16,600)

1,360
(630 - 3,030)

1,600
(610 - 4,160)

280
(110 - 740)

240
(120 - 500)

180
(95 - 360)

2020-06-29

10,800
(4,570 - 26,200)

1,990
(860 - 4,780)

2,400
(840 - 6,660)

420
(150 - 1,180)

340
(160 - 780)

200
(100 - 410)

2020-07-06

16,000
(6,260 - 41,700)

2,930
(1,170 - 7,560)

3,570
(1,160 - 10,700)

630
(200 - 1,890)

490
(210 - 1,210)

220
(110 - 480)

2020-07-13

23,600
(8,580 - 65,600)

4,310
(1,610 - 11,900)

5,290
(1,630 - 16,800)

930
(280 - 3,010)

720
(290 - 1,910)

260
(120 - 600)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

22
(12 - 46)

<10
(<10 - <10)

<10
(<10 - 15)

<10
(<10 - <10)

<10
(<10 - <10)

2020-06-22

32
(16 - 70)

<10
(<10 - 13)

<10
(<10 - 23)

<10
(<10 - <10)

<10
(<10 - 10)

2020-06-29

47
(21 - 110)

<10
(<10 - 21)

14
(<10 - 38)

<10
(<10 - <10)

<10
(<10 - 16)

2020-07-06

69
(29 - 170)

13
(<10 - 33)

21
(<10 - 60)

<10
(<10 - 10)

10
(<10 - 25)

2020-07-13

100
(39 - 270)

19
(<10 - 51)

31
(10 - 95)

<10
(<10 - 16)

15
(<10 - 39)

20

 Figure 9: North West

Cases Detected (Limited testing in yellow)

80,000 I


1

60.000
40,000 

20,000

 

 

 

 

15 Jun 22 Jun 29 Jun

ICU beds needed

400

200

 

 

 

 

15 Jun 22 Jun 29 Jun

Hospital non-ICU beds needed

9,000

6,000

3.000

 

 

 

 

15 Jun 22 Jun

Cumulative Deaths

1 .500

1 .000

500

 

 

 

 

15 Jun 22 Jun

Table 10: North West
North West
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current
Detection

Limited Detection

2020-06-15

47,100
(18,600 - 122,000)

6,440
(2,570 - 16,500)

13,500
(4,900 - 37,900)

2,270
(810 - 6,380)

900
(380 - 2,190)

900
(380 - 2,190)

2020-06-22

109,000
(39,100 - 305,000)

14,800
(5,360 - 41,500)

31,700
(10,500 95,800)

5,330
(1,750 - 16,300)

2,020
(780 - 5,430)

1,280
(510 - 3,290)

2020-06-29

249,000
(82,400 - 721,000)

34,100
(11,300 102,000)

73,000
(22,200 227,000)

12,400
(3,730 - 39,500)

4,610
(1,600 - 13,500)

2,150
(790 - 6,010)

2020-07-06

547,000
(172,000 1,490,000)

76,700
(23,600 230,000)

161,000
(46,900 478,000)

27,600
(7,870 - 84,900)

10,500
(3,360 - 32,000)

4,140
(1,380 - 12,300)

2020-07-13

1,100,000
(351,000 2,460,000)

163,000
(48,800 440,000)

326,000
(96,100 768,000)

56,800
(16,300 144,000)

23,300
(7,080 - 67,400)

8,380
(2,600 - 23,800)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

280
(120 - 700)

15
(<10 - 36)

120
(47 - 330)

<10
(<10 - 15)

18
(<10 - 42)

2020-06-22

640
(240 - 1,750)

33
(12 - 90)

290
(100 - 850)

14
(<10 - 39)

40
(16 - 100)

2020-06-29

1,480
(500 - 4,330)

76
(26 - 220)

680
(220 - 2,110)

32
(10 - 98)

92
(34 - 260)

2020-07-06

3,370
(1,060 - 10,300)

170
(54 - 530)

1,560
(460 - 4,890)

73
(22 - 230)

210
(71 - 640)

2020-07-13

7,400
(2,220 - 21,200)

380
(110 - 1,130)

3,360
(970 - 9,490)

160
(45 - 460)

480
(150 - 1,460)

22

 Figure 10: Western Cape

 

 

   

 

 

 

 

 

 

 

 

Cases Detected (Limited testing in yellow) Hospital non-ICU beds needed
300,000
7,500
200.000
5.000
100.000
2.500
Jul
ICU beds needed Cumulative Deaths
1,200
8.000
900
6.000
600 4.000
300 2,000

   

 

 

 

 

 

 

Jul

Table 11: Western Cape
Western Cape
Cumulative Incidence

Active Cases

Cumulative Detected Cases

Date

Total

Symptomatic

All

Symptomatic

Current Detection

Limited Detection

2020-06-15

1,620,000
(859,000 2,760,000)

294,000
(151,000 - 540,000)

382,000
(181,000 698,000)

67,400
(31,100 129,000)

49,800
(26,400 - 91,000)

49,800
(26,400 - 91,000)

2020-06-22

2,330,000
(1,250,000 3,690,000)

437,000
(222,000 - 766,000)

534,000
(263,000 868,000)

95,700
(45,300 165,000)

74,300
(38,200 - 134,000)

54,300
(28,500 - 99,000)

2020-06-29

3,120,000
(1,750,000 4,500,000)

615,000
(319,000 1,000,000)

667,000
(361,000 911,000)

122,000
(63,300 180,000)

107,000
(55,000 - 185,000)

60,200
(31,600 - 108,000)

2020-07-06

3,860,000
(2,350,000 5,070,000)

804,000
(444,000 1,200,000)

713,000
(458,000 862,000)

132,000
(80,800 174,000)

147,000
(77,700 - 236,000)

67,200
(35,600 - 117,000)

2020-07-13

4,470,000
(2,980,000 5,440,000)

978,000
(584,000 1,350,000)

659,000
(500,000 779,000)

124,000
(88,800 159,000)

189,000
(106,000 279,000)

74,200
(40,500 - 124,000)

Cumulative Admissions

Hospital beds needed

Date

Non-ICU

ICU

Non-ICU

ICU

Cumulative
Deaths

2020-06-15

7,890
(4,050 - 14,600)

860
(440 - 1,600)

2,550
(1,200 - 4,970)

260
(120 - 520)

1,060
(570 - 1,950)

2020-06-22

11,900
(5,990 - 21,800)

1,300
(650 - 2,390)

3,810
(1,790 - 6,990)

400
(180 - 750)

1,620
(840 - 3,010)

2020-06-29

17,300
(8,740 - 30,000)

1,890
(950 - 3,300)

5,220
(2,610 - 8,600)

550
(270 - 970)

2,420
(1,230 - 4,420)

2020-07-06

23,500
(12,300 - 37,800)

2,590
(1,350 - 4,230)

6,390
(3,520 - 9,290)

700
(370 - 1,100)

3,500
(1,780 - 6,080)

2020-07-13

29,800
(16,800 - 44,500)

3,320
(1,840 - 5,010)

6,820
(4,380 - 9,200)

780
(460 - 1,150)

4,750
(2,510 - 7,720)

24

 Key parameter values
Table 12 below shows the values of key parameters used to inform the model. Parameter values have been
selected for use by an expert panel of clinicians on the SA Covid-19 Modelling Consortium.
Table 12. Key model parameters

Infection
severity

Timeframes
& treatment
durations

Parameter

Value (range)

Sources

Proportion of cases that are asymptomatic

75% (70% - 80%) -

[3-6]

Mild to moderate cases among the symptomatic

(89.6% - 98.16%)

Severe cases among the symptomatic

(1.60% - 9.60%)

Critical cases among the symptomatic

(0.24% - 0.84%)

Fatal cases among the admitted (general)

(5.70% - 18.81%)

Fatal cases among the admitted (ICU ventilated)

(56.64% - 89.30%)

Fatal cases among the admitted (ICU nonventilated)

(16.32% - 33.66%)

Estimated through
calibration to
admissions and
fatalities count data
(DATCOV) [7]

Proportion of cases in ICU requiring ventilation

(34.38% - 48.57%)

Estimated from
NICD COVID-19
Hospital Sentinel
Surveillance
database
(DATCOV) [7]

Inflated mortality factor due to capacity breach
(applied to current mortality rates)

1.066 (1.0 - 1.1)
(non-ventilated &
severe infection)
2.0 (1.8 - 2.1) (critical
infection requiring
ventilation)

Regression analysis
based on data from
CDC [8]

Time from infection to onset of infectiousness

4 days (2.0 - 6.0)

[9-18]

Time from onset of infectiousness to onset of
symptoms

2 days (1.0 - 3.0)

with input from the
National COVID-19
Modelling
Consortium

Duration of infectiousness from onset of symptoms

5 days (4.0 - 6.0)

[18,19]

Time from onset of symptoms to testing

4 days (3.0 - 5.0)
[9,10,20-24]

Time from onset of symptoms to hospitalisation

5 days (4.0 - 6.0)

Time in non-ICU (never ICU) to death/recovery

8 days (4.0 - 12·0)

Time in non-ICU for those destined for ICU

0 days (0.0 - 2.0)

Time in ICU for those ventilated and destined to die

14 days (7.0 - 27.0)

Time in ICU for those never ventilated and destined
to die

11 days (7.0 - 18.0)

Time in ICU for those ventilated and recovered

19 days (15.0 - 37.0)

Lengths of stay:
values and ranges
sourced from NICD
COVID-19 Hospital
Sentinel
Surveillance
database
(DATCOV) [7]

25

 Time in ICU for those never ventilated and
recovered

5 days (1.0 - 10.0)

Time in non-ICUs for those who were in ICU and
recovered

0 days (0.0 - 6.0)

Data sources
The model has been informed by published and pre-print academic literature, Statistics South Africa
population projections, expert input from members of the SA COVID-19 Modelling Consortium, and national
case and hospitalisation details from the South African National Institute for Communicable Diseases and
https://sacoronavirus.co.za/category/press-releases-and-notices/.

About the South African COVID-19 Modelling Consortium
The South African COVID-19 Modelling Consortium is a group of researchers from academic, non-profit, and
government institutions across South Africa. The group is coordinated by the National Institute for
Communicable Diseases, on behalf of the National Department of Health. The mandate of the group is to
provide, assess and validate model projections to be used for planning purposes by the Government of South
Africa. For more information, please contact Dr Harry Moultrie (harrym@nicd.ac.za).

About the National COVID-19 Epi Model
The National COVID-19 Epi Model (NCEM) is a stochastic compartmental transmission model to estimate
the total and reported incidence of COVID-19 in the nine provinces of South Africa. The outputs of the model
may be used to inform resource requirements and predict where gaps could arise based on the available
resources within the South African health system. The model follows a generalised Susceptible-ExposedInfectious-Recovered (SEIR) structure accounting for disease severity (asymptomatic, mild, severe, and
critical cases) and the treatment pathway (outpatients, non-ICU, and ICU beds) as shown in Figure 13.
Contributors to the NCEM include Sheetal Silal, Jared Norman, Saadiyah Mayet, Rachel Hounsell, Juliet
Pulliam, Roxanne Beauclair, Jeremy Bingham, Jonathan Dushoff, Reshma Kassanjee, Michael Li, Cari van
Schalkwyk, Alex Welte, Lise Jamieson, Rachel Esra, Brooke Nichols and Gesine Meyer-Rath. For more
information please contact Dr Sheetal Silal (sheetal.silal@uct.ac.za).

26

 Figure 11. NCEM Model Structure (Generalised SEIR)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Model States

 

Model Flows

 

 

SUSOEDTIDIF:

 

Exposed (not infectious)

 

lnfeded, 

 

Infected. presvrrotoma?c (In)

 

lntected, miId

 

Infected, severe, untreated

 

Infected, severe, seelt'ng treatment

 

Infected, severe. wailing for hospital bed

 

Hospltalised

Infected, severe, general ward (I-l1)

 

lliected, severe, general ward pre?ICU (H2)

 

Infected, cn'tical, waiting for ICU, no ventilation (WV)

 

Infected, critical, in ICU, not ventilated, non?alrvivor
"even:

 

Infected, critical, in Icu, not ventilated, survivor
clout-m)

 

 

Infected, critical, waiting for ICU a ventilation (WV)

 

Infected, severe, general ward post?ICU (Ha)

 



lMdet

Removed (recovered)

Detection of mild cases [laboratory confirmed}

 

ISdet

 

 

Detection of severe cases [laboratory con?rmed7?49?

13.

FD

20.




23.

Force of Infection

Latent period (until Infectiousness)

Recovery: duration of infectiousness)

Latent period (until infectiousness)
Development of severe does not seek treatment
Death of severe, untreated case

Recovery: duration of severe case's Infectiousness
Development of mild 

Recovery: duration of mild case's Infectiousness
Development of severe seeks treatment

. Severe case waiting for a hospital bed [If bed capacity reached)

Critical case waiting for a hospital bed {It bed capacity reached)

. Death while waiting for hospital bed [excess modality)
14.
15.

Recovery while waiting for hospital bed

Severe case admitted to hospital

CrIticaI case admitted to hospital [pre?ICU progression}
Death of severe case while seeking treatment
Recovery of severe case while seeking treatment
Death of severe case in general hospital bed
Recovery of severe case in general hospital bed

. Critical case in hospital, waiting for ICU admission {no ventilation)
22.
23.
24.
25.

Progression to ICU admission [no ventilation), non-survivor
Progression to ICU admission [no ventilation), survivor
Progression to ICU admission [with ventilation], survivor
Progression to ICU admission [with ventilation], non?survivor
CrIticaI case in hospital, waiting for ICU admission {ventilation}
Death of cr'rtical case while awaiting ICU 8. ventilation
Recovery of critical case while awaiting ICU a ventilation

. Waiting critical case needing ventilation admitted to ICU

. Wailing critical case not needing ventilation admitted to ICU

. Death of critical case from ICU [notventilated)

. Critical case discharged from ICU [non-ventilated) to general ward
. Critical case discharged from ICU (ventilated) to general ward

34.
35.

Death of critical case from ICU (ventilated)
Recovery of critical case {discharged from hospital)

 

 

 

27

Funders

MASHA

HE2RO

SACEMA

Appendix 1. Model performance: projections and observed data up to 5 June
Figure 12 shows the projected (black line) and observed (red dots) cumulative detected cases (left) and
cumulative deaths (right) from 21 March to 5 June at a national level. The projections in Figure 12 and 13
were made on 8 May and show that the NCEM model closely estimated the actual cumulative detected cases
observed for the month.
While the model appears to have under-estimated cumulative deaths, separating cumulative deaths in the
Western Cape from cumulative deaths in the rest of the country accounts for this effect. Since releasing these
projections, it came to light that the epidemic had likely seeded earlier in the Western Cape than previously
assumed. Therefore, the incline in cases was experienced earlier than initially predicted. Figure 15 shows
the projected cumulative deaths and actual deaths recorded for the Western Cape (left) and rest of the
country (right). While the model under-estimated deaths for the Western Cape, cumulative deaths for the rest
of the country were well projected by the NCEM model. This information on earlier seeding has been
incorporated into this new set of projections.

28

 Figure 12. Projected vs observed cumulative detected cases and cumulative deaths (National)

Figure 13. Cumulative deaths predicted and actual: Western Cape (left) and rest of country (right)

29

 Appendix 2. Model data fitting for cumulative detected cases and cumulative deaths
Figure 14. Model data fitting by province

30

 150

100

50

80

60

40

20

10.0

5.0

0.0

Cumulative deaths

Eastern Cape

Free State

Gauteng

 

 

 

 

 

80

60

40

20

 

 

 

 

01Apr 15Apr 01 May 15May 01Jun

KwaZulu-Natal

May

Limpopo

May

Mpumalanga

Jun

North West

 

 

4.0

3.0

2.0

 

01 Apr

15 Apr

Northern Cape

May

Western Cape

Jun

01Apr 15Apr 01 May 15May

01 Jun

31

References
1. National Institute for Communicable Diseases. The Initial and Daily COVID-19 Effective
Reproductive Number (R) in South Africa 27 May 2020. [Internet]. 2020 May 27. Available from:
https://www.nicd.ac.za/wp-content/uploads/2020/05/The-Initial-and-Daily-COVID-19-EffectiveReproductive-Number-R-in-South-Africa-002.pdf
2. Esra R, Letswalo D, Ngcobo N, Mngadi S, Estille J, Jamieson L, Meyer-Rath G, Keiser O (2020)
Analysis of governmental non-pharmaceutical interventions for SARS-CoV-2 in the first months of
the global pandemic (Unpublished)
3. Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Chest CT Findings in Cases
from the Cruise Ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19). Radiol
Cardiothorac Imaging [Internet]. 2020 Apr 1 [cited 2020 Mar 23];2(2):e200110. Available from:
http://pubs.rsna.org/doi/10.1148/ryct.2020200110
4. Sutton D, Fuchs K, D’Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women
Admitted for Delivery. N Engl J Med [Internet]. 2020 Apr 13. Available from:
https://www.nejm.org/doi/full/10.1056/NEJMc2009316
5. Day, M., 2020. Covid-19: four fifths of cases are asymptomatic, China figures indicate. BMJ
[Internet]. 2020 Apr 2. Available from: https://doi.org/10.1136/bmj.m1375
6. Ing AJ, Cocks C, Green JP. COVID-19: in the footsteps of Ernest Shackleton. Thorax [Internet].
2020 May 27 [cited 2020 Jun 4]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32461231
7. National Institute for Communicable Diseases. COVID-19 Hospital Sentinel Surveillance database
(DATCOV). [cited 2020 Jun 4]. (Unpublished)
8. CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease
2019 (COVID-19) — United States, February 12–March 16, 2020. 2020 Mar 27. CDC MMWR,
69(12), 343–346. Available from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6912e2-H.pdf
9. Tindale L, Coombe M, Stockdale JE, Garlock E, Lau WYV, Saraswat M, et al. Transmission interval
estimates suggest pre-symptomatic spread of COVID-19. medRxiv [Internet]. 2020 Mar
6;2020.03.03.20029983. Available from:
https://www.medrxiv.org/content/10.1101/2020.03.03.20029983v1
10. Nie X, Fan L, Mu G, Tan Q, Wang M, Xie Y, et al. Epidemiological Characteristics and Incubation
Period of 7015 Confirmed Cases With Coronavirus Disease 2019 Outside Hubei Province in China.
J Infect Dis [Internet]. 2020 [cited 2020 Jun 10];1–8. Available from:
https://academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiaa211/5825699
11. Linton NM, Kobayashi T, Yang Y, Hayashi K, Akhmetzhanov AR, Jung S, et al. Incubation Period
and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right
Truncation: A Statistical Analysis of Publicly Available Case Data. J Clin Med [Internet]. 2020 Feb
17 [cited 2020 Jun 10];9(2):538. Available from: https://www.mdpi.com/2077-0383/9/2/538
12. Thompson RN, Lovell-Read FA, Obolski U. Time from Symptom Onset to Hospitalisation of
Coronavirus Disease 2019 (COVID-19) Cases: Implications for the Proportion of Transmissions
from Infectors with Few Symptoms. J Clin Med [Internet]. 2020 May 1 [cited 2020 Jun 10];9(5):1297.
Available from: https://www.mdpi.com/2077-0383/9/5/1297
13. Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019- nCoV)
infections among travellers from Wuhan, China, 20 - 28 January 2020. Vol. 25, Eurosurveillance.
32

 European Centre for Disease Prevention and Control (ECDC); 2020. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014672/
14. Jing Q, You C, Lin Q, Hu T, Yu S, Zhou X-H. Estimation of incubation period distribution of COVID19 using disease onset forward time: a novel cross-sectional and forward follow-up study. medRxiv
[Internet]. 2020 Mar 10;2020.03.06.20032417. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217033/
15. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of
coronavirus disease 2019 (CoVID-19) from publicly reported confirmed cases: Estimation and
application. Ann Intern Med [Internet]. 2020 May 5;172(9):577–82. Available from:
https://www.acpjournals.org/doi/10.7326/M20-0504
16. Ganyani T, Kremer C, Chen D, Torneri A, Faes C, Wallinga J, et al. Estimating the generation
interval for coronavirus disease (COVID-19) based on symptom onset data, March 2020.
Eurosurveillance [Internet]. 2020 Apr 30;25(17). Available from:
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.17.2000257
17. Nishiura H, Linton NM, Akhmetzhanov AR. Serial interval of novel coronavirus (COVID-19)
infections. Int J Infect Dis [Internet]. 2020 Mar [cited 2020 Mar 16]; Available from:
https://linkinghub.elsevier.com/retrieve/pii/S1201971220301193
18. He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and
transmissibility of COVID-19. Nat Med [Internet]. 2020 May 1;26(5):672–5. Available from:
https://www.nature.com/articles/s41591-020-0869-5
19. Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological
assessment of hospitalized patients with COVID-2019. Nature. 2020 May 28;581(7809):465–9.
Available from: https://www.nature.com/articles/s41586-020-2196-x
20. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019
(COVID-19) [Internet]. 2020 [cited 2020 Mar 14]. Available from: https://www.who.int/docs/defaultsource/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
21. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019
novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 [cited 2020 Mar 14];395:497. Available
from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext
22. Gaythorpe K, Imai N, Cuomo-Dannenburg G, Baguelin M, Bhatia S, Boonyasiri A, et al. Report 8:
Symptom progression of COVID-19 [Internet]. 2020 Mar [cited 2020 Mar 18]. Available from:
https://doi.org/10.25561/77344
23. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult
inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet [Internet]. 2020
Mar [cited 2020 Mar 14];0(0). Available from:
https://linkinghub.elsevier.com/retrieve/pii/S0140673620305663
24. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized
Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J Am Med
Assoc. 2020 Mar 17;323(11):1061–9. Available from:
https://jamanetwork.com/journals/jama/fullarticle/2761044
25. StatsSA. Mid-year population estimates 2019. Statistical release P0302. 2019. Available from:
http://www.statssa.gov.za/publications/P0302/P03022019.pdf

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