The COVID-19 pandemic is deepening the health crisis in South Kivu

Écochard, René; Wimba, Patient; Bengehya, Justin; Bianga, Philippe Katchunga; Lugwarha, Séraphine; Oyimangirwe, Moise; Bazeboso, Jacques-Aimé; Tshilolo, Léon; Longo-Mbenza, Benjamin; Rabilloud, Muriel; Iwaz, Jean; Étard, Jean-François; Vanhems, Philippe

Objective The outbreak of COVID-19 in South Kivu (DRC) raised the fear of added morbidity and mortality. Updating these indicators before a second wave seems essential to prepare for additional help. Methods From mid-May to mid-December 2020, weekly surveys in sampled streets from ten Health Areas quantified the application of barrier measures and analyzed questionnaires about sickness and death cases in interviewees’ households. Crude death rates (CDRs) were estimated. Results Little or no masking was observed in at least half of the streets. From May to December, the number of people presumably sick with Covid-19 increased sixfold (p < 0.05). Within 30 days before the interviews, 20% of deaths were presumably due to COVID-19. The monthly CDR at the beginning and end of the study were respectively close to 5 and 25 per 1000 people (p < 0.05); that is, annual CDRs of 60 and 260 per 1000, respectively. Thus, during the first epidemic wave, the estimated mortality rate increased by 50% vs. previous years and, by the end of 2020, it would have increased fourfold or more. Conclusion Despite possible overestimations, the excess mortality in South Kivu is extremely concerning. This profound crisis calls for rapid responses and increased humanitarian assistance.