An Early Assessment of the Omicron Covid-19 Variant: Case-Fatality Rates

By Craig Getz and Dr Gary Kantor Executive Summary The fourth wave of the Covid-19 pandemic has been dominated by the Omicron variant. The Omicron case-fatality rate (CFR)[1] has been between 89.7% and 95.2% lower than the case fatality rate of the preceding variants (the original strain, Beta and Delta). Persons testing positive for the Omicron variant are significantly younger than in previous waves[2]. After adjusting for differences in age, gender and chronic health conditions, the Omicron case-fatality rate is between 83.4% and 90.0% lower than the case-fatality rate of the preceding variants. Risk-adjusted case-fatality rates are a proxy for [...]

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Mortality Trends in South Africa

By Nick van Burick, Nicole Kriek, Zane Heyl, Alwyn Hanekom, Jannus Redelinghuys. Introduction Core to the successful operation and management of the life insurance industry is the protection of clients and their dependents in the event of the untimely death and/or disability of loved ones. In South Africa, the industry has proven that it can protect clients whilst remaining financially and actuarially sound by meeting its obligation despite record high levels of death and illness due to the COVID-19 pandemic. This blog considers the mortality trends from the mortality claims statistics released by the Association for Savings and Investment South Africa (ASISA), as [...]

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covid reinfections 2021

Covid-19 Reinfections

By Craig Getz. How often have you heard someone state that they have previously been infected with Covid-19 and that they no longer need to concern themselves with the virus? Many people believe that their previous infection is a guarantee of long-lasting immunity. This article explores whether this belief is well-founded based on observable data. Simply put, are previously infected people immune to reinfection or serious reinfections? Insight consults to a broad spectrum of medical schemes, who collect extensive data on the number of diagnosed Covid-19 infections and the hospital admissions and deaths resulting from these infections. By virtue of this [...]

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data-security

Building data security resilience

By Faheem Suban. We had the pleasure of hosting our third Foresight event of 2021 with “Reimagine, Rethink and Rebuild” as the theme. Topics included considering changes in wellness and activity levels since Covid, the possible impacts of Long Covid and we also explored a refocus on data security in order to build data resilience. When building resilience in data security, one must bear in mind that complacency is the enemy. Complacency has been described as “the kiss of death”, and this description remains apt for reflecting on data security practices given rapid changes in technology which require data security practices to [...]

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Rethinking Alternative Reimbursement Models

Rethinking Alternative Reimbursement Models

By Poonam Doolabh. We had the pleasure of hosting our second Foresight dialogues event of 2021 with “Reimagine, Rethink and Rebuild” as the theme. Topics included considering the benefits of glucose control monitoring, considering the recovery of elective care, and rethinking alternative reimbursement models (“ARMs”). See details on our Foresight events here Rethinking Alternative Reimbursement Models South Africa’s predominantly fee-for-service environment requires the rebuilding of solutions to align incentives. While many of us are aware of the role ARMs can play in correcting this, little action is implemented in this domain. By aligning financial incentives, providers and funders can prioritise high-quality, cost-effective care to improve patient outcomes [...]

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Insight-Scientific-Nutrition

Can Nutrition Be More Scientific?

By Gary Kantor. Mini-HTA #1 This is the first in a series of short articles about newer health technologies and their application. We call these “mini-HTAs” (HTA: Health Technology Assessment). We take a snapshot of new technologies, give a glimpse of the underlying science, and suggest how to evaluate the safety, effectiveness, cost, and impact. The science around nutrition has long been problematic. Published results go in all directions, some highly improbable (e.g. eat a handful of nuts each day and live 39% longer), with every nutrient (coffee, fat, alcohol, grain, gluten, fibre, you name it) associated in at least one study [...]

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Unpacking the unintended consequences of the recent CMS Undesirable Business Practice Declaration

The recent CMS Undesirable Business Practice Declaration

By Craig Getz.   Unpacking the unintended consequences of the recent CMS Undesirable Business Practice Declaration In a recent Undesirable Business Practice Declaration published in Circular 24 of 2021 and gazetted in Government Gazette No 44469 on 23 April 2021, the Council for Medical Schemes announced that certain restrictions would apply to co-payments that medical schemes will be allowed to levy when a member voluntarily chooses not to make use of a network hospital, pharmacy or doctor. As Craig Getz explains in his blog post below, the consequences of this may not be in the best interest of medical scheme beneficiaries – [...]

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long covid research

Patients can tell us more about the long-term effects of Covid-19.

By Gareth Kantor.   Most research has focused on the acute effects of Covid-19, including the devastating burden of severe disease, hospitalization and death that has resulted. But a significant number of patients experience a variety of long-term effects, troublesome symptoms that reduce quality of life, even after only a mild Covid-19 illness.  10-20% of Covid-19 patients report one or more persistent symptoms 2 months later1,2,3, an increasing concern for them, for clinicians and for health system administrators. This chronic illness has become known as “Long Covid” (LC). “Activist” patients4 have played an important role bringing it to public attention but [...]

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Give patients a voice.

By Gareth Kantor.     In South Africa, “ask a friend” or a family member is often how we choose a doctor and judge a hospital. This is because we usually trust our friends and family, share personal values and appreciate their perspective. Is there a way to more systematically obtain and reliably distil the “wisdom of crowds” to assess health care?  Increasingly, the answer is yes. Although asking a friend isn’t always best, the measurement of patient experience and patient-reported outcomes is a valid method for assessing the performance of health care systems and is becoming the norm around the world.  Asking patients doesn’t [...]

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Considerations on the new COVID variant.

By Craig Getz and Gareth Kantor South Africa is experiencing a second wave of the COVID-19 pandemic. In the last ten days, over 140,000 new cases and more than 4,000 COVID-19 related deaths have been reported. The second wave is believed to be driven by the so-called South African variant of SARS-CoV-2 (501.V2).  Concerns have been raised that the new variant spreads more rapidly and results in higher levels of morbidity and mortality including amongst the young who have been relatively insulated from severe disease. There are also questions as to whether vaccines, which have been shown to be effective in [...]

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