South Africa has a higher population density and much higher number of people with HIV, which puts them at greater risk of sever outcomes. The fact that their deaths have not been significantly higher is interesting.

But in the end this is about natural immunity and how it impacts omicrom. It's estimated SA has a 60 to 70% natural immunity level and as a result omicron has not been a serious issue. How widespread is natural immunity in Canada? Probably much less, meaning possibly that many people people will experience serious outcomes, the majority being vaccinated, not unvaccinated.