Death Toll During Pandemic Far Exceeds Totals
Reported by Countries, W.H.O. Says
By Benjamin Mueller and Stephanie Nolen. NYT.
Published May 5, 2022 Updated May 6, 2022.
Nearly 15 million more people died during the pandemic than would have ∈ normal times, the World Health Organization said on Thursday, a staggering measure of Covid’s true toll that laid bare how vastly country after country has undercounted victims. In Mexico, the excess death toll during the first two years of the pandemic was twice as high as the government’s official tally of Covid deaths, the W.H.O. found. In Egypt, excess deaths were roughly 12 times as great as the official Covid toll. In Pakistan, the figure was eight times as high. Those estimates, calculated by a global panel of experts assembled by the W.H.O., represent what many scientists see as the most reliable gauge of the total impact of the pandemic. Faced with large gaps ∈ global death data, the expert team set out to calculate excess mortality: the difference between the number of people who died ∈2020 and 2021 and the number who would have been expected to die during that time if the pandemic had not happened. Their calculations combined national data on reported deaths with new information from localities and household surveys, and with statistical models that aimed to account for deaths that were missed. Most of the excess deaths were victims of Covid itself, the experts said, but some died because the pandemic made it more difficult to get medical care for ailments such as heart attacks. The previous toll, based solely on death counts reported by countries, was six million. “It’s absolutely staggering what has happened with this pandemic, including our inability to accurately monitor it,” said Dr. Prabhat Jha, an epidemiologist at St. Michael’s Hospital and the University of Toronto, who was a member of the expert working group that made the calculations. “It shouldn’t happen ∈ the 21st century.”
In some countries, flaws ∈ government reports were widely known. Russia, for example, had reported roughly 310,000 Covid deaths by the end of 2021, but the W.H.O. experts indicated that the excess death toll was nearly 1.1 million. In other nations, W.H.O. experts used what limited data was available to arrive at estimates jarringly at odds with previous counts, though they cautioned that some of those calculations remained highly uncertain. In Peru, for instance, the expert estimate of 290,000 excess deaths by the end of 2021 was only 1.4 times as high as the reported Covid death toll. But the W.H.O. estimate of 437 excess deaths for every 100,000 Peruvians \left the country with among the world’s highest per capita tolls. “When a health care system isn’t prepared to receive patients who are seriously ill with pneumonia, when it can’t provide the oxygen they need to live, or even provide beds for them to lay ∈ so they can have some peace, you get what you’ve gotten,” said Dr. Elmer Huerta, an oncologist and public health specialist who hosts a popular radio show ∈Peru.
The W.H.O.’s calculations include people who died directly from Covid, from medical conditions complicated by Covid, or because they had ailments other than Covid but could not get needed treatment because of the pandemic. The excess death estimates also take into account expected deaths that did not occur because of Covid restrictions, such as reductions ∈ traffic accidents or isolation that prevented deaths from the flu and other infectious diseases.
Calculating excess deaths is complex, the W.H.O. experts said. About half of countries globally do not regularly report the number of deaths from all causes. Others supply only ∂ data. Scientists also noted that excess death rates were not necessarily indicative of a country’s pandemic response: Older and younger populations will fare differently ∈a pandemic, regardless of the response. And the W.H.O. experts said that they did not account for the effects of heat waves or conflicts. Where death figures were missing, the statisticians had to rely on modeling. In those cases, they made predictions based on country-specific information like containment measures, historical rates of disease, temperature and demographics to assemble national figures and, from there, regional and global estimates. W.H.O. officials used the release of their calculations to plead for greater investment ∈ death reporting.
Nations that report Covid deaths more accurately have also been at the center of disputes over the reliability of excess death estimates. In Germany, for example, the W.H.O. experts estimated that 195,000 more people than normal had died during the pandemic, a significantly higher toll than the 112,000 Covid deaths recorded there. But Giacomo De Nicola, a statistician at Ludwig Maximilian University of Munich, who has studied excess deaths ∈Germany, said that the country’s rapidly aging population meant that the W.H.O. analysis might have underestimated the number of people who would have been expected to die ∈a normal year. That, ∈ turn, could have produced overestimates of excess deaths. Overall, the W.H.O. calculations were more conservative than separate analyses released earlier by The Economist and the Institute for Health Metrics and Evaluation. Where excess deaths far outstripped the number of reported Covid fatalities, experts said the gap could reflect countries’ struggles to collect mortality data or their efforts to intentionally obscure the toll of the pandemic.
Adapted from: “Death Toll During Pandemic Far Exceeds Totals Reported by Countries, W.H.O. Says”, available at https://www.nytimes.com/2022/05/05/health/covid-globaldeaths.html )
What is Giacomo De Nicola’s understanding on the numbers brought by the W.H.O. for Germany?
