A NEW study estimates that the number of people who have died from Covid-19 is currently close to seven million. That is more than double the reported number.

The analysis comes from researchers at the University of Washington. The new figures allow us to better understand the severity of the pandemic.

Serious underestimation

To measure is to know. Especially in times of pandemics, correct measurement is very important. The figures we usually rely on for Covid deaths are those reported by the national authorities. But these now seem to be a gross underestimation of the real number.

Based on the reported numbers, both John Hopkins University and Worldometers put forward a total of 3.6 million deaths worldwide today. In reality, the number of Covid deaths is 7.7 million, or more than double what is officially recorded.

That is the conclusion of the Institute for Health Statistics and Evaluation (IMHE) at the University of Washington.

“Many countries have devoted exceptional effort to measuring the pandemic’s toll, but our analysis shows how difficult it is to accurately track a new and rapidly spreading infectious disease,” said Christopher Murray, director of the IHME.

Almost every part of the world is under-reporting Covid deaths, but in some countries, the under-reported number is particularly high.

In Belarus there are 17 times as many Covid deaths as have been reported. In Kazakhstan and Azerbaijan this is almost 15 times as much. In Egypt 13 times and, conspicuously, in Japan 10 times. In Russia the number is underestimated five times and in India and Mexico three times.

The UK had reported 127,782 Covid deaths on June 2. According to the IMHE there are 80,833 more, namely 208,615.

Reasons for the underestimation

What are the reasons for this underestimation? First of all, testing capacity varies greatly between countries. When testing capacity is weak, a lot of Covid deaths will not be included in the figures.

In addition, in many countries, deaths due to Covid-19 are only reported if they occur in hospitals or when patients have a confirmed infection. Patients who die at home or in cases where the infection has not been detected are not counted.

In some countries, the numbers are high because of a weak health reporting system or limited access to healthcare.

In many high-income countries, many deaths due to Covid-19 among elderly people in residential care centres were not registered either in the early months of the pandemic.

Methodology

According to the IMHE, correctly calculating the total number of Covid deaths is important for understanding the causes of the larger and smaller epidemics in different countries, to make an accurate estimate of the severity of the epidemic and also for better predictions about the spread of the virus.

The IHME calculates the total number of Covid deaths by comparing the expected number of all-cause deaths based on pre-pandemic trends with the actual number of all-cause deaths during the pandemic.

This excess mortality is corrected by eliminating deaths that can be indirectly attributed to the pandemic (postponement of urgent interventions due to lack of ICU beds) or deaths that are avoided by the pandemic (eg fewer traffic deaths due to reduced mobility).

This results in the number of deaths directly caused by Covid-19, Covid deaths in other words.

Covid deaths worldwide

IMHE’s study gives us a real picture of the pandemic worldwide. This picture is even less rosy than the one we already had. The US and India currently have more than 900,000 Covid deaths.

In Mexico, Brazil and Russia, the figure is above 600,000. Two European countries appear in the top ten: the United Kingdom and Italy.

Azerbaijan scores worst with 693 Covid deaths per 100,000 inhabitants. Vietnam ranks best with 0.2 per 100,000 inhabitants.

China has the best score of any major region or country for Covid-19 deaths per capita.

For the moment, Africa and Asia are doing well globally. In North and South America, Europe and Central Asia, there are on average more than 10 times as many Covid deaths per inhabitant as in Sub-Saharan Africa.

In Western Europe, Britain is the worst pupil in class, followed by Italy, Spain, Portugal and Belgium. Iceland is by far the best pupil followed by Norway.

East Asia is the region where a number of countries managed to nip the virus in the bud. They are Vietnam, China, New Zealand, Singapore, Thailand, Taiwan, South Korea and Australia.

In comparison, countries such as Japan, India, Indonesia and the Philippines did much worse.

Just like south-east Asia, the Americas show striking differences. The three largest countries, the US, Brazil and Mexico, are doing very poorly. Peru, Ecuador and Bolivia also score below par.

In contrast, there are remarkably good figures for Nicaragua, Cuba and Venezuela. This is all the more remarkable given that these three countries are affected by economic sanctions. This has a lot to do with good healthcare and mobilising the population.

Covid-19 in perspective

Based on current figures, the IHME expects nine to ten million deaths by the beginning of next fall. The common flu kills an average of 650,000 annually. The toll of the Russian flu (1889), the Asian flu (1957) and the Hong Kong flu (1968) was about one million. The swine flu (2009) killed 200,000.

With the current, provisional figures, we are still well below those of the Spanish flu (1918). That killed tens of millions of people. But at that time there was no vaccine, there were hardly any hygiene measures and healthcare was still very rudimentary.

In any case, it is clear that we are not dealing here with a “little flu,” as was often thought at the beginning of the pandemic.

The good news is that the vaccines are currently doing well in reducing the number of infections and hospital admissions. The uncertain factor for the future are the variants.

It is not yet clear whether and to what extent the vaccines offer protection against the Indian and Brazilian variants, for example.

It is therefore important that the entire world population can be vaccinated as quickly as possible, and not just the rich countries. Waiving patents is an absolute prerequisite for this.