A new analysis by the Institute for Health Metrics and Assessment (IHME), which independently investigates health at the University of Washington School of Medicine, shows that the global toll due to Coronavirus disease 2019 (COVID-19) could be more than double the officially reported death of nearly 7 million.
This striking conclusion is the result of examining the excess mortality of countries around the world and adjusting them for engines of mortality changes other than COVID-19.
Total cumulative mortality rate for COVID-19 through May 3, 2021
Unreported deaths
Many deaths due to the virus are not recorded as such because they are attributed to other causes. This is because they occur at home or in other residential facilities or in patients who have not received a positive polymerase chain reaction (PCR) that indicates the presence of the virus, as evidenced by the presence of viral ribonucleic acid. , the genetic material.
In countries with a poor medical history or a weak health care system and infrastructure, even higher disparities are likely to occur between officially reported and actual deaths. Even in high-income countries, many deaths in nursing homes went unnoticed by authorities. Therefore, excess mortality suggests an actual mortality from COVID-19 that is many times higher than indicated by official reports.
IHME | Full integration of COVID-19 mortality (May 6, 2021)
Methods
The scientists used the standard IHME methodology to assess the disease on a global scale, which has been conducted since 1990: the Global Burden of Disease study. Total deaths from COVID-19 were first assessed as excess mortality, that is, the difference between the actual number of deaths from all causes during the pandemic and the expected number of deaths from all causes according to pre-pandemic historical trends.
The main causes of indirectly related deaths were identified and eliminated. These include the delay in seeking medical attention for other conditions or the lack of adequate care because, for example, all resources were tied to the pandemic. Some deaths were reduced during the pandemic, such as traffic accidents, by more than 200,000.
Similarly, deaths from other respiratory viruses such as influenza, respiratory syncytial virus, and measles dropped to 99%, accounting for 400,000 fewer deaths.
The final number was assumed to be entirely due to COVID-19, ignoring the small or unquantifiable values of drug overdose deaths, suicide deaths due to depression caused by pandemic-related causes, and accelerating death in some fragile people. with pre-existing comorbidities for COVID-19.
What are the results?
For total deaths
This analysis placed the US, which has been the hardest hit by the pandemic, in the first place. The IHME estimate puts U.S. deaths at more than 900,000, instead of the 574,000 reported. It is followed by India, with 221,000 officially reported deaths, but an estimated real total of 654,000.
For India, this is more difficult to bear at a stage when 4,000 deaths are reported daily and every day there are new figures going through the ceiling.
For total deaths by region
When examined by region, it is seen that the most affected are Latin America with the Caribbean and Central Europe, followed by Eastern Europe and Central Asia. It should be noted that these estimates capture only those deaths that are directly attributable to the virus and that are not delayed in accessing health care or lack of community support, secondary to the pandemic.
The effects of these factors are likely to be seen in a year or two, according to scientists.
High total deaths belie claims of small outbreaks
While countries with the highest outbreaks are likely to have the highest number of deaths not recorded by COVID-19, the analysis also finds that countries such as Japan, which appears to have suffered relatively less, also have a total COVID of ten. times higher -19 mortality compared to reported deaths. Kazakhstan, in Central Asia, has 16 times more total mortality compared to the 5,000 officially reported deaths.
This should serve as a timely warning that the outbreak is more extensive than expected and will shape preventive strategies accordingly.
The highest proportion of excess mortality from officially reported statistics is found in Central Asia, Eastern Europe and Central Europe, where deaths exceed ten times the official death toll.
Even in sub-Saharan Africa, where COVID-19 was supposed to be relatively scarce, the total number of actual deaths could be up to four times the official count. For India, the proportion is almost three times the official figures.
Population ratio
However, the highest proportion of the infected population was in 12 countries, with more than 400 deaths per 100,000 inhabitants. These include Azerbaijan at 650, Bosnia and Herzegovina at 590, Bulgaria at 540 and Albania at 525 per 100,000.
Nearby are several Central American and Latin American countries and some in Central / Eastern Europe and Central Asia. The global mortality rate is about 90 per 100,000 inhabitants.
Conclusion
“As terrible as the COVID-19 pandemic appears, this analysis shows that the real toll is significantly worse“Said Dr. Chris Murray, director of IHME.”Understanding the actual number of deaths from COVID-19 not only helps us appreciate the magnitude of this global crisis, but also provides valuable information to policymakers developing response and recovery plans.“.
