PARIS — The true
global death toll of COVID-19 remains difficult to nail down three years after
the first case was detected, though experts agree there have been far more
fatalities than officially reported.
اضافة اعلان
The difference between
the official and real figures could diverge even further in 2023, with
modelling predicting more than a million deaths in post-zero-COVID China, which
recently narrowed how it counts fatalities.
There have been more
than 6.65 million officially reported COVID deaths since the virus was first
identified in China in December 2019, according to the World Health
Organization (WHO).
However, countries
count COVID deaths differently and methods have changed throughout the
pandemic.
Counting ‘excess’
deathsAttributing deaths to
COVID can be a very difficult exercise, said Antoine Flahault, director of the
Institute of Global Health at the University of Geneva.
The death of a patient
in a hospital in a developed country who had already been diagnosed with COVID
could be straightforward, but that is often not the case and doctors
"usually do not have much information" to guide them, Flahault told
AFP
Instead, researchers
have sought to compare the total number of deaths from all causes recorded
since 2020 to what would have been expected if there had been no pandemic.
Using these figures,
researchers from the WHO reported in the journal Nature earlier this month that
there were 14.83 million excess deaths from COVID in 2020 and 2021, updating a
figure first released in May.
That is nearly three
times higher than the 5.4 million officially reported COVID deaths over those
two years.
Research from the
US-based Institute for Health Metrics and Evaluation estimated in March that
the number was an even higher, at 18.2 million.
But Flahault said that
even these figures could "perhaps still be an underestimate".
The toll has risen
more slowly this year. A regularly updated tally from The Economist estimates
that there have been 21 million excess deaths since the pandemic's start —3.1
times higher than the official number.
Lacking dataAccording to the WHO
figures, India had by far the most excess deaths linked to COVID in 2020-2021
with 4.74 million, a figure the Indian government has sharply disputed.
Russia came next with
a little over one million. However the biggest disparities between the expected
number of deaths and the actual figure were in South America.
Peru, for example,
recorded around twice as many total deaths in 2020-2021 as it had in normal
times.
However, Hanno Ulmer
of Austria's Medical University of Innsbruck pointed out that there were
"also strong dengue fever outbreaks during the pandemic years in
Peru", which could have increased the number of excess deaths without
being linked to COVID.
Another problem is
that many nations have little or no data in the first place.
"For almost half
the countries of the world, tracking excess mortality is not possible using the
data that are available and for these we must rely on statistical models,"
the WHO researchers wrote in this month's study.
In Africa, monthly
data on deaths was only available for six out of 47 countries.
A million deaths in
ChinaLooking forward to
2023, China's lifting of its zero-COVID measures looms large as a possible
source of new deaths.
With the first easing
of strict measures in place since the start of the pandemic, few of China's 1.4
billion population have immunity from previous COVID infection, and vaccination
rates have lagged, particularly among the at-risk elderly.
Modelling by the IHME
predicts more than 300,000 COVID deaths in China by April 1 — and a total of
over a million across 2023.
Last week, China
reclassified what it considers to be COVID deaths, which will now only count if
they come directly from respiratory failure, in a move that analysts say will
dramatically the number of officially recognized deaths.
Hospitals across China
have been overwhelmed by an explosion of infections in recent weeks, but just
one new death was added on Thursday to a tally by a national disease control
body.
Ali Mokdad, a
professor of health metrics sciences at IHME, told AFP that good data was the
only way "we can manage to stay ahead of the virus".
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