So far, more than 300,000 people globally are known to have died because of the coronavirus. And as shocking as those numbers are, experts believe there are actually many more deaths we’re not counting.
It might sound macabre, but in order to save lives, you need to count deaths. Knowing how may have died and the context around their deaths is crucial for understanding and fighting the virus. That’s because we need to understand how fast and in what groups mortality is rising in order to fine-tune the policies that govern out response to the virus.
Experts are looking past the official count to find other ways to investigate just how many people are dying.
Alan Lopez is a laureate professor of global health at the University of Melbourne. He’s spent a lot of his life counting the dead and figuring out why people die. Now his efforts have turned to Covid-19. He says monitoring mortality right now is critical for striking the optimal balance between saving people from the pandemic and worsening other health threats.
“We need to understand how bad these deaths are increasing in order for us to turn those policy levers and knobs at the right speed in the right direction. So if mortality is still increasing, then we absolutely need to keep doing what we’re doing to prevent that. But in order for us to do that, we need to understand reliably how many people are dying as a result of the Covid-19 epidemic. And at what time and at what age they’re dying. There’s no point making policy now on Covid-19 mortality data four, five or six weeks ago. You need mortality data from the last week and you need it by age, you need it by sex. And you need it to be reliable.”
Alan and his partner Professor Christopher Murray at the University of Washington in Seattle have spent more than two decades studying mortality rates, and he says getting that reliable data can be tricky. The World Health Organization, as of May 26, said more than 5.3 million people are known to have caught the novel coronavirus and of those more than 6 percent have died. But those numbers aren’t reliable.
Many people got Covid-19 and weren’t tested, so their infection wasn’t recorded. Some people died at home, especially when hospitals were overwhelmed. Some people died, too, because they couldn’t get treated for another life-threatening condition.
So how do you factor in those unreported cases and deaths to get a more realistic number? Alan says, you ask yourself a simple question and go from there.
“What if Covid-19 never happened? What would we expect to see in terms of numbers of deaths by age and sex? And then what do we see? And in the absence of any major shock to the system, like an earthquake or a flood or some catastrophic event that causes a lot of deaths, all of those deaths must be due to the only other thing that’s happened that’s different this year from last year. And that is Covid-19.”
In countries with robust data Professor Lopez says Covid-19 is probably killing about twice as many people as officially reported.
“Somewhere between 70 to 120% more people than the official figures of confirmed possible Covid-19 deaths in hospitals. We can see that already. Unless we monitor this epidemic cleverly and comprehensively by looking at all of the deaths that Covid-19 is causing, we are going to seriously underestimate it.”
And then there’s the matter of figuring out which deaths were the direct result of Covid-19, and which ones were caused by some other, indirect factor.
“We need to understand fully the impact of Covid-19 not just as an underlying cause of death in hospitals with these confirmed Covid-19 cases, but also what we call the multiplier effects of Covid-19. The fact that it’s likely to increase the risk of major vascular diseases, heart failures, ischemic heart disease, stroke. We’re seeing increasing evidence of that. The fact that it’s likely to increase death rates from chronic obstructive lung disease, slightly increased death rates among smokers. So it’s doing a lot of things that are multiplying up the risks of other causes of death, leading to a much bigger often 2 times higher overall impact than what we’re measuring in the specific hospital mortality rate.”
Professor Lopez leads the Data for Health Initiative, which is funded by the Australian government and Bloomberg Philanthropies.
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