Governments have been grossly underreporting the number of COVID-19 pandemic deaths and the actual count could be more than three times official estimates, exposing major gaps in health reporting systems, a new study says.
According to the official death figures, the virus had claimed 5.9 million lives by the end of 2021. But an analysis by a team of researchers reveals that the actual figures could be more than 18.2 million – roughly three times the population of Singapore.
The study, the first peer-reviewed estimate on excess COVID-19 deaths, published in The Lancet on Friday, calculated the death figures using data from 191 countries and territories between January 1, 2020, and December 31, 2021.
Researchers gleaned data on deaths released by governments from 2009, 11 years before the onset of the COVID-19 pandemic, to the end of 2021 to estimate the actual death toll due to the pandemic. They used models to derive the excess COVID-19 mortality numbers.
The massive differences between excess COVID-19 deaths and official records, researchers said, may be a result of under-diagnosis due to lack of testing and issues with reporting death data.
Since a majority of developing countries struggled with shortages of testing kits, many victims had no way to confirm their infection. Such casualties might have gone unreported in government records.
“Understanding the true death toll from the pandemic is vital for effective public health decision-making,” said Dr. Haidong Wang, lead author of the study. “Several countries, including Sweden and the Netherlands, suggest COVID-19 was the direct cause of most excess deaths, but we currently don’t have enough evidence for most locations.”
The multiple waves of COVID-19, including those of Delta and Omicron variants, overwhelmed health systems from Italy to India, exposing the vulnerability of governments to deal with major outbreaks of infectious diseases.
The study pointed out that the highest number of excess deaths, 5.3 million, happened in South Asia on a regional level, followed by North Africa and the Middle East, 1.7 million and Eastern Europe, 1.4 million.
The massively undercounted national-level data exposed significant chunks in the way the number of COVID-19 deaths was counted. For example, a wide gap exists between the Indian government’s numbers on COVID-19 fatalities and the number of deaths estimated by the study. While India reported 515,000 deaths as of March 10, researchers estimate the real number to be 4.1 million, nearly eight times the government’s claim.
“Because of its large population, India alone accounted for an estimated 22 percent of the total global deaths,” the researchers said.
Excess COVID-19 deaths in the U.S and Russia were 1.1 million COVID-19 deaths, each. The U.S constantly updates COVID-19 deaths; as a result, the gap between the government’s data – 962,000 till March 10 – and that of the study is one of the lowest.
Mexico and Brazil’s pandemic-related death count was around 798,000 and 792,000, respectively. Indonesia nearly 736,000, and Pakistan 664,000. “These seven countries may have accounted for more than half of global excess deaths caused by the pandemic over the 24-month period,” researchers said.
The study also highlighted that, to date, only 36 countries have released the cause of death data for 2020.
(Cover: A patient suffering from COVID-19 is transported at a field hospital set up at Dell’Antonia sports gym in Santo Andre, on the outskirts of Sao Paulo, Brazil, April 7, 2021. /Reuters)