More than 3.4 million people worldwide have died from the deadly pandemic coronavirus. This is the official number, but who am I? According to experts, the 3.4 million is just a fraction of the real number for which the answer will not be given soon, but it may never be given.
Unrecorded deaths, hidden deaths, deaths associated with oversaturation of health systems, but also lives saved in a slow-moving world…
The complexity of the equation does not prevent scientists from looking for answers, crucial to a reliable account of a historical pandemic and to learn lessons from its management.
According to World Health Organization estimates presented today, The pandemic has so far caused about 6 to 8 million deaths, directly or indirectly, ie 2 to 3 times more than the official figure of 3.4 million.
However, some calculations are even heavier. The Seattle Institute for Health Metrics and Evaluation (IHME), according to the Athens News Agency, estimates that the number of deaths due directly to Covid worldwide has reached 6.9 million since March 2020.
An estimated 912,000 deaths in the United States
According to the study published in early May, the United States has a heavy death toll of 912,000 (compared to 578,000, according to official figures), Mexico 621,000 (compared to 219,000 officially) and Brazil 616,000 (versus 423,000). In Russia, the gap between reality and official figures is spectacular with 111,000 official deaths, compared to an estimated 600,000.
In some countries, a significant portion of this underestimation is associated with a limited number of diagnostic tests, such as in Mexico or India, explains Chris Murray, head of IHME.
Whatever the reasons, “these huge corrections of official numbers are crucial to understanding where the pandemic had the greatest impact and determining whether policies implemented by governments have mitigated the effects,” he said.
The IHME conclusions, with which not all scientists agree, illustrate the problems associated with mathematical models based on segmented data.
This model is based on a series of hypotheses that may be true globally but cannot be applied individually to countries, says Steven Woolf of Virginia Commonwealth University, who disputes the outcome of the United States estimates.
“900,000 exaggerated deaths makes sense, but not all extra deaths are directly linked to the virus,” he says.
Deficit data
To assess the true extent of the epidemic, scientists first turn their attention to the exaggerated mortality recorded in relation to the number of deaths considered expected based on data from previous years.
“Calculation is not easy. “But then we have to separate the direct and indirect effects of Covid,” said Stéphane Helleringer, a demographer at New York University in Abu Dhabi.
These indirect consequences may be deaths associated with oversaturation of hospitals that can not care for other patients or, conversely, deaths avoided may be associated with reduced road accidents or reduced air pollution.
«Globally, the calculation is extremely complex“, Continues the researcher, who is a member of the team of experts who advise him World Health Organization on the subject.
Mainly due to a glaring lack of data in poor countries. Even before the epidemic, Malawi accounted for only 10% to 15% of all deaths in its territory.
In these countries, it is completely impossible to calculate excessive mortality in real time, which is necessary for the proper allocation of resources, especially vaccines, he says.
“Today we are still discussing the Spanish flu report,” he added.
If all experts seem to agree that the death toll has been underestimated, the question is to what extent, says Stéphane Helleringer.
A study published in the medical review BMJ estimates that over 1 million deaths are due to excessive mortality in 2020 in only 29 rich countries, which is 31% more than the official Covid-19 death toll.
But that does not allow conclusions to be drawn for other parts of the world, warns one of the study’s authors, Nazrul Islam of Oxford University.
So, if the question is “Will we ever be able to calculate the global consequences, in all countries?” , the answer is “probably not”.
“We are still debating the Spanish flu report for a century,” said Stéphane Helleringer, insisting that the effects of the pandemic would plague demographers and epidemiologists for many years to come.
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