COVID-19 death toll may be much higher than what is being reported, analyses show

According to updated CDC data, the death toll in seven US states is 50% higher than previous years between March 8 to April 11. In public health circles, excess deaths are calculated by comparing trending death rates to death rates in the past. In New Jersey, for example, 5,200 excess deaths were reported, 2,183 of which were attributed to COVID-19 - that leaves around 3,000 unexplained deaths in the state. This brings us to about 9,000 total excess deaths that aren’t categorized as COVID-19 deaths in the seven states. [caption id=“attachment_8232531” align=“alignleft” width=“380”]  Representational image. Image by ISIDORO MATIAS GONZALEZ from Pixabay.[/caption] The question now is, whether some part of these unexplained deaths could also be contributed to COVID-19 - directly or due to the emergency measures caused by the pandemic. This is because only testing for COVID-19 reveals if a person is afflicted with it and it is still challenging to get tested. This makes it difficult to say how many of these additional deaths are related to the pandemic. However, these discrepancies highlight trends that have been seen by epidemiologists worldwide; Wuhan recently bumped up COVID-19 deaths by half, and New York amended its figures as well. Health experts have also suggested that deaths in Italy are much higher than have been reported. Deaths from COVID-19 are a handy indicator to gauge the situation we are in since many of those who have mild symptoms will never be tested. Here is a quick survey of excess deaths reported across the globe by governments and think tanks.

Excess deaths across the globe 

According to an analysis of 14 countries carried out by the Financial Times, the actual death toll from COVID-19 may be about 60% higher than reported. A total of 122,000 excess deaths had occurred in these areas, with 77,000 of those attributed to COVID-19 as of April 26. For example, in Belgium, there has been a 60% increase in deaths, a 90% increase in Italy and a 51% increase in Spain between March and late April. There is no doubt that some of these deaths have nothing to do with COVID-19, but a closer examination of cities that have been worst affected by the pandemic reveals staggering figures. Lombardy - the north Italian region which has seen the worst outbreak in Europe - has seen a 155% increase in deaths. This comes to over 13,000 deaths; only 4,348 had been reported as COVID-19 deaths at the time the report was published. Bergamo province, also in Italy, has seen a rise of 460% in deaths. In Guayas, Ecuador, which is now the centre of a massive outbreak, deaths have risen by close to 350%. Similarly, New York City has seen a 200% increase as well. Looking at excess deaths in epicentres does suggest that official figures may be off. Further, these estimates are likely to be undercalculating the actual death toll as well. As the world has shut down, occupational deaths and deaths by accident have also dropped precipitously. In Mumbai, for example, an average of eight people per day are killed because of commuter trains. Since March 22 to mid-April, a total of eight people have died in similar circumstances. Since these figures are a part of baseline calculations, their lower prevalence may nudge COVID-19 related deaths up further.

The situation in India

It is challenging to gauge the situation in India since, as per media reports, 80% of deaths take place at home, or at least outside hospitals. Having said that, K Srinath Reddy, president of the Public Health Foundation of India, in conversation with the BBC, said that there has not been a large increase in in-hospital deaths. Similarly, a sudden increase in deaths in households is unlikely to go unnoticed for too long either, he added. India has managed to avert a full-scale public health disaster so far - according to the latest data, there have been 0.8 deaths per million due to COVID-19. Even if this is an underestimate, the country seems to be doing comparatively well at this stage. As for why that is, the answer is still elusive. For more information, read our article on Causes of death in COVID-19. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.