Trendspotting: New Estimates on True Global Covid-19 Death Count

NewsWire: 4/4/22

• A new study estimates that the worldwide death toll for Covid-19 may be 3x greater than the count according to official data. In all, researchers say that 18.2 million people have died thus far. (The Lancet)
  
• NH: A year ago, we wrote a NewsWire on different efforts to calculate the true global Covid-19 death count. The Economist estimated that the actual Covid death toll was 2x to 4x higher than the official total, while the University of Washington’s IHME estimated it was 2x greater. (See “What Is the Global Covid-19 Death Toll?”)
• Now comes a new peer-reviewed paper by IHME that updates its estimate through the end of 2021. The researchers calculate, for each country, an "excess death" count. In brief, they look at total deaths in a pandemic year and compare them with the average deaths that occurred on an average of previous years. This gives a more accurate measure of Covid-19 deaths. So let’s dive into the results. 
• Between 2020 and 2021, there were 18.2M global excess deaths. That’s +12.3M more deaths than the official Covid-19 death count. Or, in other words, it's +3.1x higher. In absolute numbers, seven countries had excess deaths above 500K: India 4.1M, US 1.3M, Russia 1.1M, Mexico 798K, Brazil 792K, Indonesia 736K, and Pakistan 664K.

• The regions with the highest excess deaths per 100K people were the Andean states, eastern and central Europe, southern sub-Saharan Africa, and Central America. Here are the highest results by individual country: Bolivia 734.9, Bulgaria 647.3, Eswatini (formerly, Swaziland) 634.9, Lesotho 562.9, Peru 528.6, Lebanon 416.2, Russia 374.6, and Mexico 325.1. As we once frequently noted in our Covid-19 reports, these were all on the experts' short-list of most pandemic-devastated countries in 2020 in 2021.

• The paper also calculated the ratio between the excess death rate and the official Covid-19 death rate for each country. In other words, we can tell which nations did not count the highest shares of actual excess deaths. Unsurprisingly, the highest ratios were in Sub-Saharan Africa (ex South Africa) and much of South and East Asia.
• The main obstacle facing most of these states is underfunded if not primitive public health systems that often cannot afford to ascertain cause of death. Indeed, many Sub-Saharan African countries cannot afford reliable counts of total deaths--which, if this has led to an undercount of recent excess deaths--could mean that the actual toll of the pandemic here is higher than indicated by IMHE. (This continues to be one big advantage of The Economist model: As we explained in our earlier NW, it doesn't necessarily accept a country's total death count.) The actual mortality rate due to Covid-19 in Sub-Saharan Africa remains a topic of vigorous debate among epidemiologists.
• Another obstacle posed mainly by China is the deliberate official misreporting of Covid-19 cases and deaths. Because China's total death count is integrally connected to its total population count, it can't easily be hidden. So China has not been able to conceal the recent rise in its total death count. If we compare this with the PRC's next-to-zero numbers for Covid-related deaths, we are forced to conclude that China's rate of undercounting is on par with Chad's or Sudan's. The problem here is not underfunding. It's official suppression of information.

• So how do IHME’s estimates jibe with The Economist’s current model? The Economist came to a similar conclusion: Global excess deaths are 3.3x higher than the official Covid-19 death count. The Economist's total estimate is even higher than IHME's, at 20.1M excess deaths. But this is largely because they update their model daily, and IHME’s calculations stopped on Dec 31, 2021.

• In absolute numbers, the global Covid death toll is similar to the Spanish Flu: About 15 to 25 million people died from the H1N1 influenza virus between 1. But the world's population was about one-quarter of what it is today. So on a per-capita basis, the Spanish Flu was much more severe since it killed 4x more people. 

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