A vast amount of publicity has been given to a pair of as-yet-unpublished papers from a group of California researchers that indicate COVID-19 is more widespread, and as a result, has a lower fatality rate than official numbers would suggest. There are a lot of reasons to doubt those results.
But statistical reviews of mortality data conducted by The New York Times and The Economist point strongly in the other direction. By comparing deaths in 2020 to the averages found in cities around the world, analysts demonstrate a sharp increase in deaths in region after region, with a particularly obvious change in those nations that have been reluctant to admit the scope of their problem with COVID-19. Other studies have shown that, thanks to COVID-19 monopolizing hospital resources, deaths for all reasons are up. However, many of these deaths are simply people who died from COVID-19, but did so without ever being tested. In all, analysts have found what looks to be at least 25,000 excess deaths attributable to the disease itself, a number large enough to cause a re-estimate of just how deadly this pandemic may be.
Part of what the analysts uncovered was something of global version of what researchers in the U.S. announced on Wednesday: officials in several nations simply didn’t start looking for COVID-19 deaths soon enough. In many countries, deaths were already beginning in February and early March even though the disease wasn’t officially acknowledged, or was considered to be confined to a few cases. In some countries this is still going on as governments that are trying to maintain a pretense of effective action are sweeping deaths into any bin except COVID-19.
Other areas, like Spain and New York City, are areas where COVID-19 is clearly dominating an extraordinary number of excess deaths, to a point where trying to keep up means occasionally bringing forward a big group of previously unidentified deaths, as New York did on April 13. Even so, there are likely thousands of COVID-19 deaths that still need to be added to the tally.
In addition to Spain, where the New York Times researchers show almost 20,000 excess deaths not categorized as COVID-19, another hot spot for additional deaths is the U.K. Both teams find deaths there at over 15,000 above past years, with the difference only partially explained by the official case counts.
Most frightening might be those locations where there are a very large number of excess deaths, but where COVID-19 is officially a minor issue. For example, Indonesia reports just 84 deaths from COVID-19 in Jakarta, but The Economist identifies over 1,500 excess deaths in that area. That could suggest a government either failing to recognize, or deliberately mischaracterizing, a major outbreak.
One factor that affects numerous countries is that deaths are only explicitly categorized when they happen in a hospital. This isn’t so much an effort to suppress numbers on COVID-19, but a recognition that deaths which occur in the home are, in many cases, not followed up by medical experts who determine an exact cause of death. The difficulty of characterizing cause of death for victims who may never have seen a doctor before passing away is easy to understand, especially at a time when coroners and medical examiners are also struggling under a massive case load. But the failure to include these deaths means that the real cost of COVID-19 is being underreported.
And that’s the critical factor here. As right-wing sources seem intent on downplaying the danger of COVID-19 in a wrongheaded effort to “reopen the economy,” the truth is that COVID-19 is actually more dangerous than even the official numbers show. Right-wing sources have been continually pushing the idea that deaths from other causes are being pushed into the COVID-19 category to inflate the effect of the disease, but the opposite is true—tens of thousands of COVID-19 deaths are simply not being tallied as part of the cost of the disease.
When the death toll of the 1918 flu pandemic in the United States is estimated as somewhere around 500,000—plus or minus several hundred thousand—it’s easy to be frustrated by the lack of precision and to assume the fault lies with poor record-keeping a century ago. But a similar inability to pin an exact number on COVID-19 deaths is occurring, both deliberately and out of sheer inability to deal with the scope of the disaster, around the world.