Global Covid toll. Global toll from Covid-19 could be three times higher: WHO

Covid-19’s global toll could well be two-three times the 3.4 million deaths currently reported to the World Health Organization, the agency said in its World Health Statistics Report 2021.

The observation was based on the excess mortality estimates for 2020, WHO said, pointing to the toll attributable to Covid-19 standing at 3 million in the pandemic year. This was 1.2 million more deaths than the 1.8 million officially reported.

WHO’s alarming statement on significant under-couting of deaths, comes even as India witnesses similar discussions on reporting of deaths. Some researchers project it at 2 to 6 times more, depending on the State.

“At the time of writing, more than 160 million confirmed Covid-19 cases and 3.3 million deaths had been reported to WHO. Yet these numbers are only a partial picture, as many countries have not been able to accurately measure and report on deaths that are either directly or indirectly attributable to Covid-19,” said WHO chief Dr Tedros Adhanom Ghebreyesus, in the report.

“One of the greatest lessons from the pandemic is the importance of timely, reliable, actionable and disaggregated data,”he added, calling for strong country data and engagement with the private sector, academia, nonprofit organizations, and the scientific community to ensure data is accessible as a public good.

“Excess mortality refers to the difference in the total number of deaths in a crisis-related period, compared to those expected under non-pandemic conditions,”WHO said, adding that the revised toll attributable to Covid-19 provided a more accurate picture of the full impact of the pandemic as it accounted for both the directly attributable deaths and the indirect impacts of the pandemic.

“The calculation of excess deaths requires the observed numbers of deaths for a specified time and place to be compared to those expected if the pandemic had not occurred. Available evidence from the countries with rapid mortality surveillance systems suggests that in many locations the reported number of Covid-19 deaths is a significant undercount of the full toll of the pandemic, and the estimated excess mortality can be many times higher (7–9). However, it is also clear that responses to the pandemic in some locations have resulted in a number of deaths being averted,”it added.

The report notes a recent shift in the distribution of cases and deaths from higher- to lower-resource settings. For example, while HICs (high income countries) accounted for about 64 percent and 59 percent of the global monthly new cases and deaths, respectively, in January 2021, that dropped to 31 percent and 27 percent, respectively in April.

This contrasts to the rise in the share of global monthly new cases contributed by LMICs (low and middle income countries) from 8 percent in January 2021 to 37 percent in April, and the share for new deaths from 8 percent to 22 percent between January and April, this year.

With the help of a technical advisory group (TAG) to assist WHO and member states “preliminary assessments of excess mortality estimate 1.34–1.46 million excess deaths in the region of the Americas during 2020, about 60 percent more than the reported 860 000 Covid-19 deaths. Likewise, 1.11–1.21 million excess deaths are estimated for the European Region, double the 590,000 reported Covid-19 deaths. There are significant data gaps in the African Region, the Eastern Mediterranean Region, the South-East Asia Region and the Western Pacific Region, for which just over 360 000 total Covid-19 deaths were reported for this period”, the report said, called for further refining of the estimates.