Pandemic toll at end of 2021 may have reached 15 million, WHO says

The World Health Organization estimates that nearly 15 million people have been killed either by the coronavirus or its impact on overwhelmed health systems in the past two years, more than double the official figure of six million. of dead. Most deaths have occurred in Southeast Asia, Europe and the Americas.

In a report on Thursday, WHO chief Tedros Adhanom Ghebreyesus called the figure “sobering”, saying it should spur countries to invest more in their capacity to suppress future health emergencies.

Scientists commissioned by the WHO to calculate the true number of deaths from COVID-19 between January 2020 and the end of last year estimated that there were between 13.3 million and 16.6 million deaths that were either caused directly by the coronavirus or attributed in some way to the impact of the pandemic on health systems, such as people with cancer unable to seek treatment while hospitals were full of virus patients.

Figures are based on data reported by countries and statistical modelling.

“It may seem like a simple counting exercise, but having these figures from the WHO is so essential to understanding how we should fight future pandemics and continue to respond to this one,” said disease specialist Albert Ko. infections at the Yale School of Public Health that was unrelated to the WHO research.

For example, Ko said, South Korea’s decision to invest heavily in public health after suffering a severe MERS outbreak allowed it to escape COVID-19 with a per capita death rate of around 1/20th that of the United States.

Middle-income countries have struggled to report: WHO

It is estimated that nearly a third of the total surplus is in India, or 4.7 million. The country, which suffered a devastating wave spurred by the Delta variant in 2021, had declared by the end of this year that its deaths from COVID-19 stood at 481,080 people.

The number of cases in India matched a general trend in the data, which saw 68% of excess deaths concentrated in 10 populous middle-income countries, a list that includes Pakistan, Nigeria, Indonesia and Mexico. .

Countries in Europe and North America where modeling suggests the official death toll is understated include the United States, Britain, Italy, Germany, Poland and Ukraine. .

Other countries that ranked high in modeling excess deaths include Brazil, Colombia, Iran, the Philippines, Peru, Russia and South Africa.

WHO officials noted a significant gender disparity, with men accounting for 57% of estimated deaths, while the elderly were disproportionately affected compared to population share.

Excess deaths in Canada in all age groups in 2021

Statistics Canada previously estimated that there were 16,333 more deaths in the country at the end of 2020 than would otherwise be expected before the pandemic. Last month, the statistics agency estimated excess deaths between the start of the pandemic in March 2020 and the end of November 2021 in 28,987 people.

The WHO data doesn’t appear to deviate much from these numbers, but does provide context on how the virus has evolved over time. In 2020, 57.3% of excess deaths were estimated to be in the 80+ age group, although the 25-39 demographic saw deaths nearly 11% higher than might have been expected in the present. absence of the pandemic. Nearly 70% of excess deaths were among men.

But in 2021, when vaccines were readily available, the dramatic age bias is not visible. The cohorts aged 70-79, 60-69 and 25-39 all had excess deaths more than 20% higher than would be expected, while the excess deaths of 40 to 59 was estimated to be around 15% higher.

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the Canadian Medical Association and others have pointed to postponed surgeries, delayed emergency room visits, and the supply of toxic street drugs during the pandemic contributing to excess deaths.

Accurate numbers on COVID-19 deaths have been problematic throughout the pandemic, as the numbers represent only a fraction of the devastation caused by the virus, largely due to limited testing and differences in how countries count deaths from COVID-19. According to government figures reported to the WHO and a separate tally kept by Johns Hopkins University in Baltimore, there have been more than six million coronavirus deaths reported to date.

Dozens of countries do not document cause of death

Additionally, WHO officials said on Thursday that about 70 countries do not regularly produce cause-of-death certificates, a figure WHO director of data and analysis Dr Stephen MacFeely said. described as “shocking”.

Scientists from the Institute of Health Metrics and Evaluation at the University of Washington estimated that there were more than 18 million deaths from COVID-19 from January 2020 to December 2021 in a recent study published in the journal Lancet , and a team led by Canadian researchers estimated there were more than three million uncounted coronavirus deaths in India alone.

Some countries, including India, have challenged the WHO’s methodology for calculating deaths from COVID-19, resisting the idea that there were many more deaths than those officially counted. Earlier this week, the Indian government released new figures showing there were 474,806 more deaths in 2020 compared to the previous year, but did not say how many were pandemic-related. India has not released any death estimates for 2021.

Yale’s Ko said better figures from the WHO could also explain some lingering mysteries about the pandemic, such as why Africa appears to have been one of the least affected by the virus, despite its low vaccination rates. “Were the death rates so low because we couldn’t count the deaths or was there some other factor to explain that?” he said.

Dr Bharat Pankhania, a public health specialist at Britain’s University of Exeter, said we may never come close to the true toll of COVID-19, especially in poor countries.

“When you have a massive outbreak where people are dying in the streets from lack of oxygen, bodies have been dumped or people have had to be cremated quickly because of cultural beliefs, we end up never knowing how many people died,” he said. .

Pankhania warned that the cost of COVID-19 could be much more damaging in the long term, given the growing burden of long COVID.

“We don’t know to what extent people with long-lasting COVID will have their lives cut short and whether they will have repeat infections that cause them even more problems.”