The devastation to life caused by Covid-19
As each country now reports daily on the infection and unfortunate loss of life caused by Covid-19. It is quite clear that some countries are doing better than others, or so it may seem. But how are Covid-19 losses calculated?
Through many different discussion groups it has become quite hard to define and accurately report the significant damage caused by Covid-19. Many Countries report hospital admissions and loss of life. Some even report on all settings (at home, work, care home, other). But how is Covid-19 losses calculated?
However reassuring for the general public to have daily reports to detail the fight against Covid-19. We must encourage each country to do their part to report the full information when the pandemic subsides.
How do we work out the Covid-19 Mortality?
Each country reports on the loss of life per cause. This is reported annually and only a few countries share this data. Many countries around the world choose not to share the information. It is up to each person/media outlet within their country to ask the hard questions of the respective governments. This will allow a global understanding of the Covid-19 mortality. Which will show how Covid-19 losses have been calculated.
What is ‘excess mortality’?
Excess mortality is a term used in epidemiology and public health to define the number of deaths occurring during a crisis. Above and beyond what would have been expected under ‘normal’ conditions.
We are looking at excess mortality in the context of the coronavirus pandemic (Covid-19). It applies in circumstances like natural disasters, conflict, famine, other disease outbreaks.
The World Health Organization define ‘excess mortality’ as:
“Mortality above what would be expected based on the non-crisis mortality rate in the population of interest. Excess mortality is thus mortality that is attributable to the crisis conditions. It can be expressed as a rate (the difference between observed and non-crisis mortality rates), or as a total number of excess deaths.”
To calculate ‘excess mortality’ in a given period we would look at the number of people who had died over this period, and compare it to the number we would have expected to have died.
How many people die under ‘normal’ circumstances?
If we know the number of people that have died in the last month, to calculate excess deaths we still need to know how many people we would have expected to have died if the pandemic had not occurred.
To do this it is common to compare current deaths with the average number of deaths in previous years.
By looking at death tolls in previous years we can understand the baseline of how many people we would expect to have died without the pandemic.
A basic example for April would be:
to calculate the number of excess deaths in a given population in April: we could look at the total number of deaths observed in April this year, and subtract the average number of deaths in April in the previous 5 years.
Reporting varies vastly by country
The number of confirmed Covid-19 deaths may differ from the actual death toll for several reasons:
some (not all) countries only report Covid-19 deaths which occur in hospitals. People who die from Covid-19 in other circumstances do not get recorded;
some countries only report deaths for Covid-19 after completed tests, and the patient tested positive. Untested individuals remain unaccounted;
official death reporting systems may be insufficient to accurately measure mortality – this is particularly true in poorer countries;
the pandemic may result in increased deaths from other causes for a number of reasons including weakened healthcare systems; fewer people seeking treatment for other health risks; less available funding and treatment for other diseases (e.g. HIV/AIDS, malaria, tuberculosis);
the pandemic may result in fewer deaths from other causes – for example, fewer injuries from road accidents.
Why accurate reporting is important
To truly understand the mortality consequences of the pandemic – and to compare these impacts across countries.
As we see from the excess mortality estimates published by organisations below. This data is available for some countries – mainly richer countries with high-quality data reporting systems. For most low and middle-income countries, such data is not available.
Researchers can draw on some other sources to estimate excess mortality – such as funeral or burial records. However, this data is harder to find, and possibly less reliable than official statistics.
Unlike statistics on confirmed Covid-19 deaths – for which several organizations such as the WHO, ECDC and Johns Hopkins University. Are collating data for all countries – there is no single source of data on excess mortality.
Several publications have started to publish excess death visualizations for select countries. To do this they have to collect the data country-by-country.
Unfortunately, to date, no publication has published this data as a single dataset. This causes significant duplication in efforts to collect and report it.
The Question remains
Should all countries now work together for the benefit of understanding the devastation caused by Covid-19 or make the same mistakes caused by other disasters?