Global SARS-CoV-2 Death Toll Could Be 60% Higher Than Reported

Reading about the claim by the Centers for Disease Control and Prevention that the number of people in the United States who have been infected with the coronavirus is likely 10 times higher than the number of reported cases. That would mean approximately 25 million Americans have been infected so far.

That led me to several Financial Times articles from a few months ago discussing under-reported cases and deaths around the world.

FT looked at the average number of deaths in 14 countries from March 1-April 15 for the previous five years and compared it to the same time period this year, giving an idea of "excess deaths". David Spiegelhalter, the Winton professor of public understanding of risk at Cambridge University, says it's "the only unbiased comparison" given the problems measuring deaths and their causes.

In those 14 countries, the death toll from SARS-CoV-2 could be 60% higher than what has been reported officially.

Hugo López-Gatell, Mexico's health under-secretary and coronavirus tsar, admitted the true infection level in Mexico is at least eight times higher than reported. In Brazil, the real number of cases might be 12 times more than officially reported.

In Ecuador's Guayas province, there were 245 Covid deaths reported between March 1 and April 15. But the region saw more than 10,000 additional deaths than in a typical year.

In Jakarta, Indonesia, there were 1,400 more deaths than the historical average, but only 90 reported Covid deaths. Italy's Lombardy region reported 4,348 Covid deaths, but had more than 13,000 excess deaths.

Global Coronavirus Death Toll Could Be 60% Higher Than Reported
John Burn-Murdoch, Valentina Romei, and Chris Giles, Financial Times, April 26, 2020

The death toll from coronavirus may be almost 60 per cent higher than reported in official counts, according to an FT analysis of overall fatalities during the pandemic in 14 countries.

Mortality statistics show 122,000 deaths in excess of normal levels across these locations, considerably higher than the 77,000 official Covid-19 deaths reported for the same places and time periods.

If the same level of under-reporting observed in these countries was happening worldwide, the global Covid-19 death toll would rise from the current official total of 201,000 to as high as 318,000.

To calculate excess deaths, the FT has compared deaths from all causes in the weeks of a location's outbreak in March and April 2020 to the average for the same period between 2015 and 2019. The total of 122,000 amounts to a 50 per cent rise in overall mortality relative to the historical average for the locations studied.

In all the countries analysed except Denmark, excess deaths far outnumbered the official coronavirus death tolls. ...

The extra deaths are most pronounced in urban areas with the worst virus outbreaks, and have completely overwhelmed reporting mechanisms in some. This is especially worrying for many emerging economies, where total excess mortality is orders of magnitude higher than official coronavirus fatalities.

In Ecuador's Guayas province, just 245 official Covid-related deaths were reported between March 1 and April 15, but data on total deaths show that about 10,200 more people died during this period than in a typical year — an increase of 350 per cent. ...

In the northern Italian region of Lombardy, the heart of Europe's worst outbreak, there are more than 13,000 excess deaths in the official statistics for the nearly 1,700 municipalities for which data is available. This is an uptick of 155 per cent on the historical average and far higher than the 4,348 reported Covid deaths in the region.

The region surrounding the Italian city of Bergamo registered the worst increase internationally with a 464 per cent rise in deaths above normal levels, followed by New York City with a 200 per cent increase, and Madrid, Spain, with a 161 per cent increase.

In the Indonesian capital Jakarta, data on burials shows an increase of 1,400 relative to the historical average during the same period — 15 times the official figure of 90 Covid deaths for the same period. ...

UK Coronavirus Deaths More Than Double Official Figure, According To FT Study
Chris Giles, Financial Times, April 21, 2020

The coronavirus pandemic has already caused as many as 41,000 deaths in the UK, according to a Financial Times analysis of the latest data from the Office for National Statistics.

The estimate is more than double the official figure of 17,337 released by ministers on Tuesday, which is updated daily and only counts those who have died in hospitals after testing positive for the virus.

The FT extrapolation, based on figures from the ONS that were also published on Tuesday, includes deaths that occurred outside hospitals updated to reflect recent mortality trends.

The analysis also supports emerging evidence that the peak of deaths in the UK occurred on April 8 with the mortality rate gradually trending lower since, despite the 823 hospital deaths announced on Tuesday, which were sharply up on the 449 in the previous 24 hours.

The ONS data showed that deaths registered in the week ending April 10 were 75 per cent above normal in England and Wales, the highest level for more than 20 years.

There were 18,516 deaths registered during that period compared with the most recent five-year average of 10,520 for the same week of the year. There were similar patterns in Scotland and Northern Ireland

Nick Stripe, head of life events at the Office for National Statistics, said the figure was "unprecedented", especially as the weather had been sunny and warm in the run-up to the Easter weekend.

He added that because the week included Good Friday, when registrations were much lower than on a normal working day, the ONS numbers were also "conservatively" at least 2,000 too low.

Latin American Gravediggers Fear Virus Death Toll Higher Than Admitted
Andres Schipani in São Paulo and Jude Webber in Mexico City, Financial Times, April 20, 2020

Three grave diggers, one dressed in a white protective smock, quickly buried Vítor Batista's wooden coffin. Two weeks ago the 96-year-old was hospitalised with pneumonia but, like others filling graves in Brazil's biggest cemetery, he died before receiving the results of a coronavirus test.

"I am sure he had corona," said Ulisses Frutuoso, the dead man's nephew. "I feel we don't know the real extent of this tragedy, but cases must be . . ." He raised his hand to the sky, signalling that deaths from Covid-19 were probably rocketing well beyond the more than 2,400 that have been officially recorded in Brazil.

Workers at the cemetery of Vila Formosa in São Paulo, who have been busy digging rows of graves — even using a backhoe at times — are similarly convinced that the virus has claimed more casualties than official statistics suggest. "Many like him arrive here before getting the test results," said one, who wished not to be named, gesturing at the coffin while washing his hands. "We have been burying a lot."

Gravediggers, health workers, and researchers in Latin America's two biggest countries, Brazil and Mexico, tell a different story to the official numbers. As of Sunday, Mexico had 8,261 confirmed cases and 686 deaths. But Hugo López-Gatell, the health under-secretary who is the country's coronavirus tsar, has admitted that the true infection level is at least eight times higher. ...

Researchers at a group of respected Brazilian universities and institutes said last week there were probably close to 12 times more cases of coronavirus than were being officially reported by the government in Latin America's largest country, home to some 211m people. As of Sunday, Brazil had more than 38,000 confirmed cases, which would put the true tally at 456,000.

"The rapid course of the pandemic and the low number of tests performed in Brazil make it difficult to estimate the actual number of confirmed cases," the Health Operations and Intelligence Nucleus, or NOIS, said.

"The high degree of under-reporting may give a false impression about disease control and, consequently, could lead to a decline in the implementation of containment actions."