The Wuhan coronavirus (COVID-19) has claimed over 300,000 lives globally, according to official figures. However, depending on how deaths are counted, the real number of deaths could be much higher.
As of press time, data gathered by Johns Hopkins University counts 307,159 deaths from the coronavirus worldwide. These figures include only those attributed to the coronavirus. However, experts are increasingly looking at data comparing this year’s death rates with previous years — regardless of the official cause.
This “excess deaths” metric raises the possibility that the actual death toll is much higher, as it includes fatalities indirectly related to the coronavirus. This includes people suffering from other illnesses who couldn’t access treatment because of the strain the pandemic has placed on health care systems.
Excess deaths are being counted, but methods differ wildly
While they can give a better picture of the human toll of the pandemic, tracking excess deaths worldwide has proved difficult. The methods of data compilation have differed wildly between nations. This makes direct comparisons difficult.
In Italy, 12,428 people were recorded as having died due to the coronavirus between February 20 and March 31. In the same period, however, authorities noted 25,354 excess deaths compared with the yearly average of the past five years.
Germany, a country considered to have handled the pandemic better than other E.U. countries, recorded 3,706 deaths more than the average were noted in March. Its official coronavirus toll for the same period was 2,218.
The difference is even more striking in the United States. According to data for March, before the worst of the pandemic hit the country, the number of excess deaths reached around 6,000 — over triple the amount of the official COVID-19 death toll. (Related: Yale scientists say coronavirus deaths “significantly higher than reported” in U.S.)
In France, on the other hand, the COVID-19 death toll of 23,291 from the period of March 1 to April 27 is much closer to the total number of additional deaths — 24,116 — compared with 2019.
Attempts at standardized counting
The EuroMOMO project, a Danish led effort at collating mortality data in response to public health threats, provides one standardized way of tracking excess deaths in the continent. The project has already confirmed what other observations in Europe have made — that there was a rise in excess deaths in March compared to previous years.
EuroMOMO’s data confirmed that countries hit hard by the pandemic such as Spain, Italy, France and Britan had significant increases in excess mortality in March. However, this was absent in countries that escaped the worst of the pandemic, such as Norway and Finland.
“There’s nothing else that could explain the excess of deaths,” said EuroMOMO coordinator Lasse Vestergaard. “If it was in January, some of this could have been explained by influenza. And there has been no volcanic eruption or earthquake in Europe.”
However, the lack of transparency from some countries makes applying this kind of standardized monitoring difficult. For example, while Iran is widely considered to be the worst-hit Middle Eastern country, it has not published any detailed mortality figures since December 2019.
Excess deaths are still the best indicator of the pandemic’s impact
While a standardized counting method doesn’t exist, excess mortality data is still the best indicator of how the pandemic has impacted different countries, according to Yvonne Doyle, the medical director of Public Health England.
“This is a comparable measure internationally. So we would then be able to understand how we have been impacted internationally as well,” she explained.
In America, the Centers for Disease Control and Prevention (CDC) has also started looking into excess mortality to learn more about the coronavirus’s impact. The CDC has specifically looked into how it can give a better picture of the actual death toll in New York City.
According to a recent CDC report, tracking excess deaths “is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions.”
However, some experts caution against reading too much into the figures and jumping into conclusions on which countries have best dealt with the pandemic.
“These are statistical increases… But we cannot say what these increases are due to,” said Fernando Simon, head of the emergency center at Spain’s Ministry of Health.
“This excess mortality is due to the crisis as a whole,” added Michel Guillot, head of research at France’s Institute of National Demographic Studies.
“There may be indirect effects, such as an increase in other causes of death, because we know that people have gone to seek medical help less.”