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The problem is that 85 of the 194 countries surveyed by the WHO technical advisory group that made the new estimates do not have death registries good enough to be a viable approach. Forty-one of these countries are in sub-Saharan Africa.
For these countries, a team led by Jonathan Wakefield, a statistician at the University of Washington in Seattle, used data from countries with complete death registries to build another statistical model that could predict the total number of COVID deaths in any month from other measures, including temperature. , the percentage of COVID tests that come back positive, the ranking of the strictness of social distancing and other measures to limit infection, and the rate of diabetes and cardiovascular disease – conditions that put people at high risk of dying from COVID.
India’s health ministry strongly disagreed with this model in response to the New York Times article. But the WHO team did not actually use it to estimate India’s COVID deaths. India belongs to an intermediate group of countries with reasonably good data on the number of deaths in some regions but not in others. So Wakefield’s team used data from 17 Indian states with adequate death registries, applied the standard excess mortality approach used for states with comprehensive death registries, and then extrapolated from those states to all states.
“We’re just basing our projections of how many people died in India over those two years on Indian data,” Wakefield told BuzzFeed News.
Importantly, WHO’s estimate of India’s COVID deaths is also in line with other studies, including one published in the journal Science in January by a team led by Prabhat Jha, director of the Center for Global Health Research at the University of Toronto in Canada. Jha’s team estimated COVID deaths from Indian government data and from a national survey of 137,000 people, conducted by a polling company that asked people if a family member had died from COVID. “India has pretty high cell phone coverage, and they’re doing random numbers,” Jha told BuzzFeed News.
Jha’s team estimated that more than 3.2 million people in India had died from COVID in July 2021, the majority of them during the surge of COVID caused by the Delta variant of the coronavirus between April and June 2021. This happened after the government of Prime Minister Narendra. Modi has relaxed COVID controls after the previous, less severe wave. “The Indian government is declaring victory and saying, ‘Oh India beat this virus,’ and it’s a sense of satisfaction,” Jha said.
This explains the political sensitivities in India about accepting the results of studies that show higher death tolls than official numbers. In response to questions from opposition Congress party leaders about Jha’s study in February, the Ministry of Health and Family Welfare called it “speculative” and said there was “no peer-reviewed scientific data” – despite it being published in one of the world’s leading peer-reviewed scientific journals .
“This is politics,” Jha said of the Indian government’s refusal to study.
According to the WHO, Egypt has the largest proportion of pandemic deaths, with a death toll 11.6 times greater than the toll due to COVID. India, with 9.9 times more deaths than the official COVID death toll, is in second place. Russia, meanwhile, has reported 3.5 times fewer deaths from COVID than indicated by excess deaths.
Ariel Karlinsky of the Hebrew University of Jerusalem, another member of WHO’s technical advisory group, hopes the agency’s “stamp of approval” for excess mortality calculations will encourage countries to come up with more realistic numbers. “Putin doesn’t know who I am, but he knows WHO,” he told BuzzFeed News.
But instead of moving to correct the number of COVID deaths, some governments are now withholding the entire mortality data used to calculate excess deaths. Belarus, which has seen fewer COVID deaths with about 12, has stopped reporting all-cause mortality data to the UN, Karlinsky said. “The part about mortality is just missing.”
Currently, the main concern is China, which has experienced a significant wave of the Omicron variant of the coronavirus but has reported some suspicious deaths. If the current wave hitting Shanghai and other cities matches the pattern seen in Hong Kong since February, Jha fears millions of Chinese could die.
Some countries have responded to excess mortality studies with greater accountability and transparency. After an analysis of excess deaths previously suggested that Peru was underreporting COVID deaths by a factor of 2.7, the South American country reviewed its medical and death records in detail and converted the number of deaths in May 2021 to a figure consistent with the analysis of excess deaths. Currently reporting the highest official per capita death rate from COVID of any country. “Peru is doing what I want every country to do,” Karlinsky said.
The WHO’s new estimate of the pandemic’s excess death toll will include those who die from other causes as the health system is overwhelmed, as well as those who die from the coronavirus.
Karlinsky, who is an economist, said he started analyzing excess deaths because he wondered whether “the cure is worse than the disease” – in particular, he feared that the lockdown could cause more deaths than the coronavirus, partly because of the increase in suicides. But the data tells a very different story.
In countries like New Zealand that have strict lockdowns but low rates of COVID, there are no signals of excess deaths. There is no evidence of a global epidemic of suicides during the pandemic – in the US, suicides actually decreased. Only in some countries like Nicaragua, where people seem to avoid going to the hospital for fear of infection, are there signs that deaths from other causes such as heart disease are increasing, according to Karlinsky.
“The excess mortality is almost the same as the COVID mortality,” he said.
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