How many people have really died from covid-19 so far?

Looking at how many more people are dying than usual gives an idea of the coronavirus pandemic’s true effect – and suggests a far higher death toll in many countries

By Michael Le Page

Michael Dantas/Afp Via Getty Images

WITH few countries doing enough testing to identify anywhere near all the deaths caused by the coronavirus, looking at how many more people are dying than usual is a better way of assessing the pandemic’s effect.

Why are the covid-19 death counts underestimates?

Reported coronavirus deaths are typically severely ill people who have tested positive for the coronavirus in a hospital. However, many people who have died may not have been tested – especially those who died at home or in a care home. Looking at the number of excess deaths suggests the true death toll has been higher than the number reported in many places, including Italy, Spain, Sweden, and England and Wales.

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What are “excess deaths”?

It is how many more people are dying than would be expected. For instance, at this time of year, normally around 50,000 people die each week in the 24 European countries that report deaths to the EuroMOMO monitoring scheme. This has shot up to about 90,000, according to the latest numbers, which aren’t yet complete.

How big is the disparity with official counts?

It varies. One study estimates that the coronavirus had caused the deaths of 52,000 people in Italy by 18 April (medRxiv, doi.org/ds6s) – more than double the reported figure. Similarly, a Financial Times analysis suggests the virus had led to 45,000 deaths in the UK by 21 April, more than twice the official figure then of 17,000.

Are all the excess deaths due to the coronavirus?

Figures from the UK’s Office for National Statistics indicate that the coronavirus is to blame for more than two-thirds of the excess deaths in England and Wales, based on the number of confirmed or suspected cases of covid-19 reported on death certificates.

That leaves roughly a third of excess deaths unexplained. Some of these may have been coronavirus cases without obvious symptoms, or cases where doctors weren’t confident enough to mention covid-19 on the death certificate. However, some of the unexplained excess deaths could be a result of more people dying of other causes, such as heart attack or stroke, because some are avoiding going to hospital due to the coronavirus. Emergency admissions figures from Public Health England suggest that attendance at hospital emergency departments in England was down about 50 per cent in April.

What about the crisis’s impact on hospitals?

It is certainly possible that some of the unexplained deaths may be indirect coronavirus deaths: people receiving less than the usual standard of medical care for a non-coronavirus condition due to the strain the virus is placing on healthcare systems.

Will we ever know the true toll of the virus?

Not exactly. But we will be able to get a much clearer picture once the crisis eventually ends and the overall number of deaths in 2020 and 2021 can be compared with other years.

What we do know for now is that most countries’ death tolls are undoubtedly underestimates – and for places including the US and Europe, many more deaths are still expected.