The measurement of excess mortality is an essential component to understanding the real impact of a pandemic like the one caused by Covid-19. It is calculated as the difference between the number of deaths that occurred and the number that would be expected in the absence of this situation, based on data from previous years.

Now, the World Health Organization (WHO) made public a report which shows that the total number of deaths related to the pandemic between January 1, 2020 and December 31, 2021 it was from approximately 14.9 million.

It is no surprise that this latest WHO estimate is much higher than the official total of Covid deaths in all countries.

Kevin McConway, Open University

Includes deaths associated with SARS-CoV-2 directly (by the disease it causes) or indirectly (by its impact on health systems and society, such as lack of access to treatment). It is clear that the estimated value can be influenced by the deaths avoided in this period due to the lower risks of certain events due to confinements, such as car accidents or injuries occupational.

“These data point not only to the impact of covid-19, but also to the need for all countries to invest in more resilient health systems that can sustain essential services during crisis“, Explain Tedros Adhanom GhebreyesusDirector General of WHO.

The abstract argues that most of the excess of deaths (84%) focuses on Southeast Asia, Europe and America, and that about 68% are grouped in just 10 countries in the world. Middle-income countries account for 81% of the 14.9 million additional deaths (53% in lower-middle-income countries plus 28% in upper-middle-income countries), and high- and low-income countries 15 and 4%, respectively.

Unfortunately, the figure of around 15 million deaths worldwide during the first two years of the pandemic is likely to be far more accurate than the approximately 6 million confirmed deaths recorded. John Edmundsprofessor at the Center for Mathematical Modeling of Infectious Diseases at the London School of Hygiene & Tropical Medicine, speaking to the science media center From UK.

Most of the excess mortality, 84%, is concentrated in Southeast Asia, Europe and America, and about 68% is clustered in just 10 countries in the world. Middle-income territories account for 81% of these 14.9 million additional deaths

the same opinion Kevin McConwayProfessor of Applied Statistics at Open University: “It is not surprising that this WHO estimate is much higher than the official data for covid in all countries. One of the main reasons is that the count typically only includes people whose death was directly caused by the virus. That’s why it’s so important to look at the surplus.”

Assessing lives lost to the pandemic

Estimates for this 24-month period also include a breakdown of excess mortality by age and sex. Thus, it is confirmed that the global number of deaths was higher for men than for women (57% vs. 43%) and higher among the elderly, although keep in mind that the absolute count of excess deaths is affected by population size.

The method used by WHO is based on a statistical model derived from territory information, which is used to generate estimates for states with little or no data available. It is the result of a worldwide collaboration supported by the work of Technical Advisory Group on Mortality Assessment by Covid-19 and country consultations.

Report confirms that the global number of deaths was higher for men than women (57% vs. 43%) and higher among older adults

“Obviously, using these types of tools is problematic when there are large groups of countries with little or no relevant data, as is the case with Africa,” adds Edmunds. “For this reason, other works arrived at different estimates. However, the general pattern of these studies is similar: the true burden is likely to be much greater than the number of confirmed deaths, and middle-income countries tended to fare worse during the epidemic.”

According Stefan Schweinfestfrom the Department of Economic and Social Affairs at United Nations, “Data deficiencies make it difficult to assess the true scope of a crisis, with serious consequences for people’s lives. The pandemic has been a strong reminder of the need for better coordination within countries and greater international support to build better surveillance systems, such as recording deaths and other vital events.”

Many deaths could be preventable

For your part, Amitava Banerjeeprofessor at the Institute of Health Informatics at University College Londonconsiders that the WHO analysis highlights several overlooked aspects of the pandemic: “First, its impact is much greater than direct deaths from covid-19, and even more so in countries that did not prioritize infection suppression policies and had high rates”.

“Likewise, the pandemic has demonstrated the crucial role that ongoing surveillance plays in pandemic response and preparedness, which must be urgently prioritized,” he continues. As excess deaths were not rigorously accounted for in all countries, the indirect effects on non-COVID-related deaths were not fully assessed and health systems were not prepared.”

There is no hiding the fact that this devastating number of deaths was not inevitable; or that there have been many times in the last two years when world leaders have failed to act at the level necessary to save lives

Jeremy Farrar, Director of Wellcome

But how many of these deaths could have been prevented? Per Jeremy Farrardirector of Welcome, “There is no hiding the fact that this devastating number of deaths was not inevitable; or that there have been many times in the last two years when world leaders have not acted at the level necessary to save lives”.

“Governments must learn from this crisis and prevent it from happening again. This means creating and maintaining national and global surveillance networks to detect outbreaks before they escalate, supporting public health professionals so they can respond quickly when an epidemic begins, and equitably distributing R&D and manufacturing of vaccines, treatments and diagnostics. And that it is operational every day”, he concludes.


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