Epidemiologists warn that if the official figures are so wrong, then the planning to meet the requirements for everything from test kits, hospital beds, ICU, oxygen requirement, ventilators, and even funerary planning would need to be re-evaluated and up-scaled.
“We have known that under-reporting is widespread. The figures are underestimates, but the impact cannot be underestimated,” says virologist Sher Bahadur Pun at Teku Hospital. “For example, although we are just beginning to see a plateauing of the second wave, the increase in new cases is constant and the strain on the health system remains the same.”
The IHME uses the ‘excess mortality’ model to calculate a more accurate figure for the infection and death rate from Covid-19 by using data for previous years, and factoring in new variables to calculate how many more people are actually dying during the pandemic compared to pre-pandemic years.
There are many factors affecting mortality during the pandemic: deaths directly due to Covid-19, increase in mortality because patients with pre-existing conditions are not getting the hospital care they need, or deaths due to mental disorders. However, there is also a reduction during the pandemic of deaths caused by high air pollution, fatalities from other air-borne infections like tuberculosis, measles or influenza, and even a drop in highway-traffic accidents.
So, IHME modellers collected available data on excess mortality from Covid-19, added an estimate the additional deaths that were not registered to came up with the total deaths from coronavirus.
The results are shocking. The actual global death toll from Covid-19 is more than double the 3.5 million official figure. In India, the government’s figure for total fatalities till Saturday stood at 325,998, but the projections show that the actual deaths probably at more than 1 million. Although the death rate is going down, IHME says India’s cumulative deaths from Covid-19 could be 1.2 million by 1 September.
In Nepal, even official data shows a steep spike during the whole of May as Nepali workers started arriving from India with the fast-spreading B.1.617 variant. But on 1 May when the confirmed daily Covid-19 deaths was showing only 32, the model shows that 117 people were already dying every day nationwide from the disease.
Within two weeks, even when the official total had soared to 205, the graphs show that the excess daily mortality was already 742. The reason for the discrepancy was that mostly hospital deaths were being counted, and the death registration system is inaccurate and late.