Covid-19: How Should We Count Deaths?

How can we calculate the true toll of the pandemic?

- Juanita Bawagan

As the number of COVID-19 deaths worldwide surpasses one million and continues to climb, the real number could be much higher due to misclassified and indirect deaths.

At the beginning of the pandemic, information about rates of infection, hospitalisation and even deaths was often delayed or unreliable. Testing was not widely in place and the understanding of the biological and clinical features of the virus made classifying a ‘COVID death’ difficult.

As many countries are facing a second wave of COVID-19, monitoring has also entered a new phase with more robust data and better reporting systems. However, there are still many cases that may slip through the cracks.

“We will never know the exact number of COVID19 deaths simply because many patients will never be tested, even though they die from COVID-19,” says Dr Lasse Vestergaard. Vestergaard is a medical doctor and epidemiologist who coordinates EuroMOMO, which provides real-time mortality monitoring for 26 European countries. “With the estimation of excess deaths, however, we have a quite precise picture of the total mortality burden from COVID-19 and how it affects different populations,” he adds.