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The true toll of the pandemic

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  • The true toll of the pandemic

    Nature | Vol 585 | 3 September 2020

    Mortality statistics are essential for understanding the pandemic. But they fall short in a few ways.

    By Giuliana Viglione

    The Nature analysis shows that there are huge variations in excess deaths between countries (see ‘More than expected’). In the United States and Spain — two of the hard- est-hit countries so far — about 25% and 35%, respectively, of the excess death toll is not reflected in official COVID-19 death sta- tistics. But in other places, the mismatch is much greater, such as in Peru, where 74% of the excess deaths are not explained by reported COVID-19 deaths. And some countries, such as Bulgaria, have even experienced negative excess deaths during the pandemic so far — meaning that, despite the virus, fewer people have died this year than expected.

    The blunt tool of excess mortality is the best one to use during the pandemic, say most demographers. But as time goes on, they will be able to use hindsight and more-granular data to improve understanding of the pandemic’s toll. They will eventually be able to parse the deaths into three categories: direct deaths, for which COVID-19 is recorded as the cause; direct- but-uncounted deaths, in which the virus was responsible but wasn’t officially noted; and indirect deaths, which occur because of other changes wrought by the pandemic.

    Direct deaths feature on pandemic trackers showing numbers of cases and deaths, which are generally updated daily by local and national health authorities.