Dubai: The daily death toll updates for Covid-19 for several countries could be underreporting the true number by a significant margin, according to health experts and government figures.
Experts say the discrepancy is mainly due to under-reporting of milder or asymptomatic cases in countries and regions that are grappling with shortages in testing equipment and beds, or facing regulatory issues in widening the scope of testing.
“In an outbreak your really have to interpret fatality rates with a very sceptical eye, because often it’s only the very severe cases that are coming to people’s attention,” Amesh Adalja, an expert in pandemic preparedness at the Johns Hopkins Centre for Health Security in Baltimore, told Reuters.
In the UK, for instance, the government counts only people who tested positive and then died of the virus in hospital — but that doesn’t match the number of UK death certificates that list Covid-19 as a factor, CNN reported.
Since it is not easy to get a coronavirus test in the UK, many Britons are turning to mail-order kits. Last Tuesday, figures released by the UK’s Office of National Statistics (ONS) showed that 1,568 people had Covid-19 listed on their death certificates between March 5 and March 27. In contrast, death tolls released by Public Health England over the same period show only 926 confirmed deaths due to the virus in England.
British health analysts cited several factors for the difference: the two tallies are counting different things — suspected deaths versus confirmed cases that died in the hospital; there may also be a lag in reporting.
But “it’s important to have both numbers,” UK chief scientific adviser, Patrick Vallance, told media on Tuesday. “The ONS data look at overall deaths on death certificates where coronavirus is mentioned, so that they are not confirmed deaths necessarily,” he explained. The UK is using the “international reporting standard for deaths,” he added, which he described as “hospitalised deaths confirmed.”
But the UK is hardly the only country with data discrepancies and fears of undercounting deaths.
In Italy, where the official death toll from the virus stands at 13,155, the number of deaths tell only part of the story because many people who die from the virus don’t make it to the hospitals or get to have confirmed tests, according to health officials. In the Italian towns of Lodi and Coccaglio, the local nursing homes lost over a third of their residents in March — but none of them were tested for the new coronavirus.
It’s the same story in several other countries — ranging from France and Spain to Iran and even China — where despite counting more than just hospital deaths in their daily statistics, they could nevertheless be under-reporting the deaths.
“It’s very hard to say those numbers represent anything like the true burden of infection” said Adalja of Johns Hopkins. “Trying to really demystify the fatality numbers by including mildly symptomatic cases will help people to better understand the risk,” he said.
“It’s good to remember that when H1N1 influenza came out in 2009, estimates of case fatality were 10 per cent,” David Fisman, an epidemiologist at the University of Toronto, told the BBC. “That turned out to be incredibly wrong. As the denominator is growing in terms of case numbers, and case fatality goes down and down ... you start to realise it’s everywhere,” he said.
The World Health Organisation has warned of above-normal deaths unrelated to the coronavirus pandemic as health systems become overwhelmed.
But in Switzerland, emergency rooms and hospitals are quieter than usual despite an influx of Covid-19 patients, a worrying sign that some doctors say could mean more people are dying at home from other ailments — reflecting the hidden toll of the coronavirus pandemic. “Many patients tell us I waited because I am afraid of coming into contact with a Covid-19 patient,” Giovanni Pedrazzini, president of the Swiss cardiology society and co-head of cardiology at the Ticino centre which also accepts Covid-19 patients, told Reuters. “The risk is that a lot of patients will suffer or die at home when they should go to the emergency room.”