Philip Setel writes:

How best to represent the true toll of the Covid-19 pandemic on human lives is an urgent matter. Though loss of life represents the clearest indicator, limited testing, inconsistencies in assigning the cause of death, and even political influence are creating uncertainty over how deaths are being counted and attributed (or not) to Covid-19.

It’s simple, really: Limited testing gives a limited picture of confirmed Covid-19 cases and deaths. While many deaths show fairly clear evidence of Covid-19 infection even without testing (and so may be tallied as “suspected” Covid-19 deaths), even adding confirmed and suspected deaths together risks a significant undercount of the true magnitude of the epidemic’s toll.

We should be using a more encompassing metric for measuring mortality: the total number of lives lost in excess of historically expected levels. Here’s why.

A focus on just confirmed and suspected deaths misses out on those deaths from other causes resulting from more indirect effects of Covid-19. For example, deaths can occur when health systems are strained or overwhelmed and unable to provide sufficient or quality care — think of non-Covid-19 patients requiring ICU beds in units already over capacity due to the pandemic. Deaths can also arise from delays in going to the hospital among those needing care due to fear of getting infected during their stay. And lastly there are deaths stemming from Covid-19’s interactions with noncommunicable diseases such as diabetes, heart disease, cancer, kidney disease, and others. [Continue reading…]