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The challenge of counting COVID-19 deaths

How to measure the real toll of the novel c..

How to measure the real toll of the novel coronavirus has been a persistent question since the outbreak began.

There are a number of difficulties. Some countries test more per capita while others test less. And governments collect their statistics differently, making any cross-border comparisons — be it infections, recoveries, or deaths — inexact.

Researchers are narrowing in on a figure called “excess deaths” as a more reliable measure that can give insight into the true scale of the pandemic. The idea is to take the previous years deaths as a baseline and use the difference in deaths this year over the last as a more accurate metric of the virus impact. This way, researchers can capture fatalities that slipped through the cracks.

A major rationale for this approach is that theres a lot of confusion around counting COVID-19 deaths, with different countries using different methodologies. Some apply broad definitions that include all possible cases, while others use narrower standards. That latter approach, however, has sometimes led to accusations that deaths are under-counted to downplay the crisis.

By contrast excess deaths can, in theory, cut through these uncertainties by providing a reliable figure.

POLITICO has looked at how a number of European countries approach this question, placing each in one of three categories: those that use a narrow definition; those that take a more mixed approach; and those with a broad definition.

We then compared their methodology with the discrepancy between their official COVID-19 death count and excess mortality. We looked at a number of factors to sort them into their group, from whether all COVID-19 deaths had to test positive for the virus to whether deaths outside hospitals were also being counted.

In general, countries that use stricter counts (and therefore more likely to under-count) have a greater discrepancy. Austria only counts those who test positive and where it can establish that the death was due to the virus. The Netherlands only includes patients who tested positive for the disease and who died in the hospital. Dutch COVID-19 deaths amount to only 48 percent of the “excess death” total.

Mixed countries take a looser approach, counting deaths both inside, as well as outside hospitals, and they dont distinguish whether they died from, or just “with” the disease. The U.K. until recently only counted deaths of patients who tested positive and died in hospitals, but as of April 29, the country has started counting deaths in all settings.

France, meanwhile, records all deaths that are linked in some way to COVID-19, and counts them in hospitals as well as nursing homes — a major source of deaths. The gap significantly narrows in this case, with coronavirus deaths totaling 86 percent of excess mortality.

Countries in the broad group also count deaths everywhere, and include both those confirmed with COIVD-19, and cases where doctors suspect the patient was infected but havent run a test. Belgium is among those countries taking the broadest possible approach, as it Read More – Source




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