An ambitious effort by the World Health Organization to calculate the global death toll from the coronavirus epidemic has found that more people have died than previously thought – a total of about 15 million by the end of 2021, more than double the official total of six million. Even more Reported individually by countries.
But the release of startling estimates – the result of more than a year of research and analysis by experts from around the world and the most comprehensive look at the epidemic threat so far – has been delayed for months due to India’s objections. Controversy erupts over the number of civilian deaths and attempts to prevent it from going public.
More than a third of the additional 90 million deaths are estimated in India, where Prime Minister Narendra Modi’s government stands at about 520,000. He said the WHO would show that the country has a population of at least 4 million, according to people familiar with the numbers who were not authorized to disclose them, which would give India the highest number in the world. The Times was unable to learn predictions for other countries.
The WHO’s calculations combine national data on reported deaths with new information from local and domestic surveys and statistical models to account for missing deaths. Most of the differences in the new global estimates represent the first countless deaths, most of which were directly from Kovid; The new numbers also include indirect deaths, such as people unable to access care for other diseases caused by the epidemic.
The delay in releasing the data is significant because global data is needed to understand how the epidemic has unfolded and what steps can be taken to mitigate such crises in the future. This has created a mess in the generally stable world of health statistics – motivated by India’s refusal to cooperate, a controversy in the anodeine language at the United Nations Statistical Commission, the world body that collects health data. Is running
“It’s important for global accounting and moral responsibility for the dead, but it’s also important in practice. If the waves come later, then actually understanding the total number of deaths is the key to knowing if the vaccination campaigns are working, “said Dr. Prabhat Jha, director of the Center for Global Health Research in Toronto and a member of the expert working group that supports the WHO, said. Calculation of additional deaths. “And it’s important for accountability.”
In an effort to accurately measure the impact of the epidemic, the WHO gathered a collection of experts, including demographers, public health experts, statisticians and data scientists. The Technical Advisory Group, as it is known, is collaborating across all countries to try to gather the most complete accounts of the epidemic’s victims.
The Times spoke to more than 10 people familiar with the data. The WHO planned to release the numbers in January, but has been released Pushed back.
Three people familiar with the matter said that recently, some members of the group had warned the WHO that if the organization did not release the figures, the experts would do it themselves.
“Our goal is to publish in April,” Amna Smelbegovic, a WHO spokeswoman, told the Times.
Dr. Sameera Asma, WHO’s Assistant Director General for Data, Analysis and Delivery for Impact, who is helping lead the calculations, said there was a “slight delay” in releasing the data but said it was “because we have to make sure.” We wanted everyone’s advice to be sought. “
India insists that the WHO’s approach is flawed. The government said in a statement to the UN Statistics Commission in February, “India feels that this process was neither supportive nor adequately representative. It also argued that “scientific rigor and rational scrutiny were not maintained in the process as was expected from the World Health Organization’s tallest organization.”
In New Delhi, the health ministry did not respond to requests for comment.
India is not alone in reducing the death toll from the epidemic: new WHO numbers also show minorities in other populous countries, such as Indonesia and Egypt.
Dr. Asma noted that many countries have struggled to accurately calculate the impact of the epidemic. Even in the most developed countries, he said, “I think when you look under the hood, it’s challenging.” He said there were significant discrepancies in the onset of the epidemic, including how quickly the various US states were reporting deaths, and some were still collecting data by fax.
India brought in a large team to review the WHO’s data analysis, she said, and the agency was happy to do so because it wanted the model to be as transparent as possible.
India’s work on vaccination has been praised by experts worldwide, but its public health response to Kovid has been criticized for its overconfidence. Mr. Modi Boasted In January 2021, India “saved humanity from a catastrophe.” A few months later, his health minister announced that the country was “At the end of Kovid-19.” Set in satisfaction, lead Wrong step And Efforts by authorities to silence critical voices within appropriate institutions.
Science in India Increasing politicization During the epidemic. In February, India’s junior health minister criticized a study published in the journal Science Which estimates that the number of cowardly deaths in the country is seven to eight times higher than the official figure. In March The government questioned A study methodology published in The Lancet The death toll in India was estimated at 4 million.
“Personally, I have always felt that science must respond to science,” said Bharmar Mukherjee, a professor of biostatistics at the University of Michigan School of Public Health, who is working with the WHO to review the data. Said. “If you have an alternative hypothesis, which is by rigorous science, you should make it. You can’t just say, ‘I won’t accept it.’
India has not submitted its total mortality figures to the WHO for the last two years, but the organisation’s researchers have used data collected from at least 12 states, including Andhra Pradesh, Chhattisgarh and Karnataka, which experts say Shown at least five to six times. Lots of deaths as a result of Covid-19.
John Wakefield, professor of statistics and biostatistics at the University of Washington, who played a key role in shaping the model used for the estimates, said the initial presentation of WHO global data was ready in December.
“But then India was unhappy with the estimates. So since we’ve done all sorts of sensitivity analyzes later, the paper is really great for this wait, because we’ve been overboard in terms of model tests and as much as we can give the available data, we Can do Dr. Wakefield “And we’re ready to go.”
Statistics show that statisticians and researchers call them “extra deaths” – the difference between all the deaths that have occurred and those that are expected to occur under normal circumstances. The WHO calculations include deaths that occur directly from Kovid, deaths from complications caused by Kovid, and deaths from people who did not have Kovid but need treatment that they did not receive due to the epidemic. Could do The calculations also take into account possible deaths that did not occur due to coveted restrictions, such as traffic accidents.
Counting additional deaths globally is a complex task. Some countries have closely tracked the death toll and supplied it to the WHO immediately, others have supplied only partial data, and the agency has had to use modeling to complete the picture. And then there are the many countries, including almost all of sub-Saharan Africa, that do not collect death statistics and for which statisticians have to rely entirely on modeling.
Dr. of WHO Asma noted that 9 out of 10 deaths in Africa, and six out of 10 deaths globally, are not registered, and more than half of the world’s countries do not collect the exact cause of death. This means that the starting point for this type of analysis is also an “estimate”, he said. “We have to be humble about it, and say we don’t know what we don’t know.”
To generate mortality estimates for countries with partial or non-mortality statistics, the advisory group of experts used statistical models and country-specific information such as prevention measures, historical disease rates, temperature to collect national data. And made predictions based on population and, from there, regional and global estimates.
Apart from India, there are other big countries where the figures are also uncertain.
Russia’s health ministry had reported 300,000 Kovid deaths by the end of 2021, the same number that the government had given to the WHO, but Russia’s National Statistics Agency, which is completely independent of the government, put the number at more than 1 million. Death toll found. Allegedly close to the WHO draft. Group members said Russia had objected to the number, but had made no effort to block the release of the data.
China, where the epidemic began, does not release public death statistics, and some experts have questioned the low reporting of deaths, especially in the wake of the outbreak. China has officially reported less than 5,000 deaths from the virus.
While China has indeed kept Casloid at a much lower level than most countries, it has done so through some of the world’s toughest lockouts – which have had an impact on public health. one of the Some studies Using internal data from a group of government researchers to examine China’s excess mortality rate, it has been shown that the number of deaths from heart disease and diabetes in Wuhan has increased during the two-month lockout of that city. . The researchers said that the increase was probably due to the inability or reluctance of hospitals to seek help. He concluded that the total death rate in Wuhan in the first quarter of 2020 was about 50 percent higher than expected.
India’s attempt to block the release of the report makes it clear that the epidemic data is a sensitive issue for the Modi government. “This is an extraordinary step,” said Anand Krishnan, a professor of community medicine at the All India Institute of Medical Sciences in New Delhi, who is working with the WHO to review the data. “I don’t remember the time it did that in the past.”
Ariel Karlinsky, an Israeli economist who has created and maintained the World Mortality Dataset and is working with the WHO on statistics, said that when they show high deaths, they are challenging for governments. “I think it’s very sensible for those in power to be afraid of these consequences.”
Vivian Wang Contributed to reporting.
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