Editorial

What if we have drastically underestimated the consequences of COVID-19?

What if we have drastically underestimated the consequences of COVID-19?

Given how the pandemic has dominated our lives for the past 18 months, that might seem impossible. But new data suggest that even our best estimates to measure the impact of this deadly virus may have been way off.

The analytics experts at The Economist reported earlier this month they believe the true death toll from COVID–19 could be somewhere around 15 million people worldwide.

The analytics experts at The Economist reported earlier this month they believe the true death toll from COVID-19 could be somewhere around 15 million people worldwide, more than three times the current official estimate of 4.6 million. How the magazine came upon this number says as much about our inability to measure events like pandemics as it does the pandemic itself.

Rather than trying to identify deaths caused by COVID-19, The Economist focused on "excess deaths," which is an estimate of the number of deaths above what could be reasonably predicted in years when there wasn’t a natural disaster or, indeed, a pandemic. Even that was a difficult number to nail down.

The gravity of the pandemic will play a major role in determining what, if any, changes take place as we wait for the inevitable next wave or, as many expect, the next pandemic.

The magazine acknowledged that, even in the best of times, many countries around the world do not have, or are not willing to share, mortality data. Of the 156 countries with a population of at least one million, which the magazine used as the focus of its analysis, it was able to get data on total mortality from just 84. And even some of their figures were woefully out of date.

Modelling helped bridge the gaps: "Although the official number caused by COVID-19 is now 4.6m, our single best estimate is that the actual total is 15.3m people. We find that there is a 95 per cent chance that the true value lies between 9.4m and 18.3m additional deaths."

How could there be such a contrast between official numbers and these new calculations?

Even as epidemiologists have reported COVID-19 mortality data in real time, they acknowledge the numbers were likely inaccurate. The virus attacked the oldest and sickest members of society first; were these deaths from the virus, or from underlying conditions? We also know the pandemic has prevented or discouraged people from getting life-sustaining, or life-saving, medical treatments. And how many people died simply because they could not get a physical examination?

Setting aside the inevitable debate about The Economist’s model, why is this such important information? The gravity of the pandemic will play a major role in determining what, if any, changes take place as we wait for the inevitable next wave or, as many expect, the next pandemic.

How much money will the governments of the world spend on personal protective equipment and increasing vaccine capacity? How much money will wealthier nations set aside to help poorer nations combat a pandemic? And what international standards will we establish for mask use, vaccine protocols or control over travel and commerce?

If we are understating the death toll, there is a high likelihood law and policy makers around the world will start to believe our pandemic response was adequate, given the circumstances. That mindset would allow many countries to avoid critical reviews of current COVID-19 pandemic responses, leading to a failure to learn from our mistakes by investing in planning and preparation for the next pandemic.

The global pandemic we are still living with has been extremely challenging. But if it was actually worse than even our worst fears, we must acknowledge the true loss of life and the awful reality that our best pandemic efforts contributed to many of those deaths.

That is the only way we will have a fighting chance when the next pandemic arrives.