New Study Estimates More Than 900000 People Have Died Of COVID-19 In U.S.

Health

NPR 06 May, 2021 - 03:08pm 39 views

A new study estimates that the number of people who have died of COVID-19 in the U.S. is more than 900,000, a number 57% higher than official figures.

Worldwide, the study's authors say, the COVID-19 death count is nearing 7 million, more than double the reported number of 3.24 million.

The analysis comes from researchers at the University of Washington's Institute for Health Metrics and Evaluation, who looked at excess mortality from March 2020 through May 3, 2021, compared it with what would be expected in a typical nonpandemic year, then adjusted those figures to account for a handful of other pandemic-related factors.

The final count only estimates deaths "caused directly by the SARS-CoV-2 virus," according to the study's authors. SARS-CoV-2 is the virus that causes COVID-19.

Researchers estimated dramatic undercounts in countries such as India, Mexico and Russia, where they said the official death counts are some 400,000 too low in each country. In some countries — including Japan, Egypt and several Central Asian nations — the Institute for Health Metrics and Evaluation's death toll estimate is more than 10 times higher than reported totals.

"The analysis just shows how challenging it has been during the pandemic to accurately track the deaths — and actually, transmission — of COVID. And by focusing in on the total COVID death rate, I think we bring to light just how much greater the impact of COVID has been already and may be in the future," said Dr. Christopher Murray, who heads the Institute for Health Metrics and Evaluation.

The group reached its estimates by calculating excess mortality based on a variety of sources, including official death statistics from various countries, as well as academic studies of other locations.

Then, it examined other mortality factors influenced by the pandemic. For example, some of the extra deaths were caused by increased opioid overdoses or deferred health care. On the other hand, the dramatic reduction in flu cases last winter and a modest drop in deaths caused by injury resulted in lower mortality in those categories than usual.

Researchers at UW ultimately concluded that the extra deaths not directly caused by COVID-19 were effectively offset by the other reductions in death rates, leaving them to attribute all of the net excess deaths to the coronavirus.

"When you put all that together, we conclude that the best way, the closest estimate, for the true COVID death is still excess mortality, because some of those things are on the positive side, other factors are on the negative side," Murray said.

Experts are in agreement that official reports of COVID-19 deaths undercount the true death toll of the virus. Some countries only report deaths that take place in hospitals, or only when patients are confirmed to have been infected; others have poor health care access altogether.

"We see, for example, that when health systems get hit hard with individuals with COVID, understandably they devote their time to trying to take care of patients," Murray said.

Because of that, many academics have sought to estimate a true COVID-19 death rate to understand better how the disease spreads.

The revised statistical model used by the Institute for Health Metrics and Evaluation team produced numbers larger than many other analyses, raising some eyebrows in the scientific community.

"I think that the overall message of this (that deaths have been substantially undercounted and in some places more than others) is likely sound, but the absolute numbers are less so for a lot of reasons," said William Hanage, an epidemiologist at Harvard University, in an email to NPR.

Last month, a group of researchers at Virginia Commonwealth University published a study in the medical journal JAMA that examined excess mortality rates in the U.S. through December.

While that team similarly found the number of excess deaths far exceeded the official COVID-19 death toll, it disagreed that the gap could be blamed entirely on COVID-19 and not other causes.

"Their estimate of excess deaths is enormous and inconsistent with our research and others," said Dr. Steven Woolf, who led the Virginia Commonwealth team. "There are a lot of assumptions and educated guesses built into their model."

Other researchers applauded the UW study, calling the researchers' effort to produce a global model important, especially in identifying countries with small reported outbreaks but larger estimates of a true death toll, which could indicate the virus is spreading more widely than previously thought.

"We need to better understand the impact of COVID across the globe so that countries can understand the trajectory of the pandemic and figure out where to deploy additional resources, like testing supplies and vaccines to stop the spread," said Jennifer Nuzzo, an epidemiologist at Johns Hopkins.

Researchers at UW also released an updated forecast for the COVID-19 death count worldwide, estimating that roughly 2.5 million more people will die of COVID-19 between now and Sept. 1, driven in part by the dramatic surge of cases in India.

In the United States, researchers estimated roughly 44,000 more people will die of COVID-19 by September.

Read full article at NPR

COVID-19 update from ISDH for May 4

FOX59 News 06 May, 2021 - 06:01pm

Analysis: Global COVID-19 deaths actually double official estimates

The Hill 06 May, 2021 - 02:08pm

The study found that in the United States, a little more than 905,000 people have died of COVID-19 since the start of the pandemic. That is almost 40 percent higher than the 561,594 deaths estimated by the Centers for Disease Control and Prevention.

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India is hiding its Covid crisis – and the whole world will suffer for it | Ankita Rao

The Guardian 06 May, 2021 - 05:17am

Now, with Covid ravaging the country, desperate Indians have taken to Twitter to ask for oxygen cylinders or beg hospitals for an open bed. The crisis has been exacerbated by the government’s concealment of critical information. Between India’s long history of hiding and undercounting illness deaths and its much more recent history of restraining and suppressing the press, Modi’s administration has made it impossible to find accurate information about the virus’s hold in the country. Blocking that information will only hurt millions within the country. It will also stymie global efforts to stop the Covid-19 pandemic, and new variants of the virus, at India’s border.

Epidemiologists in India and abroad estimate that the country’s official reported Covid-19 death toll – around 222,000 at time of publication – accounts for only a fraction of the real number. The director of the US-based Institute of Health Metrics and Evaluation has estimated that India is only detecting 3-4% of actual cases. Other experts point to total excess deaths in cities such as Mumbai as proof that there could be 60% to 70% more deaths from Covid-19 than the government is admitting to.

There are various reasons India could be cooking the books on Covid deaths. For one, the utter failure of the public health system makes it difficult to account for the millions of bodies passing through hospitals, clinics and those dying in their own home. Despite having become one of the largest economies in the world, Indian state and federal governments spend a dismal amount on healthcare, with an investment of less than 1% of its GDP, one of the lowest rates in the world.

But systemic failure is only one part of the puzzle. The reigning party of the Indian government touted its success in curbing the virus very early in the pandemic, and has never let go of that narrative. As bodies burned in funeral pyres across Uttar Pradesh in April, Yogi Adityanath – the state’s chief minister and a key Modi lackey – claimed that everything was under control and repeatedly refused to announce new lockdown measures, even as he himself contracted Covid-19.

This denialist rhetoric is occurring at almost every level. Like India’s see-no-evil approach to malaria or tuberculosis, its Covid obfuscation suppresses “bad news” in order to buoy the country’s international image and the government party’s domestic standing. Not all countries with struggling health systems do this. Some actually at times overcount deaths from other viruses in order to get more humanitarian aid. But undercounting disease is, in many ways, far more sinister. Modi’s government had a choice between saving face and saving lives, and has chosen mass death.

Indian journalists tell me they are often asked to self-censor their reporting on the Covid-19 pandemic, as well as what they say on social media, for fear of inciting the ire of the government. Many were understandably incensed last week when the Indian central government reportedly made Twitter and Facebook remove posts critical of the government’s Covid measures. Meanwhile, India continues to be one of the most dangerous places in the world for journalists to work, and more than 165 journalists have allegedly died of Covid-19 while covering the crisis itself. (Last month Kakoli Bhattacharya, an Indian journalist who worked as a news assistant for the Guardian, died of Covid.) In the absence of trustworthy Covid information from their own government, Indians are mostly reliant on social media and foreign reporting for the story of what’s actually happening.

The result is a public health nightmare for India – and also, I fear, for the global community, which, just as many countries are breathing a sigh of relief, could face another Covid wave that includes new variants. We can learn from other epidemics what that might look like: India was one of the last countries to eradicate polio, and is one of 15 countries that still have a significant number of people with leprosy. India also has the third largest HIV/Aids epidemic in the world. India’s struggles with diseases that have been eradicated or largely ameliorated elsewhere leaves a backdoor for global public health threats and costs billions of dollars in disease burden. These health crises also harm international travel, trade and other economic indicators, creating new challenges not only for India but for its allies, as well.

India likes to tout itself as the world’s largest democracy – and use that moral authority to protect its standing in the global economy and the international diplomatic community. But with a dark curtain separating the reality of the country’s Covid-19 crisis from the rest of the world, India’s standing and authority are at risk. If the country continues to choose political expediency over transparency in the days to come, the people of India, scrambling to protect their families, are the first victims, but far from the last.

Ankita Rao is a news editor at the Guardian US

This article was amended on 6 May 2021 to clarify that government spending on healthcare in India is less than 1% of GDP.

India’s worsening Covid crisis could spiral into a problem for the world

CNBC 05 May, 2021 - 10:20pm

India's Covid-19 cases spiked in April to daily record highs, and experts warn the country's worsening health crisis could scuttle efforts to end the global pandemic.

The South Asian country — home to around 1.4 billion people or 18% of the world's population — accounted for 46% of new Covid cases globally in the past week, the World Health Organization said Wednesday. One in every four deaths in the past week came from India, the UN health agency said.

India has reported more than 300,000 new cases daily in the last two weeks, and overtook Brazil in April to become the second-worst infected country in the world. Cumulatively, coronavirus infections in India reached around 20.67 million with more than 226,000 deaths, according to health ministry data on Wednesday. Several studies of India's data, however, found that cases were likely severely underreported.

There are already signs that India's outbreak is spilling over to other countries. Its neighbors Nepal and Sri Lanka have also reported increases in infections, while other regional economies including Hong Kong and Singapore have seen imported Covid cases from India.

Here's how India's coronavirus crisis could spiral into a wider global problem.

Prolonged large outbreaks in any country could increase the possibility of new variants of Covid-19, health experts warned. Some of the variants could evade immune responses trigged by vaccines and previous infections, they said.

"Here's the bottom line: We know when there are large outbreaks, that variants arise. And so far our vaccines are holding up okay, we're seeing a few breakthrough infections but not much," Dr. Ashish Jha, dean of Brown University's School of Public Health, told CNBC's "The News with Shepard Smith."

"But India is a big country and if there are large outbreaks there, of course we're gonna all worry about more variants which will be bad for Indians and of course, it will spread around the world," he added.

India first detected the B.1.617 variant — also dubbed the "double mutant" — in October last year. The variant has since been reported in at least 17 countries including the U.S., the U.K. and Singapore.

WHO has classified the B.1.617 as a variant of interest, which suggests the mutated strain could be more contagious, more deadly, as well as more resistant to current vaccines and treatments. The organization said more studies are needed to understand the significance of the variant.

India is a major vaccine manufacturer, but the health crisis at home has led authorities to halt exports of Covid-19 vaccines as the country prioritizes its domestic needs.

The Serum Institute of India (SII) — the country's main producer — has the rights to produce the Covid vaccine co-developed by AstraZeneca and the University of Oxford. Some of its production is slated for Covax, the global initiative to supply poor countries with Covid vaccines.   

Read CNBC's latest coverage of India's battle with the coronavirus pandemic:

Developing countries are lagging advanced nations in securing vaccine supplies in what the WHO has described as a "shocking imbalance" in distribution.

A delay in vaccine exports by India could therefore leave lower-income countries vulnerable to fresh outbreaks of the coronavirus.

India is the world's sixth largest economy and a major contributor to global growth.

Some economists have downgraded their growth forecasts for India. But they remained optimistic about the economy's outlook for the year given that restrictions to curb the virus spread have been more targeted compared to the strict nationwide lockdown last year.

The International Monetary Fund last month said it expects India's economy to grow 12.5% in the fiscal year ending March 2022, after shrinking 8% in the prior fiscal year.

Still, the renewed outbreak in India has led several countries to tighten travel restrictions — and that's bad news for airlines, airports as well as other businesses that depend on the travel industry, said Uma Kambhampati, an economics professor at the University of Reading in the U.K.

Meanwhile, the U.S. Chamber of Commerce has warned that the health crisis in India could drag down the U.S. economy, reported Reuters. That's because many U.S. companies hire millions of Indian workers to run their back-office operations, according to the report.

"Given all these issues, and the humanitarian crisis unfolding, it has become imperative for the world to act quickly to help India – whether such help is requested or not," Kambhampati said in a report published on The Conversation, a not-for-profit website that carries commentaries by academics and researchers.

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India in COVID crisis: We need to send more help — but ban travel, too

The Hill 05 May, 2021 - 10:00am

Consider that just last week a flight from New Delhi to Hong Kong ended with a third of all travelers contracting COVID-19. Like Israel, or the United Kingdom, today’s success stories will be most useful to the rest of the world if we can control our own COVID-19 numbers here at home, rather than importing thousands more cases. We need to take a lead from Australia, which has suspended all flights from India until at least mid-May. We need to do the same here. 

Meanwhile, the U.S. is now sending raw materials to India for vaccine manufacturing.

Misra identified the larger problem as vaccine non-compliance rather than lack of vaccine availability. He told me that “quacks” are fanning the flames of COVID-19 in the rural areas of India by creating false fear of the vaccine. Meanwhile, hospitals in India are overloaded and there is a shortage of oxygen and other primary supplies. 

What about the World Health Organization? The answer is that the WHO is continuing its politicking in lieu of providing effective leadership or resources. A senior WHO official told me that “WHO has focused its discourse and politics on poor aid-dependent countries with its COVAX effort, largely ignoring the epidemiological patterns, which showed the development of the epidemic in large middle-income countries including India. The effort of the WHO is a drop in the 1-billion-people ocean that is India. This exposes the WHO lack of epidemiological and data skills.”  

Throughout the pandemic, even as India was trying (and, for the most part, succeeding) to control its own COVID-19 outbreaks, skirmishes between China and India occurred along the Sino-Indian border. So it is somewhat ironic that now China is offering its assistance and blaming the U.S. for being slow to provide the raw materials. At the same time, China’s own vaccine, Sinovac, has come under worldwide criticism for underperforming. 

What should the U.S. do beyond sending supplies and vaccines? The U.S. has a long history of epidemic intelligence officers, known as “disease detectives,” helping to inform and control disease outbreaks, including Ebola. The Centers for Disease Control and Prevention (CDC) was not allowed into China at the onset of this pandemic, but it certainly can do a lot of good in India now. As the White House announced last week, “The U.S. CDC, working with USAID, will urgently deploy a strike team to India which will include public health experts to work in close collaboration with our embassy, with India’s health ministries and experts, and with India’s Epidemic Intelligence Service staff.” 

The plan is for the strike team to work with India’s experts in laboratory services, surveillance and epidemiology, bioinformatics for sequencing and modeling of the disease, infection, prevention, control, vaccine rollout and risk communication. Perhaps most importantly, the strike team will include CDC epidemic intelligence officers. 

Hopefully, the CDC’s presence can help overcome the absence of the WHO and help to counter the superstition, poor information, as well as vaccine resistance, especially in rural areas, which Dr. Misra pointed to as the heart of the problem.

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