Editorial: Missing data mean we’ll probably never know how many people died of COVID
covering Denmark, Finland, Iceland, Norway and Sweden showed that the IHME results, in particular, are mysteriously out of line with those from the WHO andGiven these caveats, what is the value of estimating excess deaths? First, it emphasizes the scale of the crisis, and highlights that many low- and middle-income countries that on the face of it saw few deaths were probably hit just as hard as richer countries, if not more so.
Second, it underlines how much still needs to be done to improve systems for recording deaths. The United Nations is trying to track countries’ success in registering deaths as part of its Sustainable Development Goals. Its latest records state that by 2020, 154 countries out of 188 tracked had death data that were “at least 75% complete”. In countries with weak social safety nets, there might be little incentive for people to report deaths.
Improving the processes used to record births and deaths, known as civil registration and vital statistics systems, is crucial to improving public health. The WHO is preparing a treaty to strengthen global preparedness for and resilience to future pandemics; creating better CRVS systems is not yet part of that, but it should be.
Better, more consistent reporting is a first step towards ironing out the discrepancies between estimates, and limiting the tendency for countries to pick metrics that suit their own conclusions. Comparisons between countries will remain difficult, making it challenging to determine which policies were more or less effective at limiting deaths, or how deadly the virus was in different groups.
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