The difficult counting of deaths from the coronavirus

Le difficile comptage des morts du coronavirus

Paris | counting the daily victims of the COVID-19, which the official number is close to 100 000 dead, is a delicate exercise, the collection of real-time data being fragmentary, and the methods vary depending on the country.

Place of death, how to identify the causes of death, different timing of reporting: several elements can have an impact on those counts, necessarily under-valued, but essential to monitor the evolution of the pandemic.

It is a true “statistical challenge”, stresses the French institute of demographic studies, Ined.

Hospitals and retirement homes

If Spain and South Korea have accounted for all the deaths of people tested positive COVID-19, either in the hospital or outside, this is not the case for all countries. The figures in iran, for example, does not seem to include that of in-hospital death.

Until recently, the deaths at the retirement home were not included in the official figures, the british and French. They are, however, far from being marginal, as they represent today more than one-third of the balance in France.

In the United States, deaths are taken into account vary from one State to another: the State of New York includes retirement homes, California not.

Even in Italy, which shows formally the balance sheet, the heaviest in the world (more than 18 000 dead), the death in a retirement home are not all identified. If a large outbreak is detected in a facility, tests are made and the death recorded, but if an establishment is less affected, it is likely that this will not be the case, says the civil Protection.

COVID-19, or another disease ?

If some countries, such as South Korea, Italy, Spain and the United Kingdom, include in their figures all the people who have tested positive for coronavirus, even those who died of complications of a pre-existing illness, other countries are more selective.

In Iran, are excluded from the balance sheets of the patients tested positive, but dying as a result of another “severe respiratory illness”.

In the United States there are more and more stories of people whose loved ones have died, officially of pneumonia, before the tests are not available or at a time when they were difficult to obtain.

Lack of tests and deadlines

During an epidemic, “the rise and processing of information, even accelerated, is with a few days of lag and do not cover all deaths. It takes several weeks or several months to be able to count precisely all the dead”, say Gilles Pison, and France Meslé, demographers at Ined, on the website the Conversation.

In the United States, even in the absence of test, the death certificates should indicate whether the Covid-19 is the cause of “probable” death, but these certificates take a long time to climb back up and may not be taken into account in the balance sheets in real-time.

In Spain, the registers of civil status and the number of burials show a mortality much greater than that which should result from the official report of the COVID-19.

Due to lack of testing, Spain performs very few tests post-mortem. Thus, if a person has not been diagnosed before dying, it is not recognized by the health authorities. The judicial data, least restrictive, suggest that there is a balance much higher: for example, the superior court of Castile-La Mancha registered in march 1,921 rank acts of death the cause of which is due to the Covid or a suspicion of Covid”, which is nearly three times that of the 708 deaths (positive Covid-19) identified at the 31 march by the health authorities.

Another illustration: in Bergamo, in Lombardy, have been identified, during the first half of march, 108 dead of a plus (+193%) than a year earlier… but only 31 deaths related to the COVID-19.

China and Iran accused of lying

Sometimes, the sincerity even of the figures is questioned.

In Iran, the balance sheets, officials have been challenged, especially at the beginning of the epidemic by provincial officials and parliamentarians. Even the official agency Irna has sometimes released numbers higher than those of the authorities, balance sheets, then denials by the government. Outside of the country, Washington, notably, has accused Tehran of making up its numbers.

Regarding China, the cradle of the epidemic, a confidential report of the u.s. intelligence cited by the agency Bloomberg, has accused Beijing of intentionally under-valued its balance sheet. Its digits have also been put in doubt by several iranian officials, but the spokesman of the ministry of Health has been forced to correct his statements after you have qualified the balance sheet of chinese “joke of poor taste”.

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