COVID-19 death toll: will we ever know the exact numbers?

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TORONTO –
As epidemiologists struggle to develop models to predict the future course of the COVID-19 pandemic, health officials are trying to keep up with the increasing number of deaths from coronavirus disease.

While this may seem simple enough, the reality is far from it.

This is due in part to the difficulty of trying to accurately identify each COVID-19 victim. In hospitals, this is quite easy in the sense that patients with symptoms are swabbed and tested for respiratory disease.

If this patient dies, he is included in the official daily count of deaths for the disease. Even if this person had another underlying health problem, such as heart disease, which was then exacerbated by the virus and resulted in a heart attack, their death would still be recorded as death from COVID-19.

It’s according to the World Health Organization’s definition of what constitutes death from COVID-19. The world health organization recently released a new ICD (International Classification of Diseases) code for COVID-19 to be included on death certificates to enter mortality data for the disease.

Dr. Prabhat Jha, Director of the Center for Global Health Research at St. Michael’s Hospital in Toronto, explained that the new code is supposed to apply to cases where the patient was positive for COVID-19, the patient had a probable case of COVID -19, but laboratory results are still pending, or if the patient is positive for COVID-19, but there is another cause of death.

“It’s the default, because in an epidemic situation, you don’t want to run out of deaths if you follow where it’s going,” the epidemiologist, who specializes in research on mortality statistics, told CTVNews. .ca during a telephone interview from Toronto. Friday.

Monitoring death rates from the disease, however, becomes much more difficult when people suspected of having COVID-19 die before being tested.

Dr. Christopher Milroy, forensic pathologist and director of the Eastern Ontario Forensic Pathology Unit at the Ottawa Hospital, said that it was possible to conduct detailed inquiries into deaths and autopsies for these cases, but that will not happen because they do not have the Resources. In addition, a shortage of test kits means that the living are given priority during a pandemic.

“Unless you test everyone, autopsy everyone, you will never be 100% [certain]”He told CTVNews.ca in an Ottawa telephone interview on Friday.

The death rate may appear higher in places where they only test people with symptoms in the hospital, as opposed to areas where testing is more widespread, such as in Germany and Iceland.

“The problem with the mortality statistics right now is that they are partly based on the number of people who tested positive and died, and if we haven’t tested everyone … we don’t know the exact mortality, c is why people are varying in their numbers. “

MONITORING DAILY DEATHS

Although Jha and Milroy said it was difficult to know the exact number of deaths from the COVID-19 pandemic as it occurred, they said that a clearer picture would likely emerge afterwards.

For this to happen, Jha said it is important for government officials to redouble their efforts to keep track of all public deaths in a province or city, not just those related to COVID-19, and publish them Researchers therefore have a common denominator to work with in a timely manner when monitoring the pandemic.

For example, Jha said that if an elderly person dies of pneumonia in a nursing home, that death should be recorded and published in the province’s online registry, ideally on the same day, rather than a week. later, which is usually the case. He said these daily reports should include the number of people killed, their ages and, hopefully, a cause of death.

“Then you can look at the curves and say” Wait a minute, there has been a big increase in 80-year-old deaths and a big increase in deaths from pneumonia who died at the same time as we had the COVID epidemic, so these are likely deaths from COVID, ”he explained.

Instead of relying on modeling projections, Jha said they could use the trends identified in the global mortality data to predict the trajectory of the pandemic.

“If you follow the daily deaths, then you have an idea of ​​the direction of the epidemic and its importance,” he said. “Data systems must not go the usual way, they must be a little more on the warpath.”

Milroy said that because it is always difficult to get accurate statistics during an epidemic, he said that Canada and other countries like this one that follow mortality data will not know the full extent of it. only months or even years later.

“I think the result is this: unfortunately, we will know more after the end of this event,” he said.

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