How Many People Have Really Died?

the real number. And without knowing that number, we're only guessing at how well our disease fighting measures are really working. But first, here's what happened today. Germany wants to test more people who don't show symptoms for the coronavirus. The country's health ministry put out a proposal that would expand screening to close contacts of sick people, workers at nursing homes and meat packing plants, as well as schools and

restaurants where cases emerge. Chancellor Angela Merkel and the country States have agreed to keep contact restrictions in place until June twenty ninth. We may get a new test of the international air travel system in the time of coronavirus within weeks. Australia and New Zealand could open an air corridor between the two countries for quarantine free flights if guidelines that will be released in early June are approved.

The group drawing up the guidelines for safe travel are considering every stage of the journey, including how passengers move through airports and contact tracing requirements at their destination. Travel oilers will have to declare their healthy before they fly, and might sacrifice their fare if they're ill. Tightly controlled flight bubbles, which can be enlarged to include other countries, have emerged as potential models for the global travel industry.

China and South Korea opened a narrow travel corridor with onerous restrictions this month. Finally, Dr Anthony Fauci, the top us infectious disease expert, said in an interview on CNN he believes a vaccine could be ready to be deployed as early as late this year, but a group of people who get paid to make forecasts are far more pessimistic.

Good Judgment Incorporated, a company that maintains a global network of forecasters who scour public data, say there's only a nine percent chance that there will be a widely available vaccine before next April, and now our main story. So far, more than three hundred thousand people globally are known to have died because of the coronavirus. The US is fast approaching the grim milestone of one hundred thousand fatalities, and as shocking as those numbers are, experts believe there are

actually many more deaths were not counting. It might sound macabre, but in order to save lives, you need to count deaths. Knowing how many have died and the context around their deaths is crucial for understanding and fighting the virus. That's because we need to understand how fast and in what groups mortality is rising in order to fine tune the policies that govern our response to the virus. So experts are looking past the official count to find other ways

to investigate just how many people are dying. Bloomberg Senior editor Jason Gale has more. Alan Lopez is a laureate professor of Global health at the University of Melbourne. He spent a lot of his life counting the dead and figuring out why people die. Now his efforts have turned to COVID nineteen. He says Monitoring mortality right now is critical for striking the optimal balance between saving people from

the pandemic and worsening other health threats. We need to understand how bad these are deaths are increasing in order for us to turn those policy leavers and knobs at the right speed in the right direction. So if mortality is still increasing, then we absolutely need to keep doing what we're doing to prevent that. But in order for us to do that, we need to understand reliably u how many people are dying as a result of the COVID nineteen academic and at what time and at what

age they're dying. There's no point making policy now on COVID nineteen mortality data four or five or six weeks ago. You need mortality data from the last week, and you need it by age, need it by sex, and you need it to be reliable. Alan and his partner, Professor Christopher Murray at the University of Washington and Seattle, have spent more than two decades studying mortality rates, and he

says getting that reliable data can be tricky. The World Health Organization, as of Tuesday, said more than five point three million people are known to have caught the novel coronavirus, and of those more than six percent of died. But those numbers aren't reliable. Many people got COVID and weren't tested, so their infection wasn't recorded. Some people died at home, especially when hospitals were overwhelmed. Some people died too because

they couldn't get treated for another life threatening condition. So how do your factor in those unreported cases and deaths to get a more realistic number, Alan says, you ask a simple question and go from there. What if COVID nineteen never happened, what would we expect to see in

terms of numbers of deaths by age and sex? And then what do we see And in the absence of any major shock to the system, like an earthquake or a flood or some catastrophic event that causes a lot of deaths, all of those deaths must be due to the only other thing that's happened that's different but this year from last year, and that is COVID nineteen. And then there's the matter of figuring out which deaths were the direct result of COVID nineteen and which ones were

caused by some other interrect factor. How many more deaths are there by age and sex this year then there were last year or the year before, some some comparable basedline. In other words, we need to understand fully the impact of COVID nineteen, not just as an underlying cause of death in hospitals where there's confirmed COVID nineteen cases, but also the what we call the multiplier effects of COVID nineteen.

The fact that it's likely to increase the risk of of major vascular diseases heart fare, there, schemic card disease, stroke been seeming. We're seeing increasing evidence of that. The fact that it's likely to increase death rates from chronic obstructive lung disease, so I caually increase death rates among smokers.

So it's doing a lot of things that are multiplying up the risks of other causes of death, leading to a much bigger, often to two times higher overall impact than what we're measuring in the specific hospital mortality rates. The Centers for Disease Control and Prevention estimates that there have been as many as one thousand excess death in

the United States since February. Alan says that in countries with robust mortality data, it appears that about twice the number of people may be dying because of the pandemic then what's officially reported as a COVID death. So I think unless we monitor this epidemic cleverly and comprehensively by looking at all of the deaths that COVID nineteen is causing, we are going to seriously underestimated and that will seriously

misinform policy options and their timing. Alan says. The reasons why people die during the pandemic will also probably be quite different to what's usually observed. You've got an envelope of deaths, and you've got the COVID nineteen certified deaths, which you've got a lot of other deaths in there. So how have death rates from road traffic accidents from suicide?

So road traffic athens may have gone the other direction and gone down because there's been fewer people circulating, but on the same with asma or acute respiratory diseases because

pollution is gone down. On the other hand, you might have mental health conditions, particularly suicide, that would have incroducted well of increased We've talked also about skimmy cart disease, stroke, chronic lung disease, a number of conditions that COVID nineteen might have aggravated and we would have seen increases in

these death rates. And these I'm not expecting these to be doubling of the death rates, but I do expect that we will see some significant increases in death rates that are directly attributable to the action of COVID nineteen. Across the world, tens of millions of deaths go unrecorded each year. This lack of information is a killer in its own right. Without an accurate measure of deaths and their causes, finding the pandemic and developing countries is much harder.

Authorities simply like the basic information they need to make informed decisions. Full disclosure. Alan is the director of the Data for Health Initiative. It's funded by the Australian govern Meant and Bloomberg Philanthropies. Bloomberg Philanthropies was set up by former New York Mayor Michael Bloomberg, founder and majority owner

of Bloomberg News parent Bloomberg LP. Data for Health partners with governments in low and middle income countries to strengthen their public health data and improve the way they use this information to make public health decisions and public health investments. We've also been very active in trying to help countries build up the notification systems so they know who's dying. This is critically important. You cannot diagnose the death and listen until you know that someone has died, and to

know about that, you need notification systems in there. And remember, the vast majority of these deaths, unlike Australia, are occurring in communities, not in hospitals, and so how do you know that people are dying in villages and what they're

dying from? And so a lot of the time that we've been working in countries, we've been focusing on cost effective, quick methods that will They're not perfect, but they will yield a kind of information that countries would need to monitor COVID nineteen with reasonable reliability and cheaply, and they work. The data for health program works in twenty countries across

the world. Alan says that it's helped establish a baseline for the deaths that occur each year and that will make it easier to eventually figure out the global mortality

from the pandemic. What we now need to do is to um collect the data on who died in the era of the COVID nineteen that will be undercounted for sure, and we will need to apply the statistical methods that we've developed over the years to those data to say we should adjust them in this and this way, and when we subtract those away from the baseline, this is the excess mortality that, in my viewing is probably the

six to nine month exercise. I may be optimistic, but I think this time next year we would have a pretty good idea of the total global mortality and butten by country from COVID nineteen. Allen says the pandemic is underscoring the need to rapidly report debts to authorities in developing countries. Mobile phones have accelerated the notification process, especially when churches and other community based groups are able to

contribute to surveillance activities. The hope is that by improving the collection of this kind of data, governments will be able to respond more effectively, not just to the pandemic, but all the other major causes of death and disease, and that will ultimately improve the health and well being of people everywhere. That was Jason Gale in Melbourne, and that's our show today for coverage of the outbreak from

one bureaus around the world. Visit Bloomberg dot com slash Coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Topher FORHZ, Jordan Gaspure, Magnus Hendrickson, and me Laura Carlson. Today's main story was reported by Jason Gale. Original music by Leo Sidrin. Our editors are Francesca Levi and Rick Shine. Francesca Levie

is Bloomberg's head of podcasts. Thanks for listening.