Excess mortality estimates for last 2 years show three times as many additional deaths worldwide above baseline than given in official global Covid death estimate. Almost all of the difference comes from outside 'the West'. Study does not (could not yet) break it down further, leaving out question of effects of C19 vs. pandemic response. But let's take this initially for the excess death estimates, regardless of cause, because it already sets upper limits for overall Covid effects.
First, link to the study
https://www.thelancet.com/journals/lanc ... 40-6736(21)02796-3/fulltext
Summary
Background
Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.
Methods
All-cause mortality reports were collected for 74 countries and territories and 266 subnational locations (including 31 locations in low-income and middle-income countries) that had reported either weekly or monthly deaths from all causes during the pandemic in 2020 and 2021, and for up to 11 year previously. In addition, we obtained excess mortality data for 12 states in India. Excess mortality over time was calculated as observed mortality, after excluding data from periods affected by late registration and anomalies such as heat waves, minus expected mortality. Six models were used to estimate expected mortality; final estimates of expected mortality were based on an ensemble of these models. Ensemble weights were based on root mean squared errors derived from an out-of-sample predictive validity test. As mortality records are incomplete worldwide, we built a statistical model that predicted the excess mortality rate for locations and periods where all-cause mortality data were not available. We used least absolute shrinkage and selection operator (LASSO) regression as a variable selection mechanism and selected 15 covariates, including both covariates pertaining to the COVID-19 pandemic, such as seroprevalence, and to background population health metrics, such as the Healthcare Access and Quality Index, with direction of effects on excess mortality concordant with a meta-analysis by the US Centers for Disease Control and Prevention. With the selected best model, we ran a prediction process using 100 draws for each covariate and 100 draws of estimated coefficients and residuals, estimated from the regressions run at the draw level using draw-level input data on both excess mortality and covariates. Mean values and 95% uncertainty intervals were then generated at national, regional, and global levels. Out-of-sample predictive validity testing was done on the basis of our final model specification.
Findings
Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1–19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. The global all-age rate of excess mortality due to the COVID-19 pandemic was 120·3 deaths (113·1–129·3) per 100 000 of the population, and excess mortality rate exceeded 300 deaths per 100 000 of the population in 21 countries. The number of excess deaths due to COVID-19 was largest in the regions of south Asia, north Africa and the Middle East, and eastern Europe. At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4·07 million [3·71–4·36]), the USA (1·13 million [1·08–1·18]), Russia (1·07 million [1·06–1·08]), Mexico (798 000 [741 000–867 000]), Brazil (792 000 [730 000–847 000]), Indonesia (736 000 [594 000–955 000]), and Pakistan (664 000 [498 000–847 000]). Among these countries, the excess mortality rate was highest in Russia (374·6 deaths [369·7–378·4] per 100 000) and Mexico (325·1 [301·6–353·3] per 100 000), and was similar in Brazil (186·9 [172·2–199·8] per 100 000) and the USA (179·3 [170·7–187·5] per 100 000).
Interpretation
The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.
Funding
Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom
More
https://www.thelancet.com/journals/lanc ... 40-6736(21)02796-3/fulltext
Second, some points brought up by Raghib Ali.
https://twitter.com/drraghibali/status/ ... 8353091585
Dr Raghib Ali MD(Epi) MPH FRCP (UK)
@drraghibali
1. Far from the UK having the worst death rate in Europe (or even Western Europe) as many still think, it is actually 29th in Europe & 9th in Western Europe - below the Western European average & at the same level as France & Germany (no statistically significant difference)
W. Europe: 140.0 (133.5-146.3)
Italy: 227.4 (212.0-242.5)
Portugal: 202.2 (190.7-212.2)
Spain: 186.7 (181.3-191.5)
Belgium: 146.6 (135.8-156.3)
Netherlands: 140.0 (131.3-147.6)
UK: 126.8(122.3-130.9) Eng. 125.8(122.1-128.7)
France: 124.2 (120.5-127.7)
Germany: 120.5 (115.1-125.1)
2. Even the misleading claim that many still make that the UK had the highest death toll based on absolute numbers (which is obviously mainly determined by the population size) is now wrong:
Italy: 259000
Germany : 203000
UK: 169000 (England: 142000)
Spain: 162000
France: 155000
3. England hasn't had a higher death rate than other home nations: all are basically the same level with no statistically significant difference:
England: 125.8 (122.1 - 128.7)
Northern Ireland: 131.8 (101.6 - 165.0)
Scotland: 130.6 (115.7 - 145.1)
Wales: 135.5 (121.9 - 147.5)
4. Sweden has not had a higher excess death rates than its Scandinavian neighbours (no difference except to Norway) and is well below the W. European average (as shown above):
Denmark: 94.1 (80.5-106.3)
Sweden: 91.2 (85.2-98.1)
Finland: 80.8 (66.2-94.0)
Norway: 7.2 (0.0-15.9)
5. There is no clear relationship between levels of excess mortality and different levels of restrictions/ NPIs across Western Europe or indeed the whole of Europe. (The much higher Covid death rates in Central and Eastern Europe are mainly due to lower levels of vaccination.)
Of course as we look back, we must see what lessons we can learn from countries that have had much lower excess death rates (like Norway) but all the commentary to date as to to how and why the UK (or Sweden) has done so much worse than its neighbours is clearly no longer valid.
And of course we owe it to the tens of thousands who have died, including many of my NHS colleagues, to have a proper public inquiry that looks at all the decisions made over the last two years to ensure we learn from our mistakes and see how we can do better in the future.
There are lots of other important findings in the full paper too showing that deaths from Covid have been much higher in many countries than official figures suggest and that excess death rates have varied very widely between countries and within regions.
A lot of this was evident starting soon after the beginning. That the measures were mostly bullshit (unless the goal was a biosurveillance security state and corporate economic control given the general crises). That there was little difference among countries based on measures adopted. Will there be a reckoning with all the lies and disinfo of the last two years? Will Swedish authorities get an apology for being accused of genocide? Ha, ha, ha.
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