Pandemic Deaths Are Seriously Undercounted: New Report

A new report from the Institute for Health Metrics and Evaluation at the University of Washington is quietly shocking. With meticulous reasoning, they find that practically every government on the planet has been under-reporting COVID-19 cases and deaths.

Our own, included. A map in the report shows Canada’s total COVID-19 deaths at about 1.25 to 1.75 times the reported number. (Manitoba, ominously, shows 2.0 to 2.5 times the official reported number.) On May 6, Canada reported our total deaths as 24,489; IHME would put the current true total at between 30,611 and 42,855. That would place Canada on a path to reach a total by Sept. 1 of somewhere between 43,000 and 54,000 deaths.

In B.C., IHME’s estimate would raise our May 6 death total of 1,594 to somewhere between 1,992 and 2,789.

The IHME report uses governments’ own data: “Our approach to estimating the total COVID-19 death rate is based on measurement of the excess death rate during the pandemic week by week compared to what would have been expected based on past trends and seasonality.” It looks at six “drivers of all-cause mortality”:

• the total COVID-19 death rate


• increase in mortality due to delayed or deferred health care


• increased mortality due to mental health disorders, including depression, alcohol and opioids


• lower mortality due to fewer injuries thanks to reduced mobility


• reduced transmission of other viruses, like influenza and measles


• reduced mortality from chronic conditions like cardiovascular disease because COVID-19 killed some of those people before they could die from their conditions.

Strikingly, the report points out that the pandemic has actually saved many lives: influenza vanished in 2020, largely because people wore masks and distanced themselves. In the U.S., the report says, “influenza cases… declined 99.3 per cent from the winter season of 2019–2020 to the winter season of 2020–2021.” Evidently we never took influenza as seriously as we should have.

If the IHME numbers truly tell the story in Canada and B.C., they would seem to require more restrictions than the federal and provincial governments are currently imposing.

The B.C. government would also need to explain its reticence to share all the data it has accumulated about COVID-19 down to the neighbourhood level. Some of that information was recently leaked, suggesting that some people in B.C. health care think the rest of us should be aware of it.

The Horgan government, and Dr. Bonnie Henry, have been less than transparent. If they seem unable to trust us with important data, it becomes harder to trust them. But compared to some other countries, our officials are paragons of openness.

Donald Trump protected his pandemic inaction with a bodyguard of lies. He spent 2020 lying about COVID-19 and its remedies, even after he contracted it, and let 50 states fight one another for resources (or simply ignore the pandemic). The Johns Hopkins University COVID-19 dashboard on May 6 showed 580,054 officially reported deaths; IHME estimated that as of May 3, 905,289 Americans had died so far of COVID-19. Joe Biden’s pandemic efforts are mostly just cleaning up Trump’s mess.

India, however, may soon overtake the American death count. On May 6, Johns Hopkins reported 21,077,410 COVID-19 cases and 230,168 deaths in India. IHME, however, estimates the Indian death toll so far to be almost triple that number: 654,395.

A Guardian opinion piece noted that India under Narendra Modi suppressed malaria numbers and is doing the same with COVID-19 — while spending less than one per cent of its GDP on health. And the British journal The Lancet has published a remarkable editorial criticizing the Modi government for allowing huge religious and political gatherings and citing IHME’s projection of one million deaths by Aug. 1.

Severe undercounts may be due in part to overwhelmed health-care systems, but government mendacity is certainly a factor. IHME lists the top 20 countries with the highest mortality; Mexico, a country with a pretty good health-care system and an unreliable president, comes in third ahead of Brazil and Russia. Egypt has officially reported 13,529 COVID-19 deaths; IHME estimates 170,041.

The picture changes when IHME looks at death rates per 100,000. Now we see mostly small countries, with Azerbaijan (reporting 44.6 per 100,000) registering 648.8. Belarus, never a model of transparency, claims a death rate of 27.1 per 100,000; IHME reckons the rate is 459.6. Russia’s official death rate of 74.5 is more likely 404.6. (It’s striking to see how many of these countries are former Soviet satellites, still lying as if Stalin himself were reading their bogus statistics.)

IHME says the total global death rate is 89.5 per 100,000. A map in its report shows Canada with provincial death rates ranging from one to 10 in the Maritimes, to 100 to 200 in Manitoba and the North, to 200 to 300 in Quebec, and 50 to 100 in B.C., the Prairies and Ontario. Compared to Eastern Europe, Brazil and Peru, we’re doing all right. Compared to Vietnam (0.1 per 100,000), we look terrible.

Very few people will ever be aware of the IHME’s estimate, and fewer still in the countries suffering the highest case and death counts. But the news will filter out, strengthening public suspicions that this is a far worse pandemic than the authorities are saying. Health-care workers will certainly know how bad it is, whether their jobs are in Fraser Health or Rio de Janeiro. People in New Delhi trying to find a hospital bed for grandma may check the Corona Dashboard, but it won’t tell them where those few available beds are.

All things considered, we have been remarkably patient with our governments since New Year’s Day 2020. We have tolerated their dithering, their optimism, their incompetence and their dishonesty without putting a single politician’s head on a stick. Trump lost the election, but 74 million Americans still voted for him. Jair Bolsonaro remains in power; he’s now on health minister number four, while a Brazilian senate commission interrogates the ex-ministers on Bolsonaro’s supervision of the pandemic. Narendra Modi just lost a big state election, but he is still the boss of a billion people.

Canadians have put up with Justin Trudeau’s Liberals because the alternatives are non-starters. The same is generally true on the provincial level, though Andrea Horwath in Ontario and Rachel Notley in Alberta certainly look more competent than Doug Ford and Jason Kenney. But our governments verge on incurring a disastrous loss of trust, which could affect not only political parties but institutions like health care itself.

The leak of the BCCDC reports may show us the health-care system is getting fed up. The doctors and nurses and hospital staffers need to have a very quiet, very serious conversation with the government. This is not about you and your political career, they should say. It’s about the people we’re trying to keep alive. You’ve got to tell the truth, tell it well and tell it often, and better that you lose your job than our patients lose our lives.