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Dr Rawiri Taonui | Covid-Māori | One Million Deaths 500 Million Cases Worldwide 30 September 2020
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Dr Rawiri Taonui | Covid-Māori | One Million Deaths 500 Million Cases Worldwide 30 September 2020

World Situation

Yesterday morning the official total of reported deaths passed 1 million and total reported cases passed 33 million.

Covid-19 continues a vertiginous ascent across the globe. The first 10 million cases came in 154 days, the last full 10 million came in just 38 days. There have been 3 million new cases in just 10 days.

The first 500,000 deaths came in 179 days, the second 500,000 in 95 days.

On the current 7-day rate of over 284,000 new cases and 5,000 deaths per day, there will be 60 million cases and 1.5 million deaths by the end of the year.

Real Numbers much Higher

True numbers are difficult to judge as a pandemic outpaces the ability to test populations and health facilities are overrun, difficulties that are wider between rich countries and poorer with more robust and less sophisticated data systems. With a focus on the extremely ill, a considerable number up to 80% of asymptomatic or show mild cases go undetected.

Deaths in poorer areas are less likely to be counted. Countries define deaths differently; some do not include Covid-19 related deaths in aged care facilities.

During the 2009/2010 Swine Flu Pandemic, the official count was 250,00 cases and 15,000 deaths. After the pandemic, researchers estimated the real number of cases as high as 1.4 billion cases and up to 554,000 deaths.

Estimating Accurate Number of Cases

Serology testing, which tests for antibodies to Covid-19 thereby indicating that someone has had the disease and recovered, are a valuable tool for estimating the real number of cases in a population. Serology tests are less accurate than Swab tests but are especially useful for estimating a more accurate number of asymptomatic and mild cases in a population.

At the end of last week, The Economist completed a survey of 279 serosurveys in 19 countries. This canvass suggests that infections were already running at over 1 million per day by the end of January and up to 5 million per day in May. The uncertainties in the estimation can be large, and increase closer to the present, but overall the survey estimated that between 6.4% to 9.3% of the world’s population or 500 to 730 million people have been infected. The World Health Organisation (WHO) is conducting an estimate of its own, and though not yet completed; they have indicated an upper threshold of 10% of the global population.

Previously this column has used a factor of 3x to 4x official numbers to estimate the actual number of cases. This should now be changed to 15x to 23x or between 500 to 730 million cases worldwide.

30092020 2

Estimating an Accurate Number of Deaths

‘Excess deaths’ comparing current overall death rates with historical averages are a primary index determining more accurate fatalities from Covid-19.

For example, The European Mortality Monitoring Project (EuroMOMO), which aggregates weekly all-cause death data from 24 European countries and regions, shows that as early as March and April, deaths in Europe were 25% higher than the official figures.

In the middle of the year, The Economist gathered all-cause mortality data from countries which report them weekly or monthly, including from most of Western Europe, some from Latin America, and a few other large countries, including the United States, Russia and South Africa. Between March and August, these countries recorded 580,000 Covid-19 deaths but 900,000 excess deaths, 55% greater than the official Covid-19 total.

A broader study published earlier this month from Nature gathering figures from several databases showed significant discrepancies between official figures and excess deaths. For example, in the United States and Spain, two of the hardest-hit countries, deaths may have been 25% and 35% higher than official statistics. In poorer countries, the mismatch is much greater, such as in Peru, where fatalities are 74% greater than official numbers.

Professor Alan Lopez, the director of the University of Melbourne’s Global Burden of Disease Group estimates that fatalities are closer to 1.8 million and will exceed 3 million by the end of the year. On the assumption of many more uncounted deaths in poor countries, The Economist says the total is closer to 2 million.

This column will retain its current factoring of 3x to 4x to estimate deaths on the basis that current studies of mortality do not include sufficient data from poverty-stricken areas like the Amazon, Africa and parts of Asia. This would give a mortality rate of 0.55% to 0.6% of between 730 million and 500 million cases. This is much lower than the current official 4% rate of death based on the official total of cases but is reasonable because the official figures do not include the many more undetected asymptomatic cases suggested in serosurveys.

The Scale of Covid-19

More accurate estimations mean that Covid-19 is the most serious flu-type pandemic event since the Spanish Flu of 1918. Over a shorter period, there are already more cases than all flu events other than Swine Flu (2009-2010), and more deaths than other events except for Spanish Flu (1918), Asian Flu (1957-1958) and Hong Kong Flu (1968-1970).

Virus Infections Deaths





Spanish Flu 1918-1919


500 million

50 to 100 million

Covid-19 2020


500 to 730 million

**2 million

Asian Flu 1957-1958



1 to 4 million

Hong Kong Flu 1968-1970



1 to 4 million

Swine Flu 2009-2010

Novel H1N1

1.4 billion

250,00 to 554,000

SARS 2002-2003




MERS 2012









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