Excess Deaths: Are the Governments cheating on us about the Covid-19 related death toll?
Spoiler: The numbers might be different for multiple reasons but no, seemingly they’re not cheating on us.
Introduction
I don’t know when it has started in other countries but in Turkey two weeks ago some speculations have arised. The question was about Istanbul: Why confirmed Covid-19 related death toll doesn’t explain the difference between 5 years average and 2020 - compared to the same period of the year. The idea was that the Turkish Government is hiding / manipulating the real numbers.
When it comes to Turkish politics, that I hate to talk about, 95% of the people are -with fluctuating shares- either pro- or anti-Erdogan. (I consider myself in the miserable minority of 5%) The subject was an excellent opportunity for those who are against Erdogan so they couldn’t miss to spread the unconfirmed idea as if a fact that the Turkish Government is manipulating the death toll numbers. I did not witness that anybody involved to investigate the reason of the conflict about the numbers. But the unconfirmed argument was already famous on WhatsApp groups: “Hey, look at it, do you see that the Government is hiding the real numbers from us! Shame on them!”
On 20 April, New York Times joined the rush and published an article with a headline which is being perceived as if the idea (hiding the numbers) is a fact and intentional:
Istanbul Death Toll Hints Turkey Is Hiding a Wider Coronavirus Calamity
Istanbul recorded 2,100 more deaths over recent years between March and April, The Times found, suggesting a hidden toll.
Yet, nobody -except a few- questioned why and how that could happen to have such a deviation with past years. That is true, there are exceeding numbers which aren’t being explained by Covid-19 deaths toll. But there must be something behind this.
Later on, on 21 April, New York Times published another article which tells that the pattern they (?) found in Istanbul is relevant for many countries. Meaning: It is clear that this is happening everywhere, not only in Turkey. But if not by typo, New York Times was quite naive in second article that it was clearly and objectively investigating the issue, opposite of being harsh against Turkey case, which was clearly blaming Turkish Government for hiding the truth.
On 21 April, Economist also added Turkey to its “Tracking Covid-19 excess deaths” study, which has started tracking on 16 April. (So before NYT published Turkey case on 20 April)
Answer to headline
with a question:
Do we agree after all studies above that it is not about Turkey or specifically somewhere else and it is a fact that nobody does it intentionally?
What could be the reasons of this deviation?
Before starting, is it clear for everyone that any country and each health organization can only confirm, register, and report a coronavirus death if the patient is undoubtedly tested positive?
Since I don’t have an expertise on how these kind of data are being collected and evaluated, I’ll only put my insights about the Excess Deaths issue:
- Specifically for Istanbul: It is a huge city with 16 million people but it is also a hub for the entire region so on a regular day, there might be over 20 million people. Thus, some people who might be residents of other provinces but living or were present -due to trade or something else- in Istanbul during their illness process and died (and is buried) in Istanbul ultimately, might have been added to Istanbul figures that made the deviation bigger. If this idea has a valid background, it could be applicable to other hub-cities across Turkey (such as Trabzon, Gaziantep, Izmir, Konya etc.) and other countries as well.
- People, died with covid-19 symptoms but not hospitalized and/or tested: So the healthcare system was not able to register the death as covid-19 related. Actually that case is impossible to accurately calculate. Perhaps in the future a reliable coefficient can be applied to confirmed deaths.
- People, died with covid-19 symptoms before the test result has reached. Based on this: The numbers should be added gradually and partially if the pending tests reveal positive.
- People, died without any covid-19 symptoms, meaning normal deaths. But why normal (let’s say statistically expected) death numbers increased that much?
I- People, died because of a heart attack or any other suddenly occurring fatal problem: Was having minor symptoms related to cardiovascular problems, he/she neglected to rush to the hospital due to his/her avoidance of getting the virus. And when heart attack hit, it was too late.
II- People, died because of other diseases due to the lack of intensive healthcare quality and quantity as well: Lack of beds, intensive care units, crucial medical devices and applying them on time to most relevant patient. It differs country to country but as seen on the chart above, the biggest deviations are in Spain, England, New York, France, Netherlands, where the healthcare system either overwhelmed or very much occupied.
III- People, died because of other health problems which has been triggered by increasing anxiety due to pandemic.
The list can be longer but those mentioned above most probably will explain 80% of the excess deaths.
Conclusion
Seeking for the truth is valuable and even essential for the society. Thus, the researches which are investigating the excess deaths are important for evaluating the damage of the pandemic and consequently taking relevant measures accordingly and on time.
My point is, while diving deeper in this side-effects of the pandemic, it would be better if we’ll be emphatic and don’t blame the people in advance. Which might demotivate, distract, if nothing confuse the people, whose comprehensive service are much more important than ever.
That might be a better collaboration as a society.
