“One of the greatest lessons from the pandemic is the importance of timely, reliable, actionable and disaggregated data,” said WHO chief Dr Tedros Adhanom Ghebreyesus, calling for strong country data and engagement with the private sector, academia, non-profit organisations, and the scientific community to ensure data is accessible as a public good.

“Excess mortality refers to the difference in the total number of deaths in a crisis-related period, compared to those expected under non-pandemic conditions,” said WHO, adding that the revised toll attributable to Covid-19 provided a more accurate picture of the full impact of the pandemic, as it accounted for both the directly attributable deaths and the indirect impacts of the pandemic.

“The calculation of excess deaths requires the observed numbers of deaths for a specified time and place to be compared to those expected if the pandemic had not occurred. Available evidence from the countries with rapid mortality surveillance systems suggests that in many locations the reported number of Covid-19 deaths is a significant undercount of the full toll of the pandemic, and the estimated excess mortality can be many times higher (7-9). However, it is also clear that responses to the pandemic in some locations have resulted in a number of deaths being averted,” it added.

Distribution of cases

The report notes a recent shift in the distribution of cases and deaths from higher- to lower-resource settings. For example, while high-income countries accounted for about 64 per cent and 59 per cent of the global monthly new cases and deaths in January 2021, this dropped to 31 per cent and 27 per cent in April.

This contrasts to the rise in the share of global monthly new cases contributed by low- and middle-income countriesfrom 8 per cent in January 2021 to 37 per cent in April, and the share for new deaths from 8 per cent to 22 per cent between January and April.

With the help of a technical advisory group to assist WHO and member states, “preliminary assessments of excess mortality estimate 1.34-1.46 million excess deaths in Americas during 2020, 60 per cent more than the reported 860 000deaths. Likewise, 1.11–1.21 million excess deaths are estimated for the European Region, double the 590,000 reported deaths. There are data gaps in the African region, Eastern Mediterranean, South-East Asia and Western Pacific, for which just over 3,60,000 total deaths were reported for this period”.

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