Keep track of excess deaths in Covid times
When government surveys yield negative results, it is assumed that the results of such surveys never see the light of day. But last week the Bangladesh Bureau of Statistics (BBS) did indeed publish such a report. The figures in the survey were frightening. However, no one really seems to be bothered. No one seems to be even discussing the fact that the number of deaths in the country last year shot up considerably as compared to the year before. In the countries of the West, the excess death rate is being given serious attention. Researchers are analysing this trend and relating it to the Covid-19 pandemic.
According to BBS, the number of deaths from brain strokes last year doubled. In 2020, the total number of deaths due to brain stroke was 85,360. In 2019 this number stood at 45, 502. Deaths due to kidney diseases tripled. Similarly, deaths caused by heart attacks increased alarmingly too. Last year 180,408 persons died of heart attack. The year before, 147,259 persons died of this ailment. That means a 22 per cent increase in deaths due to heart attack. There has been an alarming increase in deaths due to cancer and kidney related diseases too. According to unofficial records, the rate of suicides and suicidal tendencies has gone up by almost 44 per cent.
The bits of good news that showed up amidst all this was that, like the previous year, no one died of HIV or AIDS last year. Also, the number of asthma related deaths had decreased somewhat. And there has been a dramatic drop in deaths caused by chikungunia and malaria. However, even though the deaths related to these couple of diseases have fallen, the deaths due to strokes, heart attacks and cancer have risen so high that there has been around 31,500 more deaths last year than the year before.
The BBS survey was run on over 300,000 families. The actual picture may vary somewhat.
According to government records, the number of Covid deaths in the country so far is 8,500. If the Covid deaths in the first two and a half months of this year are dropped, then the number of deaths last year, as recorded by the government, will be less. However, there are no officials records of how many have died with corona symptoms. This number according to unofficial records is around 2000 or so.
It is more or less established that Bangladesh has managed to avoid a massive outbreak of Covid. All statistics indicate that Bangladesh has been relatively less harmed by the pandemic. But this has a dangerous side too because it has led to a false sense of security among the people. And headlines such as ’20 times more deaths by heart ailments than corona’ or ‘More deaths by suicide than corona’ simply serve to consolidate this false sense of security. As a result, hygiene rules such as social distancing and wearing masks are being ignored and the transmission and prevalence of coronavirus is increasing.
There are deaths caused by other diseases, but the pandemic is being seen as indirectly responsible for these. One of this is suicide and the other is murder stemming from domestic violence. The loneliness, the loss or lessening of earnings due to the lockdown have led to mental health issues
A new thinking is gradually growing in the West concerning corona deaths. There are even questions concerning the official figures in countries like the US and UK where the death rates are high. It is being said that the official records do not accurately reflect the alarming extent of coronavirus. Even after having advanced systems for birth and death records, the reports are being seen as inaccurate. The reasons being shown for this are quite plausible.
Firstly, in almost all countries the treatment of other diseases is being delayed or obstructed due to Covid. That is why persons with other life-threatening diseases in critical condition, have died due to lack of treatment. So Covid is indirectly responsible or such deaths.
Secondly, a large number of patients have not undergone Covid tests. In many cases, the Covid symptoms are not apparent. And Covid suddenly increases the symptoms of other diseases.
Thirdly, many patients suffering from Covid in hospital for an extended period, recover and go home. But then they fall ill again and die. These deaths are not duly recorded. Even now thousands and thousands of patients are facing the prospect of death because their treatment and surgeries are being delayed. None of these deaths will appear on the official records.
Other than this, there are deaths caused by other diseases, but the pandemic is being seen as indirectly responsible for these. One of this is suicide and the other is murder stemming from domestic violence. The loneliness, the loss or lessening of earnings due to the lockdown have led to mental health issues. This, in turn, has led to an alarming increase in suicides. Unemployment, financial crisis, pressure of looking after children and other tensions has dramatically increased domestic violence. In many cases this has led to murder.
It is essential to have an accurate figure of deaths during Covid times based on official records, not in estimates of a survey. The record of losses and damage caused by Covid will remain incomplete unless these excess deaths are tracked and taken into account
In this backdrop it is being said that it is essential to take these excess deaths into account to understand the actual acuteness of the Covid threat. If the rate of annual deaths is calculated by averaging the deaths of the five years from 2014 to 2019 and then if this is compared to the deaths in the corona year (one year after the first 50 corona deaths), this will give the number of excess deaths. The Economist has analysed such excess deaths in 75 countries (Tracking Covid-19 excess deaths across countries). In the 9 March updated figures, the excess deaths exceed the number of official Covid deaths. In South Africa, for example, the Covid deaths are around 49,000, but the number of excess deaths is around 128,500. In the US, the number of Covid deaths is around 450,000, but excess deaths total over 550,000. The number of Covid deaths in Britain is over 140,000 and excess deaths total 124,000. There are no figures from South Asian countries on this list.
It is not that there have been excess deaths in all countries. In around a dozen countries or so, the average death rate of last year is lower than that of the average of the preceding five years. According The Economist, Covid transmission and deaths has been less in these countries possibly due to social distancing being effectively maintained. The statistics indicate that alongside Covid deaths, the rate of excess deaths has also increased in proportion to the rise in Covid transmission. The same picture emerges in month-wise records. In the case of South Africa, there was the highest number of deaths in January, the month when a highly infectious and dangerous strain of Covid was identified there.
Bangladesh also has a law making birth and death registration compulsory. Death certificates can hardly be issued unless the deaths are registered. Such certificates are necessary to settle for all types of inheritance issues. So, with a few exceptions, the government should be having a reliable record of all deaths. It is essential to have an accurate figure of deaths during Covid times based on official records, not in estimates of a survey. The record of losses and damage caused by Covid will remain incomplete unless these excess deaths are tracked and taken into account.
*Kamal Ahmed is a senior journalist.
*This column appeared in the print and online edition of Prothom Alo and has been rewritten for the English edition by Ayesha Kabir