Counting The Dead: How Do Countries Tally the Toll From COVID-19?

The United States and Russia have the two highest numbers of cumulative, confirmed coronavirus cases in the world.

As of May 20, the United States also has the highest official death toll.

Russia, however, is ranked 19th for its reported number of coronavirus fatalities, and its statistics are increasingly under scrutiny from experts who suspect something’s not quite right with Moscow’s methodology.

Is the United States overcounting its coronavirus deaths? Is Russia undercounting?

Most countries around the world try to adhere to the guidelines set out by the World Health Organization (WHO) for classifying coronavirus deaths: “a death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19.”

In other words, if a person has a heart condition, then acquires the coronavirus, and later dies, it should be classified as a coronavirus death. The same for diabetes or respiratory illnesses like pneumonia.

“When studying the pandemic, you should count as much as possible, then you can classify the cases otherwise later on,” said Steven Van Gucht, a virologist at Belgium’s main public health institution, Sciensano.

Experts say there are a mix of explanations why coronavirus fatality statistics vary, some a function of longstanding, institutional practices and traditions within countries; some potentially a function of politics.

According to Johns Hopkins University, the U.S. institution whose database on infections is considered one of the most authoritative, differences in mortality numbers can be caused by things like the number of tests performed in a population: the more testing there is, the more people with milder cases are identified, and this then lowers the ratio of cases to fatalities.

Also, the older or sicker a population is, the higher mortality rates are likely to be. And each country’s health-care system is a factor: The number and quality of hospitals and doctors, for example, affects how infected patients are treated and whether they recover.

In the United States, the Centers for Disease Control and Prevention — the lead government agency for health and disease responses — says its statistics are based on numbers entered into the National Vital Statistics System, from all 50 U.S. states.

Among the statistics’ shortcomings are the lag time: Several weeks can elapse before a COVID-19 death will be processed, coded, and tabulated, and then be reflected in national figures.

Call It COVID-19

In Russia, there’s a more fundamental issue, with mounting evidence that the deaths of many people infected with the coronavirus have been attributed to other diseases or conditions.

Yelena Malinnikova, the Health Ministry’s chief of infectious diseases, argued on May 4 that the low mortality was due to testing and quick detection.

Russia has been praised for its wide national testing program, with more than 7.5 million tests conducted.

But Russia’s official figures, already under scrutiny, drew more attention earlier this month when news media including The Moscow Times, The New York Times, and the Financial Times, examined preliminary fatality rates for Moscow for April, and discovered they were markedly above average. That has prompted angry denunciations from the Foreign Ministry.

Russia’s WHO representative has also downplayed doubts about the country’s tallies.


Copyright (c) 2015. RFE/RL, Inc. Reprinted with the permission of Radio Free Europe/Radio Liberty, 1201 Connecticut Ave NW, Ste 400, Washington DC 20036.

Leave a Reply

Your email address will not be published. Required fields are marked *

For security, use of Google's reCAPTCHA service is required which is subject to the Google Privacy Policy and Terms of Use.

I agree to these terms.