The Economist 04Apr2020

Madrid, Spain

Haut-Rhin, France

Castile-La Mancha, Spain

Castile & León, Spain

Bergamo, Italy

6,425,000

761,000

2,033,000

2,419,000

1,115,000

Mar 10th-Mar 16th

Mar 1st-Mar 20th

Mar 15th-Mar 24th

Mar 17th-Mar 24th

Mar 1st-Mar 31st

100 20 30 40 50 60 70 80 90 100 110

12

15

9

6

3

0

12

15

9

6

3

0

Jan Feb Mar

200

50

100

150

0

10

8

6

4

2

0

Jan Feb Mar

→ The increases in total mortality in these

areas were more than twice the number of

deaths officially attributed to covid-19

Region’s normal

death rate

Confirmed

covid-19 deaths

Excess deaths not

attributed to covid-19

Sum of expected deaths and

confirmed covid-19 deaths

All deaths, 2020

Expected deaths, based on past years

Nembro

Bergamo

Castile-

La Mancha

Castile

& León

Madrid

Sum of expected deaths and

confirmed covid-19 deaths

All deaths, 2020

Daily deaths Daily deaths

Expected deaths, based on past years

Europe’s worst-affected regions have many excess deaths not yet attributed to covid-19

Castile-La Mancha, region

Sources: Claudio Cancelli; Luca Foresti;L'Eco di Bergamo;El País; INSEE; Santé Publique

France; Ministero della Salute; Tuttitalia; Ministerio de Sanidad; Datadista; Instituto de

Salud Carlos III; Instituto Nacional de Estadística; InTwig *Feb 21st-Mar 31st

Deaths per 100,000 people per week, selected regions

Spain, confirmed covid-19 deaths per 100,000 people per week* Italy, confirmed covid-19 deaths per 100,000 people per week*

Nembro, town

Population Time period

The EconomistApril 4th 2020 77

T

he spreadof covid-19 is most often

measured by two numbers: how many

people are infected, and how many have

died. The first is very uncertain. Some car-

riers show no symptoms, and most coun-

tries do not test people who seem healthy.

Because data on infections are unreliable,

researchers have focused on deaths. Yet

new statistics suggest that current fatality

numbers may also understate the damage.

Official death tolls for covid-19 may ex-

clude people who died before they could be

tested. They also ignore people who suc-

cumbed to other causes, perhaps because

hospitals had no room to treat them. The

latter group has been large in other disas-

ters. For example, when Hurricane Maria

struck Puerto Rico in 2017, America record-

ed only 64 deaths. A study later found that

the surge in total deaths was close to 3,000.

Many occurred in hospitals that lost power.

Such analysis is not yet possible for na-

tions battling covid-19. The only European

country whose total death rate (as calculat-

ed by Euromomo, a research group) had

spiked by March 20th was Italy. This esti-

mate is based on a group of cities. Unfortu-

nately, Italy does not break down covid-19

deaths by city, precluding a comparison of

covid-19 and total deaths in the same area.

However, journalists and scholars have

crunched their own numbers. L’Eco di Ber-

gamo, a newspaper, has obtained data from

82 localities in Italy’s Bergamo province. In

March these places had 2,420 more deaths

than in March 2019. Just 1,140, less than half

of the increase, were attributed to covid-19.

“The data is the tip of the iceberg,” Giorgio

Gori, the mayor of Bergamo’s capital, told

L’ E c o. “Too many victims are not included

in the reports because they die at home.”

Comparable figures can be found across

Europe. In Spain El País, a newspaper, has

published the results of a study by the gov-

ernment’s health research centre, showing

that “excess” deaths in the Castile-La Man-

cha region were double the number attrib-

uted to covid-19. Jean-Marc Manach, a

French reporter, has found a similar dis-

parity in the department of Haut-Rhin.

These differences may shrink over time.

Official counts of covid-19 fatalities could

be updated to include people who have al-

ready died, because confirming the cause

sometimes takes several days. The toll

from other types of death might fall soon:

lockdowns could reduce accidents and vio-

lence, and many frail covid-19 victims were

already likely to die of other causes. And

mortality data are noisy in smaller re-

gions—especially hard-hit ones that may

not be representative of entire countries.

Still, the official covid-19 count will al-

ways seem too low in places like Nembro, a

Bergamasque town of 11,000 people. It suf-

fered 152 deaths in March, with only 39 at-

tributed to the virus so far. “Almost all the

old people got it,” says Luca Foresti, a re-

searcher. “And therefore they died, a lot.” 7

The death toll from covid-19 appears

higher than official figures suggest

Fatal flaws

Graphic detailCoronavirus statistics