"
A million is a terrible number
," commented on Friday, September 25, the director of emergency situations of the World Health Organization (WHO), Michael Ryan.
On Sunday, the death toll from the coronavirus reached this famous million.
This "
terrible
" number, however, had very probably already been crossed.
The reason ?
Since the start of the pandemic, the death toll has been underestimated in many countries.
Read also: Coronavirus: the big Chinese lie
China accused of lying about its figures
China was accused at the end of March of having underestimated the number of deaths among its population.
At the beginning of April, it advanced 3,300 deaths, when Italy (yet twenty times less populated) already recorded 13,000 deaths.
A survey by the Caixin website estimated at the end of March at 3,500 the number of deaths for the Wuhan region alone, by estimating the number of funeral urns given to families by crematoriums.
This assertion was repeated in early April by the American intelligence services in a note relayed by parliamentarians.
“Their numbers seem a bit underestimated, and I'm kind when I say that,
” then commented US President Donald Trump.
This accusation concerns other countries, such as Brazil, where the government is accused of having played down the numbers of the epidemic.
In June, he even stopped publishing the daily report, before changing his mind under media pressure.
This lack of transparency had tarnished confidence in government figures and raised the possibility of a much higher death toll within the scientific community.
Developing countries struggle to estimate their death toll
Rural or poor areas, poorly equipped with hospitals, are likely to present undervalued figures.
This is particularly the case in India and Brazil, two countries which lead the ranking of countries most affected by the epidemic.
In India, a study published in the prestigious scientific journal
The Lancet
points to a statistical problem.
The case fatality rate in this country has hovered around 1.8% in recent days, a relatively low figure.
Only, as the review notes, even in normal times, India underestimates its deaths from disease.
Only 22% of deaths are declared to the civil registry.
Rural areas, less equipped with hospitals, are particularly concerned.
In the Bihar region for example, the study notes that only 729 deaths were recorded, against 25,000 in the Bombay region, which is much more equipped with health centers.
Brazil faces the same difficulty.
A Brazilian study published in the online journal JMIR estimates this underestimation at 40% on average in the country's major cities.
These figures vary depending on the city.
Thus in Manaus, the underestimation is estimated at 62.7% by researchers.
The reason for these discrepancies is not known.
The study notes that in the poorest cities and least equipped with health facilities (like Manaus), the recorded differential is the highest.
Other surveys comparing the number of funeral ceremonies also make it possible to identify significant variations between the deaths linked to Covid-19 declared by the authorities and the number of excess deaths (additional compared to the average of deaths over previous years) .
Thus, from March 31 to April 30, if only 300 victims of Covid-19 were announced in Jakarta, (Indonesia), 14,846 burials took place, or 1,400 more than the average at this time of year.
If these 1,400 additional deaths are linked to Covid-19, it means that only 21% of the victims were taken into account.
The number of one million is as dizzying as it is symbolic.
The deaths should not stop there.
For Michael Ryan, a doubling of this number is even
"very likely"
.
