Under-reporting of deaths limits our understanding of true burden of covid-19
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Published version
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Author(s)
Type
Journal Article
Abstract
Charles Whittaker and colleagues argue that accurate mortality data are essential for a fair, just, and equitable response to pandemics and suggest how to obtain them
Estimating mortality attributable to different diseases, risk factors, or events is pivotal to inform resource allocation and evaluate public health interventions. Information on death rates and burden also supports wider aims of societal governance, public accountability, and memorialisation. Recent examples of mortality estimation include the true toll of hurricane Maria in Puerto Rico,1 mortality during famine in Somalia,2 and the war in South Sudan.
Mortality data have also been essential in understanding the spread of covid-19. However, under-reporting in official death records has greatly obscured this understanding. We explore why under-reporting of deaths should have been expected, examine how use of alternative mortality sources can help advocate for a more equitable pandemic response, and highlight the crucial need for increased investment into civil registration and vital statistics systems before the next pandemic.
Estimating mortality attributable to different diseases, risk factors, or events is pivotal to inform resource allocation and evaluate public health interventions. Information on death rates and burden also supports wider aims of societal governance, public accountability, and memorialisation. Recent examples of mortality estimation include the true toll of hurricane Maria in Puerto Rico,1 mortality during famine in Somalia,2 and the war in South Sudan.
Mortality data have also been essential in understanding the spread of covid-19. However, under-reporting in official death records has greatly obscured this understanding. We explore why under-reporting of deaths should have been expected, examine how use of alternative mortality sources can help advocate for a more equitable pandemic response, and highlight the crucial need for increased investment into civil registration and vital statistics systems before the next pandemic.
Date Issued
2021-11-06
Date Acceptance
2021-10-01
Citation
The BMJ, 2021, 375 (8313)
ISSN
0959-8146
Publisher
BMJ Publishing Group
Journal / Book Title
The BMJ
Volume
375
Issue
8313
Copyright Statement
Copyright © 2026 BMJ. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34642172
Subjects
General & Internal Medicine
Life Sciences & Biomedicine
Medicine, General & Internal
Science & Technology
Publication Status
Published
Coverage Spatial
England
Article Number
2239
Date Publish Online
2021-10-12