September 29, 2020

Global coronavirus deaths have officially topped 1M. But that's almost certainly an undercount, experts say.

Daily Briefing

    The number of reported deaths tied to the novel coronavirus worldwide surpassed one million as of Tuesday morning, with the United States reporting more coronavirus-related deaths than any other country. Public health experts say the reported death tolls likely are undercounts.

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    US new coronavirus cases near 7.2M, deaths approach 205K

    U.S. officials as of Tuesday morning reported a total of 7,176,500 cases of the novel coronavirus virus since the country's epidemic began—up from 7,139,300 cases reported as of Monday morning.

    According to data from the New York Times, the rates of newly reported coronavirus cases are "staying high" in Puerto Rico and 20 states that have had a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Alabama, Arkansas, Idaho, Illinois, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Wisconsin, and Wyoming.

    The U.S. Virgin Islands and eight states that have had comparatively low case rates are now seeing those rates "going up," according to the Times. Those states are Alaska, Arizona, Colorado, Massachusetts, Nevada, New Jersey, New Mexico, and Oregon.

    In the 24 remaining U.S. states and territories, rates of newly reported coronavirus cases are "staying low," according to the Times' analysis.

    U.S. officials as of Tuesday morning also reported a total of 204,941 deaths linked to the coronavirus since the country's epidemic began—up from 204,597 deaths reported as of Monday morning.

    US leads world in reported total of coronavirus deaths—but actual death tolls may be even higher

    The United States has reported more deaths linked to the novel coronavirus than any other country in the world. As of Tuesday morning, officials worldwide had reported more than one million deaths tied to the coronavirus—with more than half of those deaths occurring in the United States, Brazil, India, and Mexico, which are the four countries that lead the world in reported deaths linked to the novel coronavirus, according to data from the Johns Hopkins University of Medicine's Coronavirus Resource Center.

    However, public health officials say the actual death toll from the coronavirus is likely higher.

    Michael Ryan, head of the World Health Organization's emergencies program, on Monday said, "When you count anything, you never count it perfectly. But I can assure you that the current numbers are likely an underestimate of the true toll of Covid."

    Public health experts say there are several reasons why deaths linked to the novel coronavirus may go uncounted. For example, public health experts note that some Americans who died from the virus may have died at home without ever seeking care or being tested for the pathogen. Those individuals' cause of death might not be reported on their death certificates, and the individuals therefore may not be included in official coronavirus death counts.

    Because of those issues, experts say the exact death toll from the novel coronavirus likely will never be known. However, researchers are tracking so-called "excess deaths" to get a more precise estimate of who died from the virus. Researchers calculate excess deaths by subtracting the number of deaths that typically occur during a certain time period from the number of reported deaths that actually occurred during that time period. According to researchers, America's number of excess deaths suggests officials are undercounting the country's coronavirus death toll by about 30%—and many other countries are missing an even larger share of deaths linked to the virus, Axios' "Vitals" reports.

    Ryan said the reported global death toll from the new coronavirus could reach two million before a vaccine against the virus becomes widely available, "Vitals" reports.

    Separately, United Nations Secretary General António Guterres on Monday said the global community must learn from mistakes made during first 10 months of the global coronavirus pandemic. "Responsible leadership matters," he said. "Science matters. Cooperation matters—and misinformation kills."

    Trump admin to send 100M rapid coronavirus tests to states by end of 2020

    Meanwhile, President Trump during a White House press conference on Monday announced that the federal government this week will start shipping millions of rapid antigen coronavirus tests to states.

    White House officials said the Trump administration plans to distribute 100 million rapid coronavirus tests manufactured by Abbott Laboratories to states by the end of this year, with 6.5 million of the tests going out to states this week. Officials said the administration will distribute the tests—which cost $5 and can produce results in about 15 minutes—based on states' population data.

    FDA last month issued an emergency use authorization allowing providers to use Abbott's rapid coronavirus test at point-of-care settings—including physician's offices, EDs, and certain schools—and the federal government announced that it had reached a deal with Abbott to purchase 150 million of the tests for $750 billion. According to the Associated Press, the tests the Trump administration is shipping out to states will come from that stockpile.

    Although governors will decide how to use the tests their states receive, Trump and Brett Giroir, who currently is serving as the Trump administration's coronavirus testing czar, are encouraging states to use the tests to support resuming in-person instruction for students in kindergarten through 12th grade.

    "The support my administration is providing would allow every state to on a very regular basis test every teacher who needs it," Trump said.

    According to the AP, the tests could help states to conduct baseline surveillance by testing a share of their students each week or month to ensure they have a low rate of coronavirus infection. Although rapid antigen tests for the novel coronavirus are less accurate than lab-based polymerase chain reaction tests, public health experts have said rapid tests' easy administration and lower costs mean they could play a key role in preventing the coronavirus's spread.

    But experts say the number of tests the administration is shipping to states is not enough to help them provide the level of routine testing needed to screen students and teachers to the extent for which the administration is calling.

    Jennifer Nuzzo, the lead epidemiologist for the Johns Hopkins Covid-19 Testing Insights Initiative, in a tweet posted Monday wrote, "[T]he number of tests being made available [is] not close to what's needed for routine testing like [Trump administration officials] described."

    Similarly, Michael Mina—an epidemiologist, immunologist, and physician at the Harvard T.H. Chan School of Public Health and Harvard Medical School—in a series of tweets posted Monday wrote, "Don't get me wrong, these rapid tests can and will likely be crucial to control this virus. But the math here just doesn't add up." He added, "This is not near the type of rapid test volume that is needed to make a major impact" (New York Times [1], 9/29; Farzan/Hassan, Washington Post, 9/29; Owens, "Vitals," Axios, 9/29; Perrone/Freking, Associated Press, 9/28; Lim, Politico, 9/28; New York Times [2], 9/29).

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