"Based on a comparison of coronavirus deaths in 210 countries relative to their population, Peru had the most losses to COVID-19 up until April 26, 2022. As of the same date, the virus had infected over 510.2 million people worldwide, and the number of deaths had totaled more than 6.2 million."

"Note, however, that COVID-19 test rates can vary per country. Additionally, big differences show up between countries when combining the number of deaths against confirmed COVID-19 cases."

"The source seemingly does not differentiate between "the Wuhan strain" (2019-nCOV) of COVID-19, 'the Kent mutation' (B.1.1.7) that appeared in the UK in late 2020, the 2021 Delta variant (B.1.617.2) from India or the Omicron variant (B.1.1.529) from South Africa." 

Statista

Performing last rites before the cremation of a family member who died of COVID-19 in India. Anupam Nath/AP

 According to new research out of the World Health Organization, a newly-issued report concludes that official data accounting for the number of people who have died resulting from COVID infections are a third of the actual numbers. The WHO presents this latest report as representing the most comprehensive study at the actual toll globally of the pandemic to date. Their study team expressed confidence in the accuracy of a total listing 14.9 million excess deaths to the end of 2021.

 

In that period, from January 2020 to the end of December 2021, the official count directly attributable to COVID reporting to the WHO numbered just over 5.4 million. In the WHO's accounting, excess mortality figures include those who died of COVID-19 along with those who died indirectly resulting from the outbreak. Encompassing people unable to access health care to treat other conditions when hospitals were overwhelmed during the waves of pathogenic infection. 

Included were those deaths that would normally have occurred during the pandemic but did not; ie., owing to lower risk of traffic accidents taking place during lockdowns. Deaths missed in countries lacking adequate reporting account for lower official numbers being reported, according to the WHO. They pointed out that under-reporting did not arrive exclusively with COVID, but represented a situation where an estimated six in ten deaths globally failed to be registered officially, overall.

Close to half of the globally numbered deaths, it is now suggested, occurred in India with the report suggesting that 4.7 million people died there as a result of the pandemic, mostly in the May and June 2921 surge. The Indian government's official figure is put at 480,000 in the period January 2020 to December 2021, finding fault with the calculation methodology utilized by the WHO study.

It must also be borne in mind that India has an immense population of 1.3 billion, right behind China's 1.4 billion. Beijing's figures for COVID-related deaths would be hard to come by. Even given its comfortable relations with the WHO, China prefers to keep such data from prying international eyes. It is also notable that the United States, with an official death rate of 991,000 and 81-million infections, has a population about one quarter the size of India's; their numbers fairly well match.

Relatives carry a body for cremation past corpses partially exposed in shallow sand graves. In May, rains washed away the top layer of sand at a cremation ground on the banks of the Ganges River in Shringverpur, India. Ritesh Shukla/Getty Images

Comprised of international experts working for months amassing data, the WHO panel made use of a combination of national and local information, along with statistical models to estimate totals when dealing with incomplete data. Independent assessments also place the Indian death toll higher than the official government tally. A report published in Science suggested three million people could have died of COVID in India. While other models reached similar conclusions regarding the global death toll, higher by far than the recorded statistics.

 

A large study in the United States found the Omicron variant of the SARS-CoV2 virus to be intrinsically as severe as previous variants, whereas the assumption has been that Omicron, reflecting previous studies, was more transmissible, yet less severe. "We found that the risks of hospitalization and mortality were nearly identical between periods", was the consensus of the four scientists who conducted the study.

 

Previous studies assuming Omicron to be less threatening in severity took place in a number of areas including South Africa, England and Canada. The current study undergoing peer review at Nature Portfolio, posted on May 2 on Research Square, was adjusted for confounders (demographics, vaccination status and the Carlson comorbidity index) predicting risk of death within a year of hospitalization for those with specific comorbid conditions.

 

Omicron: Greater Infectiousness, More Hospitalizations

"Despite Omicron seeing the highest reported numbers of COVID-19 cases and hospitalizations during the pandemic, disease severity indicators, including length of stay, ICU admission, and death, were lower than during previous pandemic peaks."

U.S. Centers for Disease Control and Prevention

 

"There is support for both scenarios [that the Omicron variant really is a milder disease than Delta, or that it now encounters those with immunity from vaccination and old infections]."

"The emergence of another major variant of concern is highly probable as the virus has proven it can evolve to escape immunity in the current climate of infection."

Alex Sigal, virologist, South Africa

 

"It's replicating in places that cause less damage."

Suimit Chanda, infectious disease expert

 

"[Omicron entered a population] that had considerably more immunity than any previous SARS-CoV-2 variant had encountered."

"There must be a renewed push to vaccinate and boost those not yet protected, because Omicron is not necessarily intrinsically milder."

"[Matters would have been] much, much worse [with Delta]."

William Hanage, epidemiologist, Harvard University

"I think there's genuine good news about both intrinsic severity appearing to be slightly lower and immunity holding decently well against severe disease, far better than it is against infection."

"I just find myself a bit concerned about the oversimplified narrative that 'Omicron is milder', [or even worse], 'Omicron is mild'."

"The nuances matter here, I think."

Roby Bhattacharyya, infectious diseases physician, Harvard University

As much as medical science knows about the SARS-CoV-2 virus causing COVID-19, it doesn't know quite enough. Leaving too many questions and too few answers. But observation and greater understanding are all being acquired, bit by bit as the coronavirus continues its journey in its myriad mutations circulating world-wide, alerting anxious scientists time and again to new and perplexing variants.

 

Although there was a giant sigh of relief that circled the globe with the initial assurance that this form of the virus is milder, albeit more infectious than the Delta strain, there are still questions about whether, in actual fact, it is. There is the realization that its greater infectiousness means more illnesses leading inevitably to more hospitalizations, ICU treatment and deaths by virtue of sheer numbers of infection. All the more so among the as-yet-unvaccinated.

 

Compared to other variants, laboratory studies suggest that Omicron invades human cells differently than its predecessors, that once within human cells its presence is restricted for the most part to the upper respiratory tract, leaving it less likely to enter and spread in the lungs to cause more severe disease. Significantly reduced chances of severe disease developing and death for those infected with Omicron have been validated in studies.

 

 Photo by Getty Images

Researchers at Imperial College London were first to report in December that Omicron seemed to be less likely to hospitalize people or to ensure they're kept hospitalized for over a day, in comparison to people infected with the Delta strain. Since then, studies have emerged from South Africa, Southern California and the U.S. Centers for Disease Control and Prevention, finding that those with confirmed Omicron remain substantially less likely to be hospitalized, require oxygen therapy or mechanical ventilation - or die, in comparison with confirmed cases of Delta. 

Where the Omicron variant was first identified in South Africa the strain found a population with a substantial degree of immunity. Even so, Omicron excels in slipping around vaccine-produced immunity to cause breakthrough infections;'vaccines' effectiveness against hospitalization largely preserved, diminishing Omicron's impact, as a result of vaccine doses administered.

In comparison to those who have been doubly vaccinated, those who have not had any inoculation bear a five-fold higher risk of being hospitalized. Omicron has been the cause of over 2,400 deaths daily on average in the past week in the United States. Millions globally of new infections have been recorded from Omicron. The greater the number of infections, the more opportunities arise for the virus to mutate.

"Infection is the fuel that evolution has to bring us these new variants. We need to get infection numbers down."

"Those things [uncertainty over how long immunity from vaccination and exposure to Omicron lasts] will all affect how many new infections are happening per day, or per week, after this peak."

Caroline Colijn, epidemiologist, Simon Fraser University, British Columbia

Omicron is getting "an oversimplified narrative" that is it milder, but "the nuances matter here," says one infectious diseases doctor. Photo by Cole Burston/Reuters