Governments have undercounted the COVID-19 death toll by millions, the WHO says

Similar analysis to that of The Economist. Biggest surprise to me is the inclusion of the USA in the top 10 – but perhaps I shouldn’t be:

The COVID-19 pandemic directly or indirectly caused 14.9 million deaths in 2020 and 2021, the World Health Organization said on Thursday, in its newest attempt to quantify the outbreak’s terrible toll.

That’s around 2.7 times more than the 5.42 million COVID-19 deaths the WHO says were previously reported through official channels in the same 2-year period.

Here’s a rundown of four main points in WHO’s report:

Overall, deaths are far higher than those in official reports

In its tally, WHO aims to quantify “excess mortality,” accounting for people who lost their lives either directly, because of contracting COVID-19, or indirectly, because they weren’t able to get treatment or preventive care for other health conditions. The figure also takes into account the deaths that analysts say were prevented because of the pandemic’s wide-ranging effects, such as curtailing traffic and travel.

The pandemic’s current reported death toll is 6.2 million, according to Johns Hopkins University’s COVID-19 tracker.

India is seen suffering a much deeper loss than reported — a finding that India disputes

In some cases, WHO’s figures depict a shockingly wide gulf between official figures and its experts’ findings. That’s particularly true for India, where WHO says millions more people died because of the pandemic than has been officially reported.

India reported 481,000 COVID-19 deaths in 2020 and 2021. But William Msemburi, technical officer for WHO’s department of data and analytics, said on Thursday that the toll is vastly higher, with 4.74 million deaths either directly or indirectly attributable to the pandemic — although Msemburi said that figure has a wide “uncertainty interval,” ranging from as low as 3.3 million to as high as 6.5 million.

The data behind the staggering figures promise to expand the understanding of the pandemic’s true effects. But the findings are also a flashpoint in debates over how to account for unreported coronavirus deaths. India, for instance, is rejecting WHO’s findings.

India “strongly objects to use of mathematical models for projecting excess mortality estimates,” the country’s health ministry said on Thursday, insisting that WHO should instead rely on “authentic data” it has provided.

10 countries accounted for a large share of deaths

Deaths were not evenly distributed around the world. The WHO says about 84% of the excess deaths were concentrated in three regions: Southeast Asia, Europe and the Americas.

And about 68% of the excess deaths were identified in just 10 countries. WHO listed them in alphabetical order: Brazil, Egypt, India, Indonesia, Mexico, Russia, South Africa, Turkey and the United States.

Overall, WHO found the number of excess deaths was much closer to reported COVID-19 deaths in high-income countries than in lower income countries.

Many countries still lack reliable health statistics

The WHO says it relied on statistical models to derive its estimates, looking to fill in gaps in official data.

“Prior to the pandemic, we estimate that 6 out of every 10 deaths were unregistered” worldwide, said Stephen MacFeely, director of WHO’s department of data and analytics. “In fact, more than 70 countries do not produce any cause of death statistics. In the 21st century, this is a shocking statistic.”

By creating its report on excess mortality, WHO is pursuing several goals, such as urging governments to improve their health-care interventions for vulnerable populations and to adopt more rigorous and transparent reporting standards.

“Knowing how many people died due to the pandemic will help us to be better prepared for the next,” said Samira Asma, WHO’s assistant director-general for data and analytics.

Source: Governments have undercounted the COVID-19 death toll by millions, the WHO says

No evidence to back WHO director general’s accusations against Taiwan

Likely not the end of this story:

The pattern surrounding the World Health Organization (WHO) and the Beijing party-state’s ongoing influence over it continues. Taiwan, a nation that has shown impressive success in combatting the COVID-19 virus despite its exclusion from WHO, is now accused of racism by the organization’s director general.

WHO Director General Tedros A. Ghebreyesus—an Ethiopian microbiologist and the first African to hold the position—asserted that Taiwan’s government not only launched a cyber campaign against him, but is also the instigator of the racism directed at Africans in general.

In a press briefing on April 6, the director general claimed he had been the victim of racially abusive attacks emanating from Taiwan, and that the country’s foreign ministry had actually stepped up its criticism of him.

Taiwan’s President Tsai Ing-Wen and the ministry of foreign affairs have denied the charges.

Given the fraught situation between Taiwan and the Chinese Communist Party (CCP) generally, including the latter’s manipulation of WHO policies of Taiwan exclusion over the years—combined with the Beijing government’s serious mismanagement of the COVID-19 pandemic, the evidence appears clearly stacked against Tedros’ claims.

President Tsai and her government provided warnings to the WHO as early as last December, which, if not ignored, as they were, might have saved thousands of lives.

For nearly half a century, the People’s Republic of China has effectively blocked Taiwan from joining the WHO. Despite never having exercised authority over the island, the CCP deems Taiwan part of its territory, and forces international organizations—including the United Nations and its agencies like the WHO—to accept its view.

Dr. Bruce Aylward, one of WHO’s top advisers recently evaded and then abruptly cut off Hong Kong journalist Yvonne Tong’s question on whether WHO would reconsider Taiwan’s status in light of the country’s exemplary performance in curbing the spread of COVID-19.

According to the reputable Foreign Policy Magazine, Beijing succeeded from the first outbreak of the coronavirus in misdirecting the World Health Organization (WHO), which receives comparatively modest funding from it but has somehow become obedient to it on many levels.

WHO’s international experts could not gain access to China until Tedros visited President Xi Jinping in Beijing at the end of January. Before then, WHO uncritically repeated information from party-state authorities, ignoring warnings from Taiwanese doctors. Reluctant to declare a “public health emergency of international concern,” WHO denied as late as Jan. 22 that there was any need to do so.

After China’s pandemic had levelled off, notes the Foreign Policy article, Tedros then praised Beijing’s “success.”

In sharp contrast, Taiwan has been treated as an outcast by the WHO, despite its exemplary performance in the current world crisis.

Almost 100 anti-COVID-19 initiatives from Taiwan’s national government included: screening Wuhan flights as early as Dec. 31; banning Wuhan residents on Jan. 23; suspending Taiwanese visits to Hubei province on Jan. 25; and barring all Chinese arrivals on Feb. 6. These and other measures resulted in only 388 confirmed cases and six deaths as of April 12 in a population of almost 24 million.

The WHO not only ignores Taiwan’s medical expertise, but also its status vis-à-vis China.

During the current pandemic, the organization keeps changing how it refers to Taiwan, going from “Taiwan, China,” to “Taipei” to the newer “Taipei and its environs”. It permitted Beijing to report Taiwan’s coronavirus numbers as part of its own total, instead of reporting Taiwan’s numbers alone—a conflation that created headaches for the smaller nation. Some countries imposed travel restrictions  on Taiwan along with China, despite the former’s small infection rate.

“Taiwan’s selfless medical workers and volunteers can be found around the world. The Taiwanese people do not differentiate by skin colour or language; all of us are brothers and sisters,” Tsai said in response to Tedros’ accusations. “We have never let our inability to join international organizations lessen our support for the international community.” She added that the WHO head was welcome to visit Taiwan and see for himself.

The internationally acknowledged success of Taiwan with the scourge of COVID-19 might lead to a diplomatic opening. Its government has already concluded a bilateral agreement with the United States to send masks, which could lead to drugs and vaccines going to America for clinical trials. Other governments seem likely to follow.

Susan Korah is an Ottawa-based journalist and David Kilgour was secretary of state, Asia-Pacific, 2002-2003, and Africa/Latin America, 1997-2002, in the Chrétien government.

Source: OpinionNo evidence to back WHO director general’s accusations against Taiwan

WHO’s early coronavirus response raises awkward questions about Beijing relationship

Good in-depth article:

In the early afternoon of Jan. 31, the lead World Health Organization representative in Beijing held a video briefing to update diplomats on the spread of a deadly new virus – and to laud China for everything it was doing.

Only a day before, the WHO had declared a “public-health emergency of international concern” over the deadly new coronavirus that causes COVID-19, after an initial outbreak in China’s Hubei province began to spread around the world. The WHO also said no restrictions on travel or trade were necessary.

On the video briefing, the WHO’s top man in China, Gauden Galea, praised the Chinese virus response. Then he went a step further, calling on other countries not to step out of line with the WHO recommendations, a key concern for Beijing, which was furious that countries were beginning to close their borders to Chinese travellers.

Any United Nations member country “will have to scientifically justify” any measure that “goes beyond UN recommendation. This justification will be made public,” Mr. Galea said, according to notes of the meeting made by one of the participants and seen by The Globe and Mail.

It amounted to a warning from the WHO, said the person, whose identity The Globe is not disclosing because the source is not authorized to speak publicly. And it was directly in line with messages from Beijing, which in subsequent days said it “deplored” countries that ignored WHO recommendations and enacted travel bans that, according to Foreign Ministry spokeswoman Hua Chunying, “sowed panic among the public” and “gravely disrupted” trade.

Now, with the virus rapidly spreading across Canada, new questions are being asked about the WHO’s relationship with China and whether the organization has sought to curry favour with Beijing – for access or money – in ways that have undermined the reliability of its advice.

In 2003, the WHO vocally criticized Chinese leadership for covering up the initial spread of the virus that caused SARS. Amid the COVID-19 pandemic, however, the organization has pointedly refused to denounce China’s concealment of information, even after it became clear that authorities in China had muzzled doctors.

In mid-January, the WHO said it had no evidence of person-to-person transmission of a virus that has subsequently shown a remarkable ability to spread through communities. And the WHO has relied on Chinese official data even when their veracity have been called into doubt – most recently by the U.S. intelligence community, which believes China deliberately manipulated numbers to mask the severity of its COVID-19 toll.

The trustworthiness of the WHO is a particular concern for countries like Canada, where public-health leaders have sought to follow WHO recommendations despite internal warnings about the reliability of information coming from China. On Thursday, Ms. Hua sought to deflect concern, saying, “China has been giving open, transparent and timely updates to the world.” Rather than listen to those accusing China of a cover-up, she said, “we should listen to the WHO.“

But concern about the relationship between the WHO and China has grown more intense as the virus pandemic claims tens of thousands of lives, bringing new attention to early failures in detection and containment. The WHO cannot work in China without Beijing’s support, and the organization has won praise for its more recent advocacy of strong measures to counter COVID-19.

Still, Mr. Galea’s admonition in late January only added to worry that the WHO was prioritizing the interests of China over those of other countries.

The WHO, in a statement, said Mr. Galea in the January briefing “referred to the sovereign right of all countries to take the measures they see fit.” But to some in attendance, his admonition only added to worry that the WHO was prioritizing the interests of China over those of other countries.

“National governments didn’t get warned as urgently as perhaps they could have by World Health officials about the severity and potential for non-containment of the virus,” said Andrew Lakoff, an anthropologist of science and medicine at University of Southern California Dornsife. A key question now is: ”What did the WHO know and why didn’t they earlier and more urgently warn other member states?” he said.

Andrew Cooper, a professor at the Balsillie School of International Affairs in Waterloo, Ont., who studies global health governance, is blunt: For WHO director-general Tedros Adhanom Ghebreyesus, “his priority is to maintain good relations with China.” Beijing has provided more cash than Washington to the WHO COVID-19 response. But China remains far from the largest contributor to the WHO, giving less than 10 per cent of what the United States provided last year.

Beijing, however, has made concerted efforts to increase its influence at key international organizations, and the WHO missteps on COVID-19 have brought that into striking relief.

The “evident bias” in favour of China at the WHO “matches the weakness of other UN organizations in the face of China’s powerful campaigning,” François Godement, senior adviser for Asia at the Institut Montaigne, wrote in a recent internet post. Once China itself began to act decisively against the virus, the WHO became a valuable clearinghouse for information, he wrote. But a key question for the WHO remains “how to lessen the impact of a relentless authoritarian regime.”

Canada has publicly expressed confidence in the WHO. Canadian Health Minister Patty Hajdu initially said Canada would follow WHO advice to avoid travel bans, saying “there isn’t evidence” for their effectiveness. It was not until March 18 that Canada closed its borders to most foreigners.

On Thursday, Ms. Hajdu said “there is no indication” that China has falsified data about virus infection and death rates, and accused a reporter of “feeding into conspiracy theories” for questioning the accuracy of Chinese data – and the WHO information that relies upon China.

Chinese authorities have themselves admitted that, until recently, their numbers of confirmed cases did not include people without obvious symptoms. Even in China’s tightly controlled media, numerous questions have been raised about the accuracy of China’s numbers, particularly after photos from coronavirus epicentre Wuhan showed large numbers of boxes containing cremated remains.

It’s a question that has been raised at the highest levels in Canada, too.

Beginning in late January, the Prime Minister’s Office received internal warnings questioning the reliability of China’s reporting on the spread of the virus epidemic, according to a person with knowledge of the information shared internally. The Globe is not identifying the person because they are not authorized to make public comments.

Canada had long since lost some of its own ability to independently scrutinize information coming from China. Under David Butler-Jones, Canada’s Chief Public Health Officer between 2004 and 2014, the Public Health Agency of Canada stationed a representative in Beijing – a medical doctor with a specialization in public health.

“It’s a way of getting an earlier heads up … so that if something is developing, we can get good intelligence on it early and get ahead of it,” Mr. Butler-Jones said in an interview. But the doctor who occupied that post left Beijing in 2015 and has not been replaced, leaving Canada with no one in such a position in China during the spread of COVID-19.

“For me, it’s frustrating,” Mr. Butler-Jones said. The position was in China “for good reason.”

Still, other sources of information underscored the threat. One was Taiwan, a region still plagued by memories of the Chinese cover-up of the SARS epidemic nearly two decades earlier. Taiwan, shut out of the WHO at the insistence of China, was ill-disposed to believe Beijing’s early assurances on the new coronavirus.

“We don’t trust anything related to new outbreaks from China,” said Chang-Chuan Chan, dean of the college of public health at National Taiwan University.

Taiwan began inspecting passengers arriving from Wuhan on Dec. 31, and sent a technical team to the virus-stricken city on Jan. 13 to 14. The delegation, which also included experts from Hong Kong and Macau, was controlled in what it could see, and denied access to the seafood market that is believed to be at the epicentre of the COVID-19 outbreak. But the Taiwanese experts came away convinced that “there is already person-to-person transmission,” Prof. Chan said.

This was out of step with the WHO, which issued a tweet on the night the Taiwanese left Wuhan saying “preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission” of COVID-19.

The WHO acted “on the basis of available information,” said spokesperson Tarik Jasarevic, citing a statement from Chinese authorities on Jan. 14 that “there is no evidence to date of a highly contagious virus.”

The close partnership between Beijing and the WHO has continued, with some of the organization’s key leaders showing a striking deference to Chinese priorities, including Bruce Aylward, the Canadian doctor who led a WHO mission to China in February.

He attracted global attention last week when he disconnected a video interview with a Hong Kong journalist after being asked about Taiwan, which Beijing considers its territory. (“The question of Taiwanese membership in WHO is up to WHO member states, not WHO staff,” the organization said in a statement this week. On Thursday, the Hong Kong government said broadcaster RTHK “breached the One-China Principle” with the interview.)

Mr. Aylward’s mission provided another opportunity for co-operation between the WHO and China, which provided 12 of the 25 people on the delegation. Chinese involvement extended to the final edits of the subsequent report, including over which specific language was used.

“There was a bit of wording manipulation, but not the sentiment,” said Dale Fisher, a professor of medicine at the National University of Singapore, and one of the delegates. For example, “we wanted to call it a ‘dangerous’ pathogen, and they felt the word ‘dangerous’ could be linked to bio-terrorism.”

The final report calls COVID-19 “a new pathogen that is highly contagious, can spread quickly, and must be considered capable of causing enormous health, economic and societal impacts.”

The report is effusive toward China, whose virus response it calls “exceptional” and whose people it praises for a deep commitment to “collective action in the face of this common threat.”

All members of the delegation “contributed to the writing, intense discussions and finalization of the report and fully concurred with the final content and language,” said Mr. Jasarevic, the WHO spokesperson. “No major or even minor finding of the mission was not included in the final report.”

Dr. Fisher dismissed criticism that the WHO was too sunny in its report from the mission. ”Everything we saw and everything we learned has completely been replicated elsewhere,” he said, pointing to findings about the ratio of mild, severe and critical cases that have been similar in other countries. “If you’re asking me could it have been any better, my answer is no,” he said.

And it’s not fair to fault the WHO for the failures of other governments to respond, particularly after the severity of the virus became clear in Wuhan, said Bilahari Kausikan, an international affairs specialist who previously served as ambassador-at-large for Singapore.

The United States “wasted time denying that this was a serious issue,” he said. “You can’t blame the WHO for that. You can’t blame the WHO for the Europeans having a terrible, nonchalant attitude toward the whole thing.”

Source: WHO’s early coronavirus response raises awkward questions about Beijing relationship