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“As we have seen in Europe, many of the advances we have made in terms of suppressing the virus and reducing mortality are fragile. And by no means are we out of the woods yet.
“Many countries in sub-Saharan Africa took swift and decisive action to slow the spread of the virus and prevent large-scale epidemics like the ones we have seen in Europe to date; they may not have felt the full force of the pandemic, although it is hard to say.
“The quality of the systems that exist for reporting deaths varies greatly between countries. Syria is an example of this: if you look at officially reported Covid-19 deaths coming out of Damascus, fewer than 100 have been reported since the first in March.
“The work we’ve done with Syrian doctors, however, looking at excess mortality statistics and other sources of death data, including commemorative Facebook groups, suggests up to 4,500 deaths, which means that only about of one in 80 deaths from Covid-19 in the official mortality statistics that leave the country.
“Persistent limitations in testing capacity and the difficulty of recording deaths outside of hospitals in settings like these make accurate detection of the true burden challenging.
“This highlights the degree to which Covid-19 could have spread unobserved in many parts of the world that do not have the necessary systems to accurately capture mortality patterns.”
Two million deaths by the turn of the year
Epidemiologists have the unenviable task of trying to predict how the virus will take shape in the coming weeks and months.
According to projections compiled by the Centers for Disease Control and Prevention (CDC), the death toll in the United States could rise by more than 20,000 to more than 225,000 by October 17.
Some models predict much higher death tolls, with Texas Tech University projecting 244,000 deaths by mid-October.
And an analysis by Imperial College London estimates that, over the next week, five countries will accumulate more than 1,000 additional deaths each: Brazil, India, Mexico, Colombia and Argentina.
The number of new deaths reported in India alone is expected to exceed 8,500 per week.
