The Impact of a Nation’s Health System
Improvements in health system capabilities for the U.S., as well as travel restrictions, kept the COVID death rate relatively low. Spikes did occur during the reopening of industries in 2020. Although this part of the world is still seeing increasing cases from the easing of restrictions, the death rates remain low. This is likely due to extensive vaccination efforts since December 2020.
Travel and movement restrictions are still in place in the Philippines. Widespread vaccination began in March 2021. And the health system capability is much lower than in the U.S.
What Does the Data Not Tell Us?
The fact is that testing rates for the Philippines and other low- and middle-income countries remain low. In many places, this is mainly because testing remains expensive and inaccessible to the public. Thus, the capacity for testing is the first important factor in considering the true death toll of COVID-19. When many people die without testing, this can cause an underestimation of the true CFR.
The second important consideration for tallying the true COVID death rate are cases that were never confirmed with testing who died while in line for admission to hospitals. So many health systems are one big spike away from total collapse. Health workers are exhausted, resources are inadequate, and facilities can no longer accommodate everyone.
What About Everyone Else Who Died?
Another important aspect to consider when computing the COVID death rate is everything non-COVID. Many patients who had conditions other than COVID were turned away from hospitals due to lack of facilities or human resources to care for them. Other sick people chose to die in their homes for fear of exposure to COVID-19. And many people had no access to care because of redeployment of health workers and resources to places with a high COVID death rate.