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 still 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 have experienced to be just one big spike away from total collapse. Health workers have been exhausted, resources became inadequate, and facilities have not been able to accommodate everyone then.
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.
In a way, it can be argued that these people also died “because of COVID.” However, it is hard to ascertain how many of them would still have died if the pandemic never happened. Taking all of these into consideration, the 10 to 20 million deaths due to COVID estimated by The Economist does not seem too far-fetched.
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