The daily death toll has been a constant backdrop to the Covid-19 crisis. Would we ever have entered lockdown, would so many people have been driven to panic, were it not for the publication, every afternoon, of the number of deaths in the past 24 hours? It has helped set in the minds of the public the idea that this is a lethal disease, on a scale completely removed from other common diseases.
How much differently would we see Covid-19, though, if we were also fed with a slightly different statistic: the number of indirect deaths, caused not by the disease itself but by other factors associated with lockdowns: closure of medical facilities, fear of going to a hospital and so on. In England in the week ending 1 May, as I wrote here last week, the ONS recorded 2000 extra deaths from causes other than Covid-19.
The developing world however, faces the prospect of a far more serious indirect toll from Covid-19. Writing in Lancet Global Health, a team from the Johns Hopkins Bloomberg School of Public Health has made an attempt to model what could happen if maternity services are disrupted. Using knowledge of what has happened during previous epidemics, they looked at three different scenarios where the number of maternal and child health interactions – including check-ups, scans, vaccinations, and operations– was reduced by between 9.8 percent and 51.9 percent over a six month period. That would result, they say, in up to an extra 1.16 million deaths of babies and children (up to the age of five) as well as an additional 56,700 maternal deaths.
(To put these figures into context, in a normal six month period we would expect to see the deaths of 2.5 million children below the age of five and 144,000 mothers.) The global death toll from Covid-19 so far is slightly over 300,000.
This research goes to show that while we wince at the latest death figures from Covid-19, a far higher death toll awaits if we mishandle the pandemic and neglect other areas of medicine in order to concentrate wholly on Covid-19. We have already seen an elevated death rate in Britain from non-Covid-19 causes, but a tragedy on a much larger scale awaits if our response to the virus compromises everyday health services in poorer countries.
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