1 00:00:07,800 --> 00:00:13,000 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day seventy seven 2 00:00:13,280 --> 00:00:18,200 Speaker 1: since coronavirus was declared a global pandemic. Our main story. 3 00:00:19,200 --> 00:00:22,760 Speaker 1: Hundreds of thousands of people around the world are reported 4 00:00:22,800 --> 00:00:27,440 Speaker 1: to have died from COVID nineteen, and yet we don't 5 00:00:27,440 --> 00:00:32,720 Speaker 1: know the true number of virus deaths. Experts widely agree 6 00:00:32,800 --> 00:00:36,400 Speaker 1: that the three hundred thousand deaths from the virus is 7 00:00:36,440 --> 00:00:40,199 Speaker 1: an undercount, but there are ways to get closer to 8 00:00:40,240 --> 00:00:44,520 Speaker 1: the real number. And without knowing that number, we're only 9 00:00:44,640 --> 00:00:49,120 Speaker 1: guessing at how well our disease fighting measures are really working. 10 00:00:50,640 --> 00:01:02,120 Speaker 1: But first, here's what happened today. Germany wants to test 11 00:01:02,280 --> 00:01:06,200 Speaker 1: more people who don't show symptoms for the coronavirus. The 12 00:01:06,240 --> 00:01:09,319 Speaker 1: country's health ministry put out a proposal that would expand 13 00:01:09,360 --> 00:01:13,440 Speaker 1: screening to close contacts of sick people, workers at nursing 14 00:01:13,480 --> 00:01:16,800 Speaker 1: homes and meat packing plants, as well as schools and 15 00:01:16,880 --> 00:01:21,680 Speaker 1: restaurants where cases emerge. Chancellor Angela Merkel and the country 16 00:01:21,840 --> 00:01:25,760 Speaker 1: States have agreed to keep contact restrictions in place until 17 00:01:25,880 --> 00:01:29,760 Speaker 1: June twenty ninth. We may get a new test of 18 00:01:29,800 --> 00:01:33,280 Speaker 1: the international air travel system in the time of coronavirus 19 00:01:33,880 --> 00:01:38,760 Speaker 1: within weeks. Australia and New Zealand could open an air 20 00:01:38,800 --> 00:01:42,959 Speaker 1: corridor between the two countries for quarantine free flights if 21 00:01:43,000 --> 00:01:46,360 Speaker 1: guidelines that will be released in early June are approved. 22 00:01:47,240 --> 00:01:49,840 Speaker 1: The group drawing up the guidelines for safe travel are 23 00:01:49,840 --> 00:01:54,440 Speaker 1: considering every stage of the journey, including how passengers move 24 00:01:54,480 --> 00:01:59,960 Speaker 1: through airports and contact tracing requirements at their destination. Travel 25 00:02:00,000 --> 00:02:02,800 Speaker 1: oilers will have to declare their healthy before they fly, 26 00:02:03,640 --> 00:02:08,799 Speaker 1: and might sacrifice their fare if they're ill. Tightly controlled 27 00:02:08,960 --> 00:02:12,519 Speaker 1: flight bubbles, which can be enlarged to include other countries, 28 00:02:12,800 --> 00:02:16,760 Speaker 1: have emerged as potential models for the global travel industry. 29 00:02:17,440 --> 00:02:21,160 Speaker 1: China and South Korea opened a narrow travel corridor with 30 00:02:21,360 --> 00:02:27,680 Speaker 1: onerous restrictions this month. Finally, Dr Anthony Fauci, the top 31 00:02:27,880 --> 00:02:31,560 Speaker 1: us infectious disease expert, said in an interview on CNN 32 00:02:32,040 --> 00:02:34,760 Speaker 1: he believes a vaccine could be ready to be deployed 33 00:02:34,960 --> 00:02:37,880 Speaker 1: as early as late this year, but a group of 34 00:02:37,919 --> 00:02:41,760 Speaker 1: people who get paid to make forecasts are far more pessimistic. 35 00:02:42,720 --> 00:02:46,640 Speaker 1: Good Judgment Incorporated, a company that maintains a global network 36 00:02:46,639 --> 00:02:50,200 Speaker 1: of forecasters who scour public data, say there's only a 37 00:02:50,320 --> 00:02:53,240 Speaker 1: nine percent chance that there will be a widely available 38 00:02:53,320 --> 00:03:10,320 Speaker 1: vaccine before next April, and now our main story. So far, 39 00:03:10,720 --> 00:03:13,960 Speaker 1: more than three hundred thousand people globally are known to 40 00:03:14,040 --> 00:03:18,040 Speaker 1: have died because of the coronavirus. The US is fast 41 00:03:18,040 --> 00:03:23,240 Speaker 1: approaching the grim milestone of one hundred thousand fatalities, and 42 00:03:23,320 --> 00:03:27,400 Speaker 1: as shocking as those numbers are, experts believe there are 43 00:03:27,440 --> 00:03:33,680 Speaker 1: actually many more deaths were not counting. It might sound macabre, 44 00:03:33,919 --> 00:03:37,480 Speaker 1: but in order to save lives, you need to count deaths. 45 00:03:38,520 --> 00:03:41,839 Speaker 1: Knowing how many have died and the context around their 46 00:03:41,840 --> 00:03:46,960 Speaker 1: deaths is crucial for understanding and fighting the virus. That's 47 00:03:47,040 --> 00:03:49,960 Speaker 1: because we need to understand how fast and in what 48 00:03:50,080 --> 00:03:54,200 Speaker 1: groups mortality is rising in order to fine tune the 49 00:03:54,280 --> 00:03:59,120 Speaker 1: policies that govern our response to the virus. So experts 50 00:03:59,120 --> 00:04:02,480 Speaker 1: are looking past the official count to find other ways 51 00:04:02,520 --> 00:04:07,320 Speaker 1: to investigate just how many people are dying. Bloomberg Senior 52 00:04:07,400 --> 00:04:16,680 Speaker 1: editor Jason Gale has more. Alan Lopez is a laureate 53 00:04:16,680 --> 00:04:19,719 Speaker 1: professor of Global health at the University of Melbourne. He 54 00:04:19,839 --> 00:04:21,760 Speaker 1: spent a lot of his life counting the dead and 55 00:04:21,920 --> 00:04:25,720 Speaker 1: figuring out why people die. Now his efforts have turned 56 00:04:25,760 --> 00:04:29,880 Speaker 1: to COVID nineteen. He says Monitoring mortality right now is 57 00:04:29,920 --> 00:04:33,560 Speaker 1: critical for striking the optimal balance between saving people from 58 00:04:33,600 --> 00:04:37,880 Speaker 1: the pandemic and worsening other health threats. We need to 59 00:04:37,960 --> 00:04:43,000 Speaker 1: understand how bad these are deaths are increasing in order 60 00:04:43,000 --> 00:04:46,240 Speaker 1: for us to turn those policy leavers and knobs at 61 00:04:46,240 --> 00:04:49,840 Speaker 1: the right speed in the right direction. So if mortality 62 00:04:49,880 --> 00:04:54,000 Speaker 1: is still increasing, then we absolutely need to keep doing 63 00:04:54,040 --> 00:04:56,800 Speaker 1: what we're doing to prevent that. But in order for 64 00:04:56,839 --> 00:04:59,840 Speaker 1: us to do that, we need to understand reliably u 65 00:05:00,000 --> 00:05:02,120 Speaker 1: how many people are dying as a result of the 66 00:05:02,120 --> 00:05:05,359 Speaker 1: COVID nineteen academic and at what time and at what 67 00:05:05,480 --> 00:05:08,760 Speaker 1: age they're dying. There's no point making policy now on 68 00:05:08,920 --> 00:05:11,800 Speaker 1: COVID nineteen mortality data four or five or six weeks ago. 69 00:05:12,160 --> 00:05:14,680 Speaker 1: You need mortality data from the last week, and you 70 00:05:14,760 --> 00:05:17,200 Speaker 1: need it by age, need it by sex, and you 71 00:05:17,240 --> 00:05:27,000 Speaker 1: need it to be reliable. Alan and his partner, Professor 72 00:05:27,120 --> 00:05:30,440 Speaker 1: Christopher Murray at the University of Washington and Seattle, have 73 00:05:30,560 --> 00:05:34,080 Speaker 1: spent more than two decades studying mortality rates, and he 74 00:05:34,120 --> 00:05:37,960 Speaker 1: says getting that reliable data can be tricky. The World 75 00:05:38,040 --> 00:05:41,599 Speaker 1: Health Organization, as of Tuesday, said more than five point 76 00:05:41,760 --> 00:05:45,160 Speaker 1: three million people are known to have caught the novel coronavirus, 77 00:05:45,720 --> 00:05:49,000 Speaker 1: and of those more than six percent of died. But 78 00:05:49,120 --> 00:05:53,839 Speaker 1: those numbers aren't reliable. Many people got COVID and weren't tested, 79 00:05:54,360 --> 00:05:58,120 Speaker 1: so their infection wasn't recorded. Some people died at home, 80 00:05:58,760 --> 00:06:03,000 Speaker 1: especially when hospitals were overwhelmed. Some people died too because 81 00:06:03,160 --> 00:06:07,040 Speaker 1: they couldn't get treated for another life threatening condition. So 82 00:06:07,200 --> 00:06:10,719 Speaker 1: how do your factor in those unreported cases and deaths 83 00:06:10,760 --> 00:06:15,160 Speaker 1: to get a more realistic number, Alan says, you ask 84 00:06:15,240 --> 00:06:18,960 Speaker 1: a simple question and go from there. What if COVID 85 00:06:19,000 --> 00:06:22,440 Speaker 1: nineteen never happened, what would we expect to see in 86 00:06:22,520 --> 00:06:25,040 Speaker 1: terms of numbers of deaths by age and sex? And 87 00:06:25,080 --> 00:06:28,200 Speaker 1: then what do we see And in the absence of 88 00:06:28,200 --> 00:06:31,120 Speaker 1: any major shock to the system, like an earthquake or 89 00:06:31,160 --> 00:06:35,360 Speaker 1: a flood or some catastrophic event that causes a lot 90 00:06:35,360 --> 00:06:37,919 Speaker 1: of deaths, all of those deaths must be due to 91 00:06:38,320 --> 00:06:41,080 Speaker 1: the only other thing that's happened that's different but this 92 00:06:41,160 --> 00:06:45,920 Speaker 1: year from last year, and that is COVID nineteen. And 93 00:06:45,960 --> 00:06:48,840 Speaker 1: then there's the matter of figuring out which deaths were 94 00:06:48,880 --> 00:06:52,560 Speaker 1: the direct result of COVID nineteen and which ones were 95 00:06:52,720 --> 00:06:57,080 Speaker 1: caused by some other interrect factor. How many more deaths 96 00:06:57,120 --> 00:07:00,120 Speaker 1: are there by age and sex this year then there 97 00:07:00,160 --> 00:07:03,840 Speaker 1: were last year or the year before, some some comparable basedline. 98 00:07:04,080 --> 00:07:07,360 Speaker 1: In other words, we need to understand fully the impact 99 00:07:07,360 --> 00:07:10,720 Speaker 1: of COVID nineteen, not just as an underlying cause of 100 00:07:10,760 --> 00:07:14,760 Speaker 1: death in hospitals where there's confirmed COVID nineteen cases, but 101 00:07:14,840 --> 00:07:18,360 Speaker 1: also the what we call the multiplier effects of COVID nineteen. 102 00:07:18,840 --> 00:07:22,360 Speaker 1: The fact that it's likely to increase the risk of 103 00:07:22,360 --> 00:07:25,560 Speaker 1: of major vascular diseases heart fare, there, schemic card disease, 104 00:07:25,600 --> 00:07:29,800 Speaker 1: stroke been seeming. We're seeing increasing evidence of that. The 105 00:07:29,800 --> 00:07:32,680 Speaker 1: fact that it's likely to increase death rates from chronic 106 00:07:32,720 --> 00:07:37,000 Speaker 1: obstructive lung disease, so I caually increase death rates among smokers. 107 00:07:37,040 --> 00:07:39,600 Speaker 1: So it's doing a lot of things that are multiplying 108 00:07:39,680 --> 00:07:42,720 Speaker 1: up the risks of other causes of death, leading to 109 00:07:43,200 --> 00:07:47,880 Speaker 1: a much bigger, often to two times higher overall impact 110 00:07:48,040 --> 00:07:52,120 Speaker 1: than what we're measuring in the specific hospital mortality rates. 111 00:07:53,080 --> 00:07:56,200 Speaker 1: The Centers for Disease Control and Prevention estimates that there 112 00:07:56,200 --> 00:08:00,160 Speaker 1: have been as many as one thousand excess death in 113 00:08:00,200 --> 00:08:04,200 Speaker 1: the United States since February. Alan says that in countries 114 00:08:04,240 --> 00:08:07,760 Speaker 1: with robust mortality data, it appears that about twice the 115 00:08:07,800 --> 00:08:10,520 Speaker 1: number of people may be dying because of the pandemic 116 00:08:10,880 --> 00:08:14,360 Speaker 1: then what's officially reported as a COVID death. So I 117 00:08:14,400 --> 00:08:21,280 Speaker 1: think unless we monitor this epidemic cleverly and comprehensively by 118 00:08:21,320 --> 00:08:24,480 Speaker 1: looking at all of the deaths that COVID nineteen is causing, 119 00:08:24,520 --> 00:08:27,720 Speaker 1: we are going to seriously underestimated and that will seriously 120 00:08:28,040 --> 00:08:32,480 Speaker 1: misinform policy options and their timing. Alan says. The reasons 121 00:08:32,520 --> 00:08:36,040 Speaker 1: why people die during the pandemic will also probably be 122 00:08:36,200 --> 00:08:39,880 Speaker 1: quite different to what's usually observed. You've got an envelope 123 00:08:39,880 --> 00:08:42,920 Speaker 1: of deaths, and you've got the COVID nineteen certified deaths, 124 00:08:42,920 --> 00:08:44,680 Speaker 1: which you've got a lot of other deaths in there. 125 00:08:45,400 --> 00:08:50,160 Speaker 1: So how have death rates from road traffic accidents from suicide? 126 00:08:50,160 --> 00:08:52,199 Speaker 1: So road traffic athens may have gone the other direction 127 00:08:52,520 --> 00:08:55,520 Speaker 1: and gone down because there's been fewer people circulating, but 128 00:08:55,600 --> 00:08:58,480 Speaker 1: on the same with asma or acute respiratory diseases because 129 00:08:58,480 --> 00:09:01,000 Speaker 1: pollution is gone down. On the other hand, you might 130 00:09:01,040 --> 00:09:04,800 Speaker 1: have mental health conditions, particularly suicide, that would have incroducted 131 00:09:04,800 --> 00:09:08,800 Speaker 1: well of increased We've talked also about skimmy cart disease, stroke, 132 00:09:08,920 --> 00:09:12,600 Speaker 1: chronic lung disease, a number of conditions that COVID nineteen 133 00:09:12,679 --> 00:09:15,120 Speaker 1: might have aggravated and we would have seen increases in 134 00:09:15,160 --> 00:09:17,800 Speaker 1: these death rates. And these I'm not expecting these to 135 00:09:17,880 --> 00:09:20,439 Speaker 1: be doubling of the death rates, but I do expect 136 00:09:20,440 --> 00:09:24,120 Speaker 1: that we will see some significant increases in death rates 137 00:09:24,160 --> 00:09:27,000 Speaker 1: that are directly attributable to the action of COVID nineteen. 138 00:09:31,760 --> 00:09:35,760 Speaker 1: Across the world, tens of millions of deaths go unrecorded 139 00:09:35,760 --> 00:09:39,800 Speaker 1: each year. This lack of information is a killer in 140 00:09:39,880 --> 00:09:43,040 Speaker 1: its own right. Without an accurate measure of deaths and 141 00:09:43,080 --> 00:09:47,640 Speaker 1: their causes, finding the pandemic and developing countries is much harder. 142 00:09:48,320 --> 00:09:51,520 Speaker 1: Authorities simply like the basic information they need to make 143 00:09:51,520 --> 00:09:56,160 Speaker 1: informed decisions. Full disclosure. Alan is the director of the 144 00:09:56,320 --> 00:09:59,960 Speaker 1: Data for Health Initiative. It's funded by the Australian govern 145 00:10:00,040 --> 00:10:05,000 Speaker 1: Meant and Bloomberg Philanthropies. Bloomberg Philanthropies was set up by 146 00:10:05,040 --> 00:10:08,600 Speaker 1: former New York Mayor Michael Bloomberg, founder and majority owner 147 00:10:08,640 --> 00:10:12,880 Speaker 1: of Bloomberg News parent Bloomberg LP. Data for Health partners 148 00:10:12,920 --> 00:10:16,240 Speaker 1: with governments in low and middle income countries to strengthen 149 00:10:16,240 --> 00:10:18,960 Speaker 1: their public health data and improve the way they use 150 00:10:19,080 --> 00:10:23,120 Speaker 1: this information to make public health decisions and public health investments. 151 00:10:24,480 --> 00:10:27,640 Speaker 1: We've also been very active in trying to help countries 152 00:10:28,120 --> 00:10:32,679 Speaker 1: build up the notification systems so they know who's dying. 153 00:10:33,160 --> 00:10:35,800 Speaker 1: This is critically important. You cannot diagnose the death and 154 00:10:35,880 --> 00:10:39,000 Speaker 1: listen until you know that someone has died, and to 155 00:10:39,360 --> 00:10:42,440 Speaker 1: know about that, you need notification systems in there. And remember, 156 00:10:42,520 --> 00:10:46,120 Speaker 1: the vast majority of these deaths, unlike Australia, are occurring 157 00:10:46,160 --> 00:10:48,960 Speaker 1: in communities, not in hospitals, and so how do you 158 00:10:49,000 --> 00:10:51,080 Speaker 1: know that people are dying in villages and what they're 159 00:10:51,120 --> 00:10:53,559 Speaker 1: dying from? And so a lot of the time that 160 00:10:53,600 --> 00:10:57,400 Speaker 1: we've been working in countries, we've been focusing on cost effective, 161 00:10:58,040 --> 00:11:01,680 Speaker 1: quick methods that will They're not perfect, but they will 162 00:11:02,760 --> 00:11:05,480 Speaker 1: yield a kind of information that countries would need to 163 00:11:05,520 --> 00:11:10,600 Speaker 1: monitor COVID nineteen with reasonable reliability and cheaply, and they work. 164 00:11:11,720 --> 00:11:15,040 Speaker 1: The data for health program works in twenty countries across 165 00:11:15,080 --> 00:11:18,880 Speaker 1: the world. Alan says that it's helped establish a baseline 166 00:11:18,920 --> 00:11:21,680 Speaker 1: for the deaths that occur each year and that will 167 00:11:21,720 --> 00:11:24,800 Speaker 1: make it easier to eventually figure out the global mortality 168 00:11:24,920 --> 00:11:28,040 Speaker 1: from the pandemic. What we now need to do is 169 00:11:28,080 --> 00:11:34,120 Speaker 1: to um collect the data on who died in the 170 00:11:34,200 --> 00:11:37,800 Speaker 1: era of the COVID nineteen that will be undercounted for sure, 171 00:11:38,280 --> 00:11:40,960 Speaker 1: and we will need to apply the statistical methods that 172 00:11:41,000 --> 00:11:43,520 Speaker 1: we've developed over the years to those data to say 173 00:11:43,559 --> 00:11:45,760 Speaker 1: we should adjust them in this and this way, and 174 00:11:45,800 --> 00:11:48,760 Speaker 1: when we subtract those away from the baseline, this is 175 00:11:48,800 --> 00:11:52,800 Speaker 1: the excess mortality that, in my viewing is probably the 176 00:11:52,840 --> 00:11:55,720 Speaker 1: six to nine month exercise. I may be optimistic, but 177 00:11:55,800 --> 00:11:58,400 Speaker 1: I think this time next year we would have a 178 00:11:58,440 --> 00:12:02,240 Speaker 1: pretty good idea of the total global mortality and butten 179 00:12:02,280 --> 00:12:06,200 Speaker 1: by country from COVID nineteen. Allen says the pandemic is 180 00:12:06,280 --> 00:12:10,160 Speaker 1: underscoring the need to rapidly report debts to authorities in 181 00:12:10,200 --> 00:12:15,520 Speaker 1: developing countries. Mobile phones have accelerated the notification process, especially 182 00:12:15,520 --> 00:12:18,640 Speaker 1: when churches and other community based groups are able to 183 00:12:18,679 --> 00:12:23,720 Speaker 1: contribute to surveillance activities. The hope is that by improving 184 00:12:23,720 --> 00:12:26,440 Speaker 1: the collection of this kind of data, governments will be 185 00:12:26,480 --> 00:12:30,120 Speaker 1: able to respond more effectively, not just to the pandemic, 186 00:12:30,600 --> 00:12:33,400 Speaker 1: but all the other major causes of death and disease, 187 00:12:33,920 --> 00:12:38,000 Speaker 1: and that will ultimately improve the health and well being 188 00:12:38,520 --> 00:12:47,320 Speaker 1: of people everywhere. That was Jason Gale in Melbourne, and 189 00:12:47,360 --> 00:12:50,400 Speaker 1: that's our show today for coverage of the outbreak from 190 00:12:50,400 --> 00:12:55,240 Speaker 1: one bureaus around the world. Visit Bloomberg dot com slash 191 00:12:55,320 --> 00:12:59,480 Speaker 1: Coronavirus and if you like the show, please leave us 192 00:12:59,480 --> 00:13:02,959 Speaker 1: a review and a rating on Apple Podcasts or Spotify. 193 00:13:03,760 --> 00:13:06,360 Speaker 1: It's the best way to help more listeners find our 194 00:13:06,400 --> 00:13:12,160 Speaker 1: global reporting. The Prognosis Daily edition is produced by Topher FORHZ, 195 00:13:12,520 --> 00:13:18,520 Speaker 1: Jordan Gaspure, Magnus Hendrickson, and me Laura Carlson. Today's main 196 00:13:18,600 --> 00:13:23,880 Speaker 1: story was reported by Jason Gale. Original music by Leo Sidrin. 197 00:13:24,600 --> 00:13:29,440 Speaker 1: Our editors are Francesca Levi and Rick Shine. Francesca Levie 198 00:13:29,480 --> 00:13:32,840 Speaker 1: is Bloomberg's head of podcasts. Thanks for listening.