Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day seventy seven
Speaker 1: since coronavirus was declared a global pandemic. Our main story.
Speaker 1: Hundreds of thousands of people around the world are reported
Speaker 1: to have died from COVID nineteen, and yet we don't
Speaker 1: know the true number of virus deaths. Experts widely agree
Speaker 1: that the three hundred thousand deaths from the virus is
Speaker 1: an undercount, but there are ways to get closer to
Speaker 1: the real number. And without knowing that number, we're only
Speaker 1: guessing at how well our disease fighting measures are really working.
Speaker 1: But first, here's what happened today. Germany wants to test
Speaker 1: more people who don't show symptoms for the coronavirus. The
Speaker 1: country's health ministry put out a proposal that would expand
Speaker 1: screening to close contacts of sick people, workers at nursing
Speaker 1: homes and meat packing plants, as well as schools and
Speaker 1: restaurants where cases emerge. Chancellor Angela Merkel and the country
Speaker 1: States have agreed to keep contact restrictions in place until
Speaker 1: June twenty ninth. We may get a new test of
Speaker 1: the international air travel system in the time of coronavirus
Speaker 1: within weeks. Australia and New Zealand could open an air
Speaker 1: corridor between the two countries for quarantine free flights if
Speaker 1: guidelines that will be released in early June are approved.
Speaker 1: The group drawing up the guidelines for safe travel are
Speaker 1: considering every stage of the journey, including how passengers move
Speaker 1: through airports and contact tracing requirements at their destination. Travel
Speaker 1: oilers will have to declare their healthy before they fly,
Speaker 1: and might sacrifice their fare if they're ill. Tightly controlled
Speaker 1: flight bubbles, which can be enlarged to include other countries,
Speaker 1: have emerged as potential models for the global travel industry.
Speaker 1: China and South Korea opened a narrow travel corridor with
Speaker 1: onerous restrictions this month. Finally, Dr Anthony Fauci, the top
Speaker 1: us infectious disease expert, said in an interview on CNN
Speaker 1: he believes a vaccine could be ready to be deployed
Speaker 1: as early as late this year, but a group of
Speaker 1: people who get paid to make forecasts are far more pessimistic.
Speaker 1: Good Judgment Incorporated, a company that maintains a global network
Speaker 1: of forecasters who scour public data, say there's only a
Speaker 1: nine percent chance that there will be a widely available
Speaker 1: vaccine before next April, and now our main story. So far,
Speaker 1: more than three hundred thousand people globally are known to
Speaker 1: have died because of the coronavirus. The US is fast
Speaker 1: approaching the grim milestone of one hundred thousand fatalities, and
Speaker 1: as shocking as those numbers are, experts believe there are
Speaker 1: actually many more deaths were not counting. It might sound macabre,
Speaker 1: but in order to save lives, you need to count deaths.
Speaker 1: Knowing how many have died and the context around their
Speaker 1: deaths is crucial for understanding and fighting the virus. That's
Speaker 1: because we need to understand how fast and in what
Speaker 1: groups mortality is rising in order to fine tune the
Speaker 1: policies that govern our response to the virus. So experts
Speaker 1: are looking past the official count to find other ways
Speaker 1: to investigate just how many people are dying. Bloomberg Senior
Speaker 1: editor Jason Gale has more. Alan Lopez is a laureate
Speaker 1: professor of Global health at the University of Melbourne. He
Speaker 1: spent a lot of his life counting the dead and
Speaker 1: figuring out why people die. Now his efforts have turned
Speaker 1: to COVID nineteen. He says Monitoring mortality right now is
Speaker 1: critical for striking the optimal balance between saving people from
Speaker 1: the pandemic and worsening other health threats. We need to
Speaker 1: understand how bad these are deaths are increasing in order
Speaker 1: for us to turn those policy leavers and knobs at
Speaker 1: the right speed in the right direction. So if mortality
Speaker 1: is still increasing, then we absolutely need to keep doing
Speaker 1: what we're doing to prevent that. But in order for
Speaker 1: us to do that, we need to understand reliably u
Speaker 1: how many people are dying as a result of the
Speaker 1: COVID nineteen academic and at what time and at what
Speaker 1: age they're dying. There's no point making policy now on
Speaker 1: COVID nineteen mortality data four or five or six weeks ago.
Speaker 1: You need mortality data from the last week, and you
Speaker 1: need it by age, need it by sex, and you
Speaker 1: need it to be reliable. Alan and his partner, Professor
Speaker 1: Christopher Murray at the University of Washington and Seattle, have
Speaker 1: spent more than two decades studying mortality rates, and he
Speaker 1: says getting that reliable data can be tricky. The World
Speaker 1: Health Organization, as of Tuesday, said more than five point
Speaker 1: three million people are known to have caught the novel coronavirus,
Speaker 1: and of those more than six percent of died. But
Speaker 1: those numbers aren't reliable. Many people got COVID and weren't tested,
Speaker 1: so their infection wasn't recorded. Some people died at home,
Speaker 1: especially when hospitals were overwhelmed. Some people died too because
Speaker 1: they couldn't get treated for another life threatening condition. So
Speaker 1: how do your factor in those unreported cases and deaths
Speaker 1: to get a more realistic number, Alan says, you ask
Speaker 1: a simple question and go from there. What if COVID
Speaker 1: nineteen never happened, what would we expect to see in
Speaker 1: terms of numbers of deaths by age and sex? And
Speaker 1: then what do we see And in the absence of
Speaker 1: any major shock to the system, like an earthquake or
Speaker 1: a flood or some catastrophic event that causes a lot
Speaker 1: of deaths, all of those deaths must be due to
Speaker 1: the only other thing that's happened that's different but this
Speaker 1: year from last year, and that is COVID nineteen. And
Speaker 1: then there's the matter of figuring out which deaths were
Speaker 1: the direct result of COVID nineteen and which ones were
Speaker 1: caused by some other interrect factor. How many more deaths
Speaker 1: are there by age and sex this year then there
Speaker 1: were last year or the year before, some some comparable basedline.
Speaker 1: In other words, we need to understand fully the impact
Speaker 1: of COVID nineteen, not just as an underlying cause of
Speaker 1: death in hospitals where there's confirmed COVID nineteen cases, but
Speaker 1: also the what we call the multiplier effects of COVID nineteen.
Speaker 1: The fact that it's likely to increase the risk of
Speaker 1: of major vascular diseases heart fare, there, schemic card disease,
Speaker 1: stroke been seeming. We're seeing increasing evidence of that. The
Speaker 1: fact that it's likely to increase death rates from chronic
Speaker 1: obstructive lung disease, so I caually increase death rates among smokers.
Speaker 1: So it's doing a lot of things that are multiplying
Speaker 1: up the risks of other causes of death, leading to
Speaker 1: a much bigger, often to two times higher overall impact
Speaker 1: than what we're measuring in the specific hospital mortality rates.
Speaker 1: The Centers for Disease Control and Prevention estimates that there
Speaker 1: have been as many as one thousand excess death in
Speaker 1: the United States since February. Alan says that in countries
Speaker 1: with robust mortality data, it appears that about twice the
Speaker 1: number of people may be dying because of the pandemic
Speaker 1: then what's officially reported as a COVID death. So I
Speaker 1: think unless we monitor this epidemic cleverly and comprehensively by
Speaker 1: looking at all of the deaths that COVID nineteen is causing,
Speaker 1: we are going to seriously underestimated and that will seriously
Speaker 1: misinform policy options and their timing. Alan says. The reasons
Speaker 1: why people die during the pandemic will also probably be
Speaker 1: quite different to what's usually observed. You've got an envelope
Speaker 1: of deaths, and you've got the COVID nineteen certified deaths,
Speaker 1: which you've got a lot of other deaths in there.
Speaker 1: So how have death rates from road traffic accidents from suicide?
Speaker 1: So road traffic athens may have gone the other direction
Speaker 1: and gone down because there's been fewer people circulating, but
Speaker 1: on the same with asma or acute respiratory diseases because
Speaker 1: pollution is gone down. On the other hand, you might
Speaker 1: have mental health conditions, particularly suicide, that would have incroducted
Speaker 1: well of increased We've talked also about skimmy cart disease, stroke,
Speaker 1: chronic lung disease, a number of conditions that COVID nineteen
Speaker 1: might have aggravated and we would have seen increases in
Speaker 1: these death rates. And these I'm not expecting these to
Speaker 1: be doubling of the death rates, but I do expect
Speaker 1: that we will see some significant increases in death rates
Speaker 1: that are directly attributable to the action of COVID nineteen.
Speaker 1: Across the world, tens of millions of deaths go unrecorded
Speaker 1: each year. This lack of information is a killer in
Speaker 1: its own right. Without an accurate measure of deaths and
Speaker 1: their causes, finding the pandemic and developing countries is much harder.
Speaker 1: Authorities simply like the basic information they need to make
Speaker 1: informed decisions. Full disclosure. Alan is the director of the
Speaker 1: Data for Health Initiative. It's funded by the Australian govern
Speaker 1: Meant and Bloomberg Philanthropies. Bloomberg Philanthropies was set up by
Speaker 1: former New York Mayor Michael Bloomberg, founder and majority owner
Speaker 1: of Bloomberg News parent Bloomberg LP. Data for Health partners
Speaker 1: with governments in low and middle income countries to strengthen
Speaker 1: their public health data and improve the way they use
Speaker 1: this information to make public health decisions and public health investments.
Speaker 1: We've also been very active in trying to help countries
Speaker 1: build up the notification systems so they know who's dying.
Speaker 1: This is critically important. You cannot diagnose the death and
Speaker 1: listen until you know that someone has died, and to
Speaker 1: know about that, you need notification systems in there. And remember,
Speaker 1: the vast majority of these deaths, unlike Australia, are occurring
Speaker 1: in communities, not in hospitals, and so how do you
Speaker 1: know that people are dying in villages and what they're
Speaker 1: dying from? And so a lot of the time that
Speaker 1: we've been working in countries, we've been focusing on cost effective,
Speaker 1: quick methods that will They're not perfect, but they will
Speaker 1: yield a kind of information that countries would need to
Speaker 1: monitor COVID nineteen with reasonable reliability and cheaply, and they work.
Speaker 1: The data for health program works in twenty countries across
Speaker 1: the world. Alan says that it's helped establish a baseline
Speaker 1: for the deaths that occur each year and that will
Speaker 1: make it easier to eventually figure out the global mortality
Speaker 1: from the pandemic. What we now need to do is
Speaker 1: to um collect the data on who died in the
Speaker 1: era of the COVID nineteen that will be undercounted for sure,
Speaker 1: and we will need to apply the statistical methods that
Speaker 1: we've developed over the years to those data to say
Speaker 1: we should adjust them in this and this way, and
Speaker 1: when we subtract those away from the baseline, this is
Speaker 1: the excess mortality that, in my viewing is probably the
Speaker 1: six to nine month exercise. I may be optimistic, but
Speaker 1: I think this time next year we would have a
Speaker 1: pretty good idea of the total global mortality and butten
Speaker 1: by country from COVID nineteen. Allen says the pandemic is
Speaker 1: underscoring the need to rapidly report debts to authorities in
Speaker 1: developing countries. Mobile phones have accelerated the notification process, especially
Speaker 1: when churches and other community based groups are able to
Speaker 1: contribute to surveillance activities. The hope is that by improving
Speaker 1: the collection of this kind of data, governments will be
Speaker 1: able to respond more effectively, not just to the pandemic,
Speaker 1: but all the other major causes of death and disease,
Speaker 1: and that will ultimately improve the health and well being
Speaker 1: of people everywhere. That was Jason Gale in Melbourne, and
Speaker 1: that's our show today for coverage of the outbreak from
Speaker 1: one bureaus around the world. Visit Bloomberg dot com slash
Speaker 1: Coronavirus and if you like the show, please leave us
Speaker 1: a review and a rating on Apple Podcasts or Spotify.
Speaker 1: It's the best way to help more listeners find our
Speaker 1: global reporting. The Prognosis Daily edition is produced by Topher FORHZ,
Speaker 1: Jordan Gaspure, Magnus Hendrickson, and me Laura Carlson. Today's main
Speaker 1: story was reported by Jason Gale. Original music by Leo Sidrin.
Speaker 1: Our editors are Francesca Levi and Rick Shine. Francesca Levie
Speaker 1: is Bloomberg's head of podcasts. Thanks for listening.