Estimating excess mortality in the first wave of Peru’s COVID-19 pandemic: more than just an academic exercise?

21 August 2021.

Lancet Americas has just published a paper in which we develop a new method for estimating excess numbers of deaths during the COVID-19 pandemic and applies this method to Peru  https://www.sciencedirect.com/science/article/pii/S2667193X21000314

What does the paper show?

• During Peru’s 1^st wave of the pandemic (March to December 2020), we estimate there were 173,099 “excess deaths”. Considering the size of Peru’s population (33 million), this is the highest per capita rate of excess mortality reported for any country during the pandemic in 2020.
• Our excess mortality estimate is almost double official reports of COVID-19 deaths over the same period. This is a much larger difference than those reported in studies of high-income countries. In other words, the impact of the pandemic in countries like Peru (probably most low and middle-income countries) has been grossly under-estimated, due to under-reporting or misdiagnosis.
• 12.5% of Peru’s population is aged 60 or more, but this age group accounted for 74 per cent of our estimated excess deaths.

What does this actually mean?

Estimates of excess all-cause mortality are the most effective way to assess the impact of COVID-19 on people of all ages, including older adults. Robust estimates take into account that not all deaths caused by COVID-19 will be registered or attributed to that cause. They also include indirect mortality effects of the pandemic, such as deaths caused by reduced treatment for other health conditions. All of this is especially important for low and middle-income countries where death registration tends to be less complete and cause of death data less reliable than in high-income countries.

It is not possible to be sure about how representative these findings are for other countries in Latin America or other regions. And it should not be forgotten that our study does not include Peru’s second and more severe pandemic wave which occurred in 2021.

Although we did not aim to be obscure, our paper is not a simple read. Making reliable estimates about excess deaths over a period of time may sound simple, but in practice it is a messy and complicated process; especially for those countries where the data are less complete or reliable.

Some might question the purpose of perfecting methods to count deaths in Peru or anywhere else for that matter. In our view, it is vital that we document the real impact of this global catastrophe, especially in poorer countries where it continues to be under-stated.