Read on Twitter
I& #39;m very glad "excess mortality" is garnering so much interest. It& #39;s a much better measure of the total death toll of the pandemic. But it is NOT "the most comparable across countries". In fact, it simply excludes low income and lower-middle income countries. \begin{short rant} https://twitter.com/J_CD_T/status/1261625840439263233">https://twitter.com/J_CD_T/st...
In most LLMICs, the coverage of death registration is often very low. So when they are produced, series of weekly/monthly deaths only include a varying % of all deaths, often well below 50% 2/n
So, these data are not well suited to measure the level of mortality. Might they be suited to pick up trends? Only if we& #39;re ready to make strong assumptions about how the coverage of death registration might change over time, including during a pandemic 3/n
Why is coverage of death registration so low? a multitude of reasons, both on the supply side and the demand side. There are several ongoing initiatives to try and improve the legislation and administrative systems, e.g., http://apai-crvs.org"> http://apai-crvs.org or https://crvsgateway.info/ ">https://crvsgateway.info/">... 4/n
On the demand side, together with @AneFisker we recently asked people in Guinea-Bissau in West Africa, why they did not register death of a relative. Main reasons: not aware of need to register death, or did not perceive any benefit https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13177">https://onlinelibrary.wiley.com/doi/full/... 5/n
With focus on excess mortality, I worry that a) LLMICs lack important data to respond to pandemic, b) LLMICs are unable to quantify their death toll according to new standard, and c) we might dismiss prevention successes in LLMICs due to lack of data on excess mortality 6/n
In short, excess mortality is great for the few countries that can calculate it in near real-time. For the rest of the world, uncertainty and lack of information. Invest in CRVS!! 7/end of rant
Bonus tweet: a truly excellent resource of registration systems--> https://www.idrc.ca/en/initiative/centre-excellence-civil-registration-and-vital-statistics-systems">https://www.idrc.ca/en/initia...
One more bonus tweet, great people to follow about the registration of vital events in LLMICs: @GloriaMathenge, @ChalapatiRao13, @Romesh_Silva, @IrinaDincu, @Daniel_Cobos_PH, @ThandoAmankwah