Admittedly I major in Poli Sci, and I do suck at maths. But.
Our approach to estimating the excess COVID-19 death rate is based on measurement of the excess death rate during the pandemic week by week compared to what would have been expected based on past trends and seasonality. However, the total excess death rate does not equal the excess COVID-19 death rate. Excess mortality is influenced by six drivers of all-cause mortality that relate to the pandemic and the social distancing mandates that came with the pandemic. These six drivers are: a) the excess COVID-19 death rate, that is, all deaths directly related to COVID-19 infection; b) the increase in mortality due to needed health care being delayed or deferred during the pandemic; c) the increase in mortality due to increases in mental health disorders including depression, increased alcohol use, and increased opioid use; d) the reduction in mortality due to decreases in injuries because of general reductions in mobility associated with social distancing mandates; e) the reductions in mortality due to reduced transmission of other viruses, most notably influenza, respiratory syncytial virus, and measles; and f) the reductions in mortality due to some chronic conditions, such as cardiovascular disease and chronic respiratory disease, that occur when frail individuals who would have died from these conditions died earlier from COVID-19 instead. To correctly estimate the excess COVID-19 mortality, we need to take into account all six of these drivers of change in mortality that have happened since the onset of the pandemic.
Our analysis follows four key steps. First, for all locations where weekly or monthly all-cause mortality has been reported since the start of the pandemic, we estimate how much mortality increased compared to the expected death rate. In other words, we estimate excess mortality in all locations with sufficient data. Second, based on a range of studies and consideration of other evidence, we estimate the fraction of excess mortality that is from excess COVID-19 deaths as opposed to the five other drivers that influence excess mortality. Third, we build a statistical model that predicts the ratio of excess COVID-19 deaths to reported COVID-19 deaths based on covariates and spatial effects. Fourth, we use this statistical relationship to predict the ratio of excess to reported COVID-19 deaths in places without data on excess COVID-19 deaths and then multiply the reported COVID-19 deaths by this ratio to generate estimates of excess COVID-19 deaths for all locations. More details on each of these analytical steps are presented below.
And.
We analyzed data from 12 countries that provide cause of death data by week or month, which allows us to test whether some causes decreased significantly during 2020 and whether that decrease was related to the decreases in mobility that have been reported.
Seems a bit sus for me. The paper doesn't specify which countries they analyzed. Only saying that.
Based on our analysis, we have generated a ratio of excess mortality to reported COVID-19 mortality for each location. These analyses, based on weekly or monthly mortality data, have been
supplemented with published studies for 12 national and subnational locations where the detailed data have not been made publicly available for our analysis. Figure 4 shows the distribution of these ratios in the available data.
So okay, they used some 12 papers that supplemented the data from countries/ sub-regions that might not have data, but when I see the references section. It only has 11 references? And they're all papers that were meant to supplement previous points?
Again, I'm a Poli-Sci major, so I could be talking out of my ass. But Doing Ctrl-F on Chrome only points to 1 section where it says 12. And that's the paragraph mentioned upwards. I don't see no justification for why those 12 countries are chosen, why they are chosen, how the data from those 12 countries could be used to make a model for a global trend, and
who are those 12 countries to begin with.
This could be a paper where the actual paper is paywalled, or they haven't done the publishing in some sort of academic conference, so the details might be good/ bad. But with my limited knowledge, I lean towards cautiously skeptical on this one.
If someone with a background in STEM can refute me on any of my points, feel free to do so. Maybe I am wrong the entire time.
EDIT: I am VERY certain pretty much all countries under report COVID deaths BTW. This is such a fast-moving pandemic with symptoms that might not even exist for some people, that, even at a pretty generous interpretation, means that a significant part of the population can have COVID and is spreading it, but does not have the symptoms of COVID and thereby doesn't report it to the gov.
And there's the incentives for authoritarian countries which is a whole can of worms I don't wanna open.