Recording and understanding the numbers of cases and deaths from COVID-19 at a local, regional and national level and how these vary over time and changing circumstances, is an epidemiological, as well as a moral imperative. However, as with many human endeavours, especially those based on good intentions, the reporting of this “truth” is never straightforward. 

And this happens at a time when death from COVID-19 has also generated challenges at a personal level including due to social distancing, lockdowns and travel restriction measures which impact on the spiritual and mental health of human beings is likely to far outlive the period of high mortality bound up with the pandemic

By Dr. Brian Johnston

London, United Kingdom

Death in the Time of COVID

In many ways, COVID-19 has changed and shaped our relationship with death, both at a personal and societal level. COVID, as it is presented in the media, has understandably focussed on the physical manifestations of death – the cessation of life, the stopping of the heartbeat, the termination of electrical activity in the brain… By this reckoning the pandemic has already claimed millions of lives, each one of which is a real and personal tragedy for those involved. The daily and weekly tallies of these COVID deaths are published in macabre tables, where the misfortune of one country can be readily compared with that of another from various perspectives.

Recording and understanding the numbers of cases and deaths from COVID-19 at a local, regional and national level and how these vary over time and changing circumstances, is an epidemiological, as well as a moral imperative. However, as with many human endeavours, especially those based on good intentions, the reporting of this “truth” is never straightforward.

In some countries, the sheer magnitude of the impact of COVID on health, social and economic systems have prevented the accurate recording of deaths or made it extremely difficult. In these circumstances, there has undoubtedly been an under-reporting of the mortality associated with the pandemic. Where the infrastructure of the country was already stretched before COVID, the damage done by the virus has rubbed salt into an already open wound. Perhaps in the aftermath of COVID, the health, economic and social deficiencies highlighted by this global catastrophe can act as a catalyst to more affluent countries in their efforts to help those societies facing fundamental challenges on numerous levels. We shall see…

Under-reporting of deaths is to be regretted from a scientific perspective. Our ability to learn lessons from this terrible disease is compromised by poor or inaccurate data. Models and theories with their foundations in questionable information are like structures built on shifting sand. Theoretically, the next time we have a pandemic, the greater our knowledge and understanding; the greater our ability will be to address the new challenges and avoid making the same mistakes we made this time around. However, human beings do have a remarkable capacity for self-destruction and our decision-making processes are far from perfect and never straightforward.

In contrast, under-reporting of COVID deaths becomes sinister and divisive when the prestige of a country becomes tied to the number of deaths published. From this perverse perspective, the websites recording pandemic deaths are treated as league tables, in which the barometer of success of a state is measured by a lower tally of cases and/or deaths. The actual situation within such countries is to a large extent irrelevant, as media and official channels are used as conduits for misinformation aimed at keeping the reported numbers low. Modelling based on such data is immediately compromised and the impact from a scientific and epidemiological perspective is both immediate, long standing and perhaps irreversible.

Such dishonesty, aimed at making a country look good on the international stage is both short-sighted and counter-productive – it does a disservice to the citizens of the country in question, as well as to humanity in general.

A major barrier to effective action when addressing any problem is to deny its existence or to downplay its importance – if there are only a small number of deaths reported in a country, then those in power can justify treating COVID as a lower priority, or worse still, take measures that allow the damage to continue hidden from sight. Similarly, the ability of other states to find effective solutions to the many challenges offered by COVID is compromised by questionable or distorted data from countries consciously engaging in under-reporting of deaths.

Death from COVID-19 has also generated challenges at a personal level. Normally, the major events in life (births, marriages, funerals etc.) are marked by traditions and social gatherings. The risk of death from COVID has curbed many of these activities, which form a cornerstone of our existence and how we live our lives. Social distancing, lockdowns and travel restrictions have curtailed the way we express ourselves as social creatures. Traditions have been suppressed in the name of public health and the status quo has shifted radically to protect the population.

Whilst necessary in the short term, the impact of these measures on the spiritual and mental health of human beings is likely to far outlive the period of high mortality due to the pandemic. Similarly, the economic impact of COVID will take years to repair and in many cases the scars left by this pandemic will last a lifetime.

If we are to salvage anything positive from COVID-19 and truly learn practical and tangible lessons that will protect us in the future, we must deepen our knowledge of the disease. Any action which taints or compromises the creation of this shell of protective wisdom should be regarded as unacceptable and steps taken to neutralise the corrosive effects of such activities.

In gaining a deeper understanding of COVID-19 we are shaping our destiny and that of future generations, so that another pandemic will lead to fewer deaths and less suffering. Hope is a wonderful thing, but it must be linked to knowledge and action for effective solutions to be created.

COVID has brought us to our knees, but when its cousin arrives at our door in the years to come and reaches out a skeletal hand, we must drag it to its knees instead. Let’s hope we can…

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By the same Author recently on PEAH

Unleashing the True Potential of Data – COVID-19 and Beyond

The myriad of data sources now available create a real challenge for even the most literate of analysts and researchers, when trying to make sense of the emerging picture of COVID-19, in real time. Against this background, it could be argued that what we now need is greater synthesis of information, where data from multiple sources is combined and refined, to improve clarity and reduce the ambient “noise” that is currently in the system