Thread by @Romesh_Silva

@jonmarsk Indeed, @jonmarsk, we do not know the true scale of COVID-19 mortality and it will take time, much more and better quality data, and careful research to better clarify #COVID-19’s overall mortality impact. #poptwitter (1/11)

@jonmarsk N.B. demographers r still studying the nature + extent of the 1918 flu pandemic. Death reg today, whilst still incomplete & deficient in many countries, is better than 100 yrs ago. But the wide range + uncertainty assoc. w/ 1918 flu pandemic deaths shld give us much pause. (2/11)

@jonmarsk First - we need to remind ourselves that #COVID-19 related mortality is multi-faceted, as described by @AndrewNoymer, entailing direct-direct deaths, direct-indirect deaths, and indirect deaths. And we also need to think about competing risks. #poptwitter #epitwitter (3/11)

@jonmarsk @AndrewNoymer For context, @WHO & @UN estimate that prior to COVID-19, ~2/3 of worldwide deaths were not registered by official civil registration systems. So there are still serious gaps and major structural weaknesses. Data gaps are biggest where mortality risk and burden is highest. (4/11)

@jonmarsk @AndrewNoymer @WHO @UN The #COVID-19 pandemic has elevated death registration and high-quality mortality statistics in broader public consciousness. Mainstream media, as part of COVID-19 reporting, now routinely discuss XS mortality figures and death registration data. tinyurl.com/yxzl3fsr (5/11)

@jonmarsk @AndrewNoymer @WHO @UN This public discussion about the completeness of death registration, health facility reporting systems, and plausibility of mortality statistics reaches far beyond the technical communities of demographers and epidemiologists. (6/11) tinyurl.com/y6map8bm

@jonmarsk @AndrewNoymer @WHO @UN However, in many communities people are unaware about the importance of death registration & perceive it to have no real individual or societal benefits. Here’s the humbling reality in Guinea Bissau from new research by @helleringer143 et al. tinyurl.com/y5q8shaa (7/11)

@jonmarsk @AndrewNoymer @WHO @UN @helleringer143 Govt action is critical. Countries that have declared #CRVS an essential service r better positioned to utilize death reg data w/ other data sources.🇲🇺🇿🇦🇨🇻🇦🇫🇳🇿 Importance of death reg needs to be louder, clearer + embedded in public health messages tinyurl.com/y5o4tbdz (8/11)

@jonmarsk @AndrewNoymer @WHO @UN @helleringer143 Some national authorities have quickly adapted their vital statistics systems and now publish weekly or monthly mortality statistics. E.g. South Africa, Ecuador, France, UK, … This stengthens the pandemic response + saves lives. tinyurl.com/yxbkcst4 (9/11)

@jonmarsk @AndrewNoymer @WHO @UN @helleringer143 Disseminating regular mortality data updates w/ technical doc'n facilitates cross validation of sources and analyses that can go beyond a single source. This enriches understanding + provides a crucial basis for informed public health response. See tinyurl.com/y42ran6w (10/11)

@jonmarsk @AndrewNoymer @WHO @UN @helleringer143 For more musings by demographers on death registers, mortality data & estimation of excess mortality, see @monicajalexander, @AndrewNoymer, @helleringer143, @sinafala, @timriffe1, @tomtom_m For a fab knowledge repository on #CRVS, see @IDRC_CRDI’s crvssystems.ca/home (11/11)

@jonmarsk @AndrewNoymer @WHO @UN @helleringer143 @sinafala @timriffe1 @tomtom_m @IDRC_CRDI Apologies, twittersphere. Typo in tweet 11 above. Should read @monjalexander. So let me add more excellent demographers engaged on this @LeontineAlkema, @PetraNahmias, @EvertonCL_81, @Purdinola. & here's some fab #CRVS experts: @IrinaDincu @MontasserK @claudiommachado (12/11)🤔