Aaron Derfel Profile picture
I'm a health journalist at the Montreal Gazette. You can also find me on Mastodon at https://t.co/bN8cuUa6ID and Telegram at https://t.co/FQuHM9YNSZ. Here's my bio: ↓

Feb 6, 2022, 14 tweets

1) Two years into the #pandemic, something odd is now occurring worldwide in the #COVID19 crisis, with the number of global deaths surging while cases seem to be falling. This has not happened quite this way previously. In this thread, I will try to explain why this is occurring.

2) During the first wave of the pandemic in the winter of 2020, #COVID testing wasn't widely conducted around the world. The best indicator at the time was the number of deaths, which quickly skyrocketed. Please see the chart below comparing global cases with deaths at that time.

3) But later on, as countries around the world started testing for #COVID intensively, another pattern emerged. Deaths started to track more closely with the number of new cases, with declared deaths appearing a few weeks after infections were recorded. See an example below.

4) Yet a new pattern has emerged during the latest #Omicron-fuelled wave: #COVID cases and deaths are diverging dramatically. At first glance, it doesn’t make any sense. If deaths are rising worldwide, the number of cases must, too. What’s the possible explanation?

5) The only explanation that I can find is that many jurisdictions around the world have recently decided to test for #COVID a lot less. If true, this would give us a misleading picture of the true extent of the contagion globally. Let me cite a few examples.

6) On Jan. 5 this year, the United States carried out 3.08 million #COVID tests, according to the reliable Our World in Data website. But on Jan. 29, it conducted 972,253 tests, even as its #pandemic death toll climbed upward. Please see the chart below.

7) The situation in Canada is even more dramatic. On Jan. 4, Canada performed 601,278 #COVID tests. Nearly a month later, on Feb. 3, Canadian authorities carried out just 84,728 tests. This occurred as some provinces, like Quebec, stopped widespread screening.

8) A similar drop-off in testing is occurring in Denmark, which is now starting to ease #pandemic restrictions despite a spike in #COVID hospitalizations (although Danish authorities are emphasizing that ICU stays have not spiked). See Denmark’s testing chart below.

9) There are exceptions to this trend of decreasing tests. Russia seems to be testing more recently, which implies its apparently declining death toll may be inaccurate. More transparent Japan has been testing a lot, too, and a result, its cases are tracking well with its deaths.

10) Perhaps one of the best examples of the paradox of dwindling cases and rising deaths is Mexico. In reality, there is no paradox. Cases are probably not dwindling. As the side-by-side charts below reveal, COVID testing has been dropping off in Mexico, while deaths are rising.

11) There might very well be other explanations for what is now occurring globally. But the latest weekly epidemiological update by the World Health Organization does not focus on a drop-off in testing. And our World in Data does not calculate the overall global testing trend.

12) Could it be that the #Omicron variant – previously considered so mild – is much more virulent than suspected and has a much higher fatality rate? I doubt that is the case, although Omicron should never have been described as "mild" in the first place.

13) For now, the most plausible explanation is a drop-off in tests, which we know has been occurring in Québec and Ontario. It’s as if overwhelmed authorities around the world have given up on testing diligently for #COVID as #pandemic exhaustion has set in.

14) But if history has taught us anything (see the Spanish Flu of more than a hundred years ago as an example), now is not the time to ease up on #COVID testing, especially since Omicron and its sub-variant BA.2 are so much more contagious. End of thread.

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