Thread by @GidMK

A fascinating paper on COVID-19 death underreporting in Zambia. Of 364 people tested after death:

- 6 officially recorded as a COVID-19 death
- 70 tested positive to COVID-19 on PCR

Implies ~90%(!) underreporting of COVID-19 burden

bmj.com/content/372/bm…

In patients where a clinical cause was able to be identified, the vast majority of cases were clearly deaths caused by COVID-19, which means that this is likely a true undercount of the deaths

Worryingly, only 1 in 7 of the children who died of COVID-19 had been tested for it beforehand

If this paper is true for the entire country, it implies that the COVID-19 death toll for Zambia could be up to 10x higher (!) that reported figures

Sorry, the above tweet should read "at least" 10x higher than official figures, it is entirely possible that it is much higher

https://twitter.com/zchagla/status/1367627991308763136?s=20

Worth noting tho that this is a small and unrepresentative sample of deaths. That being said, even just the deaths identified in this one study of part of one city would raise the country's COVID-19 death numbers by 6% 😬

This is also worth bearing in mind when you see reports of extremely low death counts in some countries. There is a strong possibility that the official statistics in many places represent a substantial undercount of the true COVID-19 burden