It has taken just over three months for the death toll from COVID-19 to climb from 2 million to 3 million, with the devastating statistics reached on April 17 according to data from Johns Hopkins University. But it was a toll that analyses from January never expected would be reached. Though the death toll was predicted to rise after the Christmas and New Year holiday periods, forecasts accounting for planned vaccine rollouts did not anticipate an additional million deaths.
Although the number of deaths started trending down in February, it never reached less than 5,000 additional deaths per day. But by mid-March, it was again rising.
Understanding the toll by region
According to Johns Hopkins University, 10 countries are still entirely free from COVID-19 deaths: Dominica, Holy See, Laos, Marshall Islands, Micronesia, Saint Kitts and Nevis, Samoa, Solomon Islands, and Vanuatu. An additional 8 countries have not seen changes to their death tolls: Bhutan, Brunei, Fiji, Grenada, Iceland, Tajikistan, Tanzania, and Vietnam.
Pacific islands dominate this list as isolation and travel restrictions have limited the spread of the disease. But that confidence was until recently shared by neighboring Papua New Guinea — which has suffered a rapid increase in cases and deaths since January, when it had recorded just 9 deaths. This toll was at 82 as of April 17, though experts on the ground suggest the true toll could be much higher. Cambodia and Timor-Leste also recorded deaths for the first time.
By raw numbers, the deaths since January continued to be led by the United States. An additional 174,085 people died in the U.S. from COVID-19 between Jan. 16 and April 17, bringing the total to 566,224. Brazil was narrowly behind adding 16,503 deaths — a 77% increase on the death toll from January.
To date, 368,749 deaths have been recorded in Brazil. Mexico had the third-largest death toll for this period, adding 72,671 deaths, followed by the United Kingdom (40,024), Russia (39.317), Italy (35,041), Germany (33,671), and France (30,473). Combined, these countries accounted for 59% of new deaths.
A total of 38 countries saw their death toll more than double, including Hungary, where deaths increased from 11,264 on Jan. 16 to 24,979 on April 17.
Pausing or restricting the use of the Oxford-AstraZeneca vaccine in some countries has impacted planned rollouts. But there have also been supply problems, with exports of doses manufactured in Europe blocked as battles for vaccine intensified. Vaccine hesitancy is also on the rise, especially in countries where Oxford-AstraZeneca is the only option.
But the battle for vaccines is putting low- and middle-income countries at the back of the line.
“Papua New Guinea is a perfect example of why vaccine equity is so important,” Dr. Tedros Ghebreyesus, director-general of the World Health Organization, explained to reporters on April 16. “It has held COVID-19 at bay for so long but with rising infections, understandable fatigue with social restrictions, low levels of immunity among the population, and a fragile health system it's vital that it receives more vaccines as soon as possible.”
As confidence rises globally that the COVID-19 pandemic may be nearing an end, restrictions have loosened, putting the most vulnerable countries at risk — and potentially hastening the rise of new variants.
The challenges that have emerged since January relating to vaccines and easing restrictions has seen the Institute for Health Metrics and Evaluation forecasting a devastating year ahead. Their current projections suggest a global death toll of 4 million will be reached by mid May, and 5 million if conditions worsen by the end of July.
But these projections are based on the best available data. Papua New Guinea is likely to be one of many countries underreporting deaths due to poor systems in place for the recording of civil registration and vital statistics data, particularly in remote localities. The true number of lives lost and families impacted could still be much higher.