Low COVID-19 Testing in the Majority of Nations Has Resulted in Gross Undercounting of Infections and Deaths

Abstract

Abstract: The volume of COVID-19 testing in the world’s countries shows an exponential decline that is correlated with GDP per capita and ranges from relative testing levels starting at a low of 3,300 cumulative tests per million persons (during the first 18 months of the pandemic) in the Democratic Republic of Congo (DRC) to a high of 13.7 million cumulative tests per million in Denmark. Somewhere greater than 1 million cumulative tests per million population is needed to obtain a reasonable estimate of the true extent of COVID-19 mortality. Around 155 countries (70% of world countries) lie below this threshold. In addition to having a relatively low amount of testing, these countries are also often characterised by a deficient mortality reporting process. My research points to a finding that gross undercounting of COVID-19 infection and mortality is occurring in at least half of world countries. These countries then act as a reservoir for the virus and travel from these countries then spreads the virus feeding further international outbreaks. The situation is made even more confused by a reliable definition of a genuine COVID-19 caused death, and by countries reporting according to different standards. The UK reports a “with COVID” death as any person testing positive in the 28 days prior to decease, which is probably an over-estimate, although this is counterbalanced by low testing in the first 9 months of the pandemic. Consequently, the reported fatality rate per person testing positive varies by over 10-fold between both high and low testing countries. The big unknown is whether asymptomatic COVID-19 infection can precipitate death from seemingly unrelated causes. At the end of August 2021 a conservative estimate is greater than 14 million COVID-19 deaths around the world.