Intended for healthcare professionals


Covid-19: Peru’s official death toll triples to become world’s highest

BMJ 2021; 373 doi: (Published 04 June 2021) Cite this as: BMJ 2021;373:n1442

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  1. Owen Dyer
  1. Montreal

Peru has revised its official death toll in the covid-19 pandemic from 69 342 to 185 380, after a scientific review of medical records ordered by the government. The new figure means that Peru has had 5551 covid deaths per million population, proportionally the worst official toll in the world. Hungary, which before this week had the world’s highest official toll per capita, now stands a distant second at 3094 deaths per million.

More than 0.5% of Peru’s people have died from covid-19, a toll worse than that recorded by the UK in the 1918-20 “Spanish” influenza pandemic.

“We think it is our duty to make public this updated information,” said the Peruvian prime minister, Violeta Bermúdez, at a news conference announcing the publication of the report.1

Many covid-19 deaths were not initially classified as such, said health minister Óscar Ugarte, because of a lack of testing. But a review of cases that sought covid symptoms has brought the official figure into line with the country’s actual spike in excess deaths over the past year.

Whether Peru is actually the hardest hit country is unclear, as several others show evidence of undercounting their losses, including Russia, India, Mexico, and much of Eastern Europe and Central Asia.2

There is no doubt that Peru’s pandemic experience has been exceptionally grim, despite a government response that won praise from international experts. Peru locked down early and tested faster than many rich countries, but its testing resources were soon overstretched. Widespread poverty and a large informal economy undermined social distancing measures.

Many Peruvian households lack a fridge, necessitating daily trips to crowded food markets. In one acknowledged mis-step Peru became one of the first countries to issue relief cheques to compensate for lost income, but because only 38% of Peruvians have bank accounts they had to crowd into banks to collect cash.

The country’s fragile health system was overwhelmed by waves of infection in May 2020, then February and April-May this year. One woman whose husband died told the newspaper La Republica how patients’ families in hospital fought over oxygen supplies for their loved ones. “We were like wolves, waiting for someone to die to take their tank,” she said.

Peru is not the first country to acknowledge undercounting covid-19 deaths. Mexico’s National Centre for Preventive Programs and Disease Control produced a report last October estimating that the death count, which then stood at 88 924, was about 50 000 short of the true figure.3

Russia’s statistics agency Rosstat seemed to contradict the country’s health ministry in February by reporting 162 429 covid deaths in 2020, while the ministry’s figure for that year was 57 019.4

But neither of those updates changed the country’s official figure. Peru’s update, by contrast, is now reflected on global databases such as that maintained by Johns Hopkins University.

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