Statistics show that the confirmed number of worldwide deaths from COVID-19 approached 2 million as of Thursday. But experts say that the actual number of casualties caused by the pandemic may be closer to 3 million.

According to an analysis conducted by The Wall Street Journal, COVID-19 indirectly as well as directly contributed to a global surge of deaths that rose 12% above average last year.

Experts say that less than two-thirds of the excess deaths recorded were attributable to COVID-19, but the majority were linked to the disease especially in the earlier months when testing and treatment were scarce. Additionally, researchers found that many people died from medical conditions not directly related to the coronavirus but from other causes such as Alzheimer’s disease and fatal heart attacks as individuals shunned medical screenings and emergency room visits due to fear of becoming infected.

The Journal’s researchers gathered data on the death toll from all causes from countries who compiled those records. They found an additional 821,000 deaths in these nations that were not reported in their COVID-19 mortality figures. The countries tallied by the Journal would normally have 15 million deaths last year based on previous statistics. Instead, they reported nearly 17 million fatalities.

Tracking these figures is vital to understanding the far-reaching effects of the pandemic. While a rise in heart disease may be linked to COVID-19, a rise in cancer might indicate that people are afraid to go to the hospital, noted Colin Mathers, a former analyst with the World Health Organization.

Medical tests plummeted during the early months of the coronavirus outbreak. Komodo Health, which has a large medical claims database, said that cervical cancer screenings fell by 68%, cholesterol panels were down 67%, and blood sugar tests to detect and manage diabetes fell 65% in the U.S.

Millions of Americans postponed critical tests as residents obeyed stay-at-home orders, according to Fox News.

“We’re seeing a tremendous impact on preventative care,” said Komodo Health Chief Executive Dr. Arif Nathoo. “It speaks volumes as to how much COVID is impacting everyone’s health and wellness.”

Dr. David Tom Cooke, head of general thoracic surgery at University of California, Davis, Health, told Reuters that while his cancer patients are getting treatment, he worries that new cancers will go undetected until they are more advanced and less treatable.

“We’re not doing cancer screenings, such as mammography for breast cancer, and lung cancer screening,” he said. “There is concern that we are delaying standard care of treatment for patients with potentially curable cancers.”

According to the Journal, the toll from the countries analyzed by the paper showed a “staggering human loss, even before accounting for all deaths from the late-year surge in COVID-19 cases.” Although some countries, such as Norway and New Zealand, showed negative excess deaths last year, these were the exceptions. Researchers say these countries managed to contain the virus effectively through behavioral changes that may have positively affected their death rate.

In the U.S., the Journal reports that there were 475,000 excess deaths last year through early December, according to the Centers for Disease Control and Prevention. This included 281,000 casualties attributed to COVID-19 during the same time frame, marking a 10% increase in mortality. Typically, death rates in America increase 1.6% annually.

The death toll continues to climb as the countries analyzed by the Journal report an additional 444,000 COVID-19 deaths through early 2021.

“The last word won’t be known for a couple of years, when the full analysis of all causes of death is complete,” said Mathers, who retired from the Mortality and Health Analysis Unit of WHO in 2018.

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