Morgue data reveal Africa's high COVID-19 death toll bmj_latest BMJ_Open
We recognised that the categories used for adjudication rested on clinical information that may have been incomplete, a particular problem with the verbal autopsy data given that the respondent providing the information was necessarily relaying these data secondhand. A gold standard for asserting causality would have been PCR coupled with histology showing end organ damage consistent with SARS-2 infections.
Following this reasoning further, we conducted an analysis exploring the distribution of Ct values by age groups. As noted previously, we were sceptical that COVID-19 was the cause of death in young children, largely because the clinical presentations in children, and especially children <5 years, differed from adults. Therefore, we reasoned that COVID-19 was more likely to be a coincidental finding in children.
As in our prior analysis, COVID-19+ deaths were concentrated in Lusaka’s most densely populated wards where Lusaka’s poorest and most vulnerable citizens reside. Access to care is challenging in these communities, and we have described elsewhere how delays in seeking care may contribute to infant deaths in the community.This highlights a sad element to the global COVID-19 narrative.
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