AS the world rushed towards the official tally of six million deaths from 446 million COVID-19 infections, Jamaica remained clueless about the true toll of cases and deaths caused by the pandemic, which entered its third year Sunday.

But Jamaica is not alone in under-counting the number of people who have been sickened or killed by the novel coronavirus, because of the insurmountable obstacles nearly all countries face in determining an accurate picture of the Earth’s worst natural disaster.

Up to Sunday, Jamaica’s health authorities had officially recorded 128,240 cases of the virus and 2,825 deaths, with a vaccination rate of under 25 per cent of the population, the second lowest in the Caribbean after severely impoverished Haiti. But that is guesswork at best.

Health and Wellness Minister Dr Christopher Tufton admitted he could only rely on the official figures and would not speculate on the number of other Jamaicans who died from the virus but were not captured in the official numbers.

“The formula we are using is that for every one who tested positive, there are likely to be six to eight times more positives in the untested population,” he told the Jamaica Observer.

The impossibility of getting precise figures has been acknowledged by the United States Centers For Disease Control and Prevention (CDC) which now estimates that the true number of novel coronavirus infections in the US may be double official figures — 140 million against 74 million.

CDC said many cases had likely been missed by official counts due to test shortages and asymptomatic cases going unreported, which is similar to the situation in Jamaica, where testing started out at a snail’s pace and exorbitant cost before picking up.

“Due to testing shortages, especially early on in the pandemic and during the Omicron surge, asymptomatic cases and people testing positive at home and then never reporting their case to officials, experts have long known that COVID cases are drastically being under-counted,” Daily Mail quoted CDC as saying.

Severe under-counting of COVID cases was blamed on the fact that currently only people that are professionally tested, or receive a PCR (polymerase chain reaction) test, are included in figures. Many people might know they are sick, likely with the virus, but don’t get tested, and some people could be actively infected and have no idea, said CDC.

Poor record-keeping in many parts of the world and excess deaths related to the pandemic but not from actual COVID-19 infections — such as people who died from preventable causes but remained untreated because hospitals were overwhelmed — were also blamed.

The Associated Press reported Edouard Mathieu, the head of data for the Our World in Data portal as saying that when countries’ excess mortality figures are studied, as many as nearly four times the reported death toll have likely died because of the pandemic.

An analysis of excess deaths by a team at The Economist estimated that the number of COVID-19 deaths is between 14 million and 23.5 million worldwide.

“Confirmed deaths represent a fraction of the true number of deaths due to COVID, mostly because of limited testing, and challenges in the attribution of the cause of death,” Mathieu told the wire service.

“In some, mostly rich, countries that fraction is high and the official tally can be considered to be fairly accurate, but in others, it is highly underestimated,” especially where, as on the African continent, the smaller death toll is thought to stem from under-reporting, as well as a generally younger and less mobile population.

Meanwhile, experts who still believe that vaccination is the best defence against sickness and deaths from the virus, are increasingly examining the view that natural immunity is responsible for saving lives, given the relatively low rates of vaccination.

“In the case of Jamaica, the health authorities need to step up their game to find out what is happening in the population. With only 24 per cent vaccinated, we should be seeing more cases of infection, hospitalisation and death,” said an epidemiologist who preferred not to be named. “But we are not.

“We need to hear that the health ministry is studying the situation, if for nothing else than the fact that once the theory of natural immunity is established, it will make it possible to concentrate more of our efforts on forging ahead as we learn to live with the virus.”