From New York Review of Books :
To the Editors:
Helen Epstein’s article “Flu Warning: Beware the Drug Companies!” [NYR, May 12] contains a significant factual error. It states that worldwide the death toll from the 2009 H1N1 influenza pandemic was 18,000. In fact, as the World Health Organization has tried, but apparently failed, to make clear, that number represents only laboratory-confirmed cases, and these numbers are a small fraction—possibly a tiny fraction—of the true death toll.
In the United States, there were 2,117 laboratory-confirmed deaths, yet the Centers for Disease Control estimate actual deaths in the US alone at between 8,870 and 18,300. Applying similar multiples to laboratory-confirmed cases around the world would yield 72,000 to 162,000 deaths. But that number, since it is still based on confirmed cases, still understates the deaths by a wide margin. Few countries—and none in the developing world—devoted much resources to testing cases. In many countries there were so few laboratory-confirmed cases that the number is meaningless. All of Africa had only 168 laboratory-confirmed deaths.
In addition, since the people who died were much younger than is normally the case from influenza, in terms of years of life lost the H1N1 pandemic was significantly more lethal than the raw numbers suggest.