Mortality during the COVID-19 pandemic: the blind spots in statistics

A small proportion of the population might have initially visited local practitioners from alternative systems of medicine, which again could have contributed to a missed or delayed diagnosis and treatment, ultimately adding to the increased mortality. [...]social issues such as reluctance to transfer older people (especially those who are staying alone with relatively poor quality of life) with respiratory symptoms to a health-care facility due to the fear or stigma associated with contracting COVID-19 might have additionally increased the mortality tally. [...]there is an unsubstantiated perception that human and political factors might have influenced the documentation to some extent in certain countries. [...]the increased deaths in the second wave might have occurred not only due to the higher R0 and virulence of the delta strain (B.1.617.2) and laxity in COVID-19-appropriate behaviour (the public feeling that the game is over), but also due to the inadequate anticipation of the health systems and the logistical obstacles this creates both for health-care facilities and individuals in need of care.