More than 186,000 expected deaths in Gaza

We are witnessing a human-caused catastrophe, whether it is called genocide or not.

A letter published in the Lancet caused controversy recently. I asked perplexity about the reliability of the Lancet piece on the Gaza death toll, which estimates that the true number of deaths could exceed 186,000. This is its summary:

1. Methodology: The Lancet report uses a combination of direct death counts and estimates of indirect deaths to arrive at the figure of 186,000. This approach is based on historical data from other conflicts, where indirect deaths (due to factors like malnutrition, disease, and lack of medical care) often significantly outnumber direct deaths. The report applies a conservative estimate of four indirect deaths for every direct death[2][4][7].

2. Sources and Data: The Lancet’s estimates are supported by data from multiple credible sources, including the Gaza Ministry of Health, the United Nations, and various humanitarian organizations. These sources have reported significant destruction of infrastructure, which exacerbates the indirect death toll[1][3][4]. Additionally, the report notes that the official death toll does not account for thousands of bodies still buried under rubble, which further supports the higher estimate[3][4].

3. Peer Review and Publication: The study was published in the correspondence section of The Lancet, which means it was not peer-reviewed in the traditional sense. However, The Lancet is a highly respected medical journal known for its rigorous editorial standards[4][5].

4. Expert Opinions: The report has been corroborated by other studies and experts in the field. For instance, a study by Johns Hopkins University also projected high excess deaths due to the conflict, including from non-communicable diseases and malnutrition[3]. Furthermore, humanitarian agencies and experts have generally found the Gaza Ministry of Health’s mortality reporting reliable and not inflated[5][7].

5. Criticism and Counterpoints: The report has been criticized by some quarters, including the Israeli military, which has rejected the numbers as not correlating with reality[3]. However, these criticisms often lack detailed counter-evidence and do not address The Lancet’s comprehensive methodology.

In conclusion, while the Lancet piece on the Gaza death toll is based on estimates and projections that inherently carry some uncertainty, it is grounded in a robust methodology and supported by credible sources. Therefore, it can be considered a reliable and serious attempt to document the full impact of the conflict, highlighting the importance of acknowledging both the direct and indirect consequences of war.

Citations:
1. Anadolu Ajansı – Gaza Death Toll Could Be Over 186,000
2. Arab News – Gaza Death Toll Report
3. The National News – Lancet Journal: Gaza War Death Toll May Have Reached 186,000
4. Al Jazeera – Gaza Toll Could Exceed 186,000, Lancet Study Says
5. The Lancet – Gaza War Death Toll Study
6. VOV World – Gaza Death Toll Could Exceed 186,000
7. The New Arab – Lancet Experts Put Harrowing Gaza Death Toll at 186,000
8. The Lancet – Gaza War Death Toll Abstract
9. Free Press Kashmir – Gaza Genocide Death Toll Could Exceed 186,000
10. Yahoo News – Gaza Death Toll Could Be as High as 186,000
11. The Lancet – Gaza Death Toll Study Full Text
12. Democracy Now – Gaza’s True Death Toll Could Be 186,000 or Higher
13. Scheerpost – Israeli Campaign Against Gaza May Kill 186,000 or More
14. The Lancet – Gaza War Death Toll Study Full Text
15. Timeline Daily – Gaza Death Toll Up to 186,000 or Even More

How do The Lancet’s estimates compare to other reports on the Gaza conflict

The Lancet’s estimates of the Gaza death toll, which suggest that the true number of deaths could exceed 186,000, are significantly higher than other reports on the conflict. Here is a comparison of The Lancet’s estimates with other reports:

The Lancet’s Estimates

• Total Death Toll: Over 186,000
• Direct Deaths: Approximately 38,200 (as of the latest reports)
• Indirect Deaths: Estimated using a conservative ratio of four indirect deaths for every direct death, accounting for deaths due to malnutrition, disease, and lack of medical care[1][2][6].

Other Reports

• Gaza Ministry of Health: Reports nearly 38,200 direct deaths due to the conflict[1][3][5].
• Johns Hopkins University: Estimated 70,000 excess deaths, including 10,000 from disease, projecting multiple health impacts such as non-communicable and infectious diseases, malnutrition, and maternal and newborn mortality[6].
• Oxfam: Highlighted that the daily death rate in Gaza is higher than any other major 21st-century conflict, with an average of 250 deaths per day[4].
• UN and Other Humanitarian Organizations: Estimates vary, but they generally report figures close to the Gaza Ministry of Health’s numbers for direct deaths. The UN has cited over 35,000 deaths, with significant numbers of women and children among the casualties[7][9].

Key Differences

• Scope of Indirect Deaths: The Lancet’s estimates include a substantial number of indirect deaths, which are not typically accounted for in other reports. This inclusion significantly raises the total death toll.
• Methodology: The Lancet uses a historical ratio of indirect to direct deaths from other conflicts to project the total death toll, while other reports primarily focus on direct deaths and immediate casualties.
• Infrastructure Impact: The Lancet emphasizes the destruction of healthcare facilities, food distribution networks, and sanitation systems, which contribute to the high number of indirect deaths[1][2][6].

Conclusion

The Lancet’s estimates are more comprehensive in that they account for both direct and indirect deaths, leading to a significantly higher total death toll compared to other reports. This approach underscores the broader humanitarian impact of the conflict, beyond immediate casualties, highlighting the long-term consequences of infrastructure destruction and resource shortages.

Citations:
1. Anadolu Ajansı – Gaza Death Toll Could Be Over 186,000
2. Al Jazeera – Gaza Toll Could Exceed 186,000, Lancet Study Says
3. Anadolu Ajansı – Gaza Death Toll Nears 38,200 as Israel Kills 40 More Palestinians
4. Oxfam – Daily Death Rate in Gaza Higher Than Any Other Major 21st Century Conflict
5. Al Jazeera – Dozens Killed Across Gaza as Israel’s War Enters 10th Month
6. The National News – Lancet Journal: Gaza War Death Toll May Have Reached 186,000
7. ReliefWeb – Gaza War: UN Revises Death Toll for Women and Children
8. TRT World – Death Toll in Gaza Could Exceed 186,000, The Lancet
9. Reuters – Gaza Death Toll: How Many Palestinians Has Israel’s Campaign Killed?
10. Gaza Projections
11. BBC – Gaza Death Toll