Reliable data establishing which deaths were directly caused by COVID-19, which were indirectly caused by COVID-19 because of failed health-care systems, and how many people would have died anyway may not be available for months or years. In the meantime, the best guide for how to think about these trade-offs may be earlier epidemics, like Ebola. With that outbreak, cases of malaria in West Africa shot up when hospitals were overwhelmed by patients seeking treatment for Ebola between 2014 and 2016. Several studies have tried to quantify the indirect effects of the Ebola epidemic on mortality, factoring in interruptions in malarial control programs like distribution of bed nets, and found that more people died of the indirect effects than the virus itself.

“The number of deaths that are being predicted from the pandemic are huge and will actually end up becoming the second or third leading cause of death this year,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “But for the back of the envelope, all you need to do is think out a scenario where mortality rates from the leading causes of death, like heart disease, cancer, and so forth, increase by 10 percent and you’re suddenly dealing with very big numbers.”