Fig. 2: Community-uploaded death notifications in Damascus and the inferred epidemic trajectory.

In (a) we show the number of obituary notification photos uploaded monthly to the community maintained ‘Damascus Mortality’ Facebook page revealing a substantial increase in July and August 2020. This is in contrast to the consistent monthly number of notifications uploaded between 2016 and 2020. In (b), the daily inferred excess death notifications are shown, with error bars showing the 95% CI (n = 100) and the blue line indicating the weekly average excess deaths. In (c) model fits to the notification excess death data (vertical bars) are shown under different assumptions of the proportion of total COVID-19 deaths that are ascertained by the notification excess deaths. In both (b, c) the points show the government-reported excess deaths between 25 July and 1 August. The predicted hospital occupancy is shown in (d), with the hospital capacity for Damascus shown with a dashed horizontal line, with the 2-week period in which hospitals were reported to be first at capacity shown shaded in red. In (c, d) the 50% and 95% CI are shown with dark and light shaded regions respectively.