In recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths. Applying a conservative estimate of four indirect deaths per one direct death [9] to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza. Using the 2022 Gaza Strip population estimate of 2,375,259, this would translate to 7.9% of the total population in the Gaza Strip. A report from Feb 7, 2024, at the time when the direct death toll was 28,000, estimated that without a ceasefire there would be between 58,260 deaths (without an epidemic or escalation) and 85 750 deaths (if both occurred) by Aug 6, 2024.[10]

A note on the "direct death toll" of 37,396:

By June 19, 2024, 37 396 people had been killed in the Gaza Strip since the attack by Hamas and the Israeli invasion in October, 2023, according to the Gaza Health Ministry, as reported by the UN Office for the Coordination of Humanitarian Affairs.[1] The Ministry's figures have been contested by the Israeli authorities, although they have been accepted as accurate by Israeli intelligence services,[2] the UN, and WHO. These data are supported by independent analyses, comparing changes in the number of deaths of UN Relief and Works Agency (UNRWA) staff with those reported by the Ministry,[3] which found claims of data fabrication implausible.[4]

Collecting data is becoming increasingly difficult for the Gaza Health Ministry due to the destruction of much of the infrastructure.[5] The Ministry has had to augment its usual reporting, based on people dying in its hospitals or brought in dead, with information from reliable media sources and first responders. This change has inevitably degraded the detailed data recorded previously. Consequently, the Gaza Health Ministry now reports separately the number of unidentified bodies among the total death toll. As of May 10, 2024, 30% of the 35 091 deaths were unidentified.[1]

Some officials and news agencies have used this development, designed to improve data quality, to undermine the veracity of the data. However, the number of reported deaths is likely an underestimate. The non-governmental organisation Airwars undertakes detailed assessments of incidents in the Gaza Strip and often finds that not all names of identifiable victims are included in the Ministry's list.[6] Furthermore, the UN estimates that, by Feb 29, 2024, 35% of buildings in the Gaza Strip had been destroyed,[5] so the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10 000.[7]

This would raise the estimate to 237,000