An official Palestinian tally of direct deaths in the Israel-Hamas war likely undercounted the number of casualties by 41% through the middle of 2024 as the Gaza Strip's healthcare infrastructure unravelled, according to a study published in The Lancet journal. Using a statistical method called capture-recapture analysis, the researchers estimated 64,260 deaths due to traumatic injury during this period, about 41% higher than the official Palestinian Health Ministry count. The study said 59.1% were women, children and people over the age of 65. The Lancet study said the Palestinian health ministry's capacity for maintaining electronic death records had previously proven reliable, but deteriorated under Israel's military campaign, which has included raids on hospitals and other healthcare facilities and disruptions to digital communications.