The Lancet medical journal reported that it is “not implausible” for the Gaza death toll to have reached 186,000 or more since the Israeli bombardment began on October 7, considering direct and indirect causes.

The report, titled Counting the Dead in Gaza: Difficult but Essential, said that using the 2022 Gaza Strip population estimate of 2,375,259, the death toll would be equivalent to 7.9 per cent.

The estimate published on Friday includes direct deaths from the conflict as well as indirect deaths from causes such as reproductive, communicable and non-communicable diseases.

“Applying a conservative estimate of four indirect deaths per one direct death 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,” the Lancet report said.