Here’s how one arrives at the rough estimate of 434,800 dead in Gaza:

First, the prestigious British medical journal The Lancet conservatively estimated in a peer-reviewed analysis that as of 19 June 2024 roughly 186,000 Gazans had died from “direct” and “indirect” deaths since 8 October 2023. That article and an explanation of the statistical model used is here. To be clear, “direct” deaths under the model are caused by the Israeli military; “indirect” deaths are caused by a lack of access to food, water, and medical care (all largely denied by Israel to Gaza) and by disease.

The Lancet found that on average, 732 people died every day from “direct” and “indirect” causes since Israel started attacking Gaza.

There were 469 days between 8 October 2023 and 18 January 2025 when a temporary ceasefire was implemented and there was relative quiet in the territory. There were 125 days between the collapse of the ceasefire – on 18 March – and yesterday, 21 July 2025. This amounts to 594 total days of killing.

Based on The Lancet’s data, if 732 people died every day for the 594 days of conflict, then the true Gaza death toll is now more than 434,800. The calculation — which for various reasons might underestimate the actual death toll — is laid out below...

https://stevendonziger.substack.com/p/shock-israel-has-killed-207-of-gazas

Not sure if you're in denial or just a zio