A new study suggests the Covid-19 pandemic may have claimed 18.2 million lives worldwide, more than three times the official death toll.
According to an analysis by a consortium of health researchers published in the Lancet, the higher figure is a more accurate estimate of the true global toll at the end of 2021.
They based their calculations on the number of “excess deaths” that they believed were directly or indirectly caused by the pandemic. They are calculated by looking at the difference between the number of deaths reported from all causes and the number of deaths expected based on previous models.
“Our estimates of excess mortality from Covid-19 indicate that the impact of the Covid-19 pandemic on mortality was more devastating than the situation documented by official statistics,” said the co-authors, led by Dr. Haidong Wang, assistant professor of health science at the University of Washington.
“Official statistics on reported deaths from Covid-19 provide only a partial picture of the true burden of mortality. While the official death toll from Covid-19 between January 1, 2020 and December 31, 2021 was 5.9 million, a new study estimates that there were 18.2 million additional deaths during the same period, suggesting that the total impact could have been greater.”
The study is based on what Wang and his collaborators say are the first peer-reviewed estimates of excess mortality due to the pandemic in 191 countries and territories.
Previous studies in Sweden and the Netherlands have shown that Covid-19 is directly responsible for most of the excess deaths found there.
If their estimate is correct, then “the global excess death rate for all ages due to the Covid-19 pandemic was 120.2 deaths per 100,000 population and [the] excess mortality exceeded 300 deaths per 100,000 population in 21 countries.”
Globally, South Asia (5.3 million), North Africa and the Middle East (1.7 million) and Eastern Europe (1.4 million) have the highest number of excess deaths.
In absolute terms, India had more excess deaths due to Covid-19 than anywhere else, at 4.07 million, according to the data. They are followed by the US (1.13 million), Russia (1.07 million), Mexico (798,000), Brazil (792,000), Indonesia (736,000) and Pakistan (664,000).
For the UK, the estimated excess deaths from Covid (between 163,000 and 174,000) in the report were close to the reported figure of 173,000.
The five highest rates of excess deaths per 100,000 people were in Bolivia (734.9), Bulgaria (647.3), Eswatini (634.9), North Macedonia (583.6) and Lesotho (562.9).
The authors say differences between official Covid-related deaths and researchers’ estimates could be due to a lack of testing, problems reporting such deaths, or inability to access healthcare because services have been disrupted by the pandemic. This gap is largest in South Asia and sub-Saharan Africa.
They developed a statistical model to measure excess deaths in countries where all-cause mortality data were not available, allowing them to come up with a figure of 18.2 million deaths. They also excluded weeks that had heatwaves so as not to skew the numbers.
“The key finding of our study is that the overall impact of the pandemic on mortality far exceeds the reported number of Covid-19 deaths,” Wang said. “Our analysis would not have been possible without the weekly/monthly live data on weekly/monthly all-cause mortality from so many countries. These data are critical for assessing disease burden and population health in any country.”
Overcoming “political barriers to accurate [death] reporting is needed in countries where they exist to track the true death toll from future pandemics, the Lancet paper argues.
“However, in many countries there is still no functioning vital [deaths] registration system. What happened during the pandemic demonstrated the need for civil registration and vital registration systems, as well as a disease surveillance system.”