Globally, official records as of the end of 2021 show that 6 million people have died directly due to Covid-19. But researchers estimate in a new study that from the start of 2020 to the end of 2021, there were at least 18 million more deaths than researchers normally expect within two years.
Some of this excess mortality may have been missed in official counts due to a lack of diagnostic or reporting resources. But some of them may be related to other indirect effects of the pandemic, such as lack of access to health care, changes in behavior during quarantine, or economic shocks. There is not enough data to determine the cause of death.
Excess deaths are a “much more accurate indicator of the true impact of the pandemic” precisely because of known problems with underreporting direct deaths from Covid-19 and because of the deadly indirect effects of the pandemic, said Haidong Wang, a demographer at the Institute for Health Metrics and Evaluation. University of Washington.
The Wang-led researchers analyzed all-cause mortality in 187 countries, using weekly or monthly reporting data where available, and building models to estimate other countries. Their study was published Thursday in The Lancet.
They found that seven countries accounted for more than half of all excess deaths in the past two years: India, the US, Russia, Mexico, Brazil, Indonesia and Pakistan. There have been over 4 million excess deaths in India alone and over 1.1 million in the United States.
For every 1,000 people in the world, the pandemic has resulted in more than one excess death within two years, according to the study.
The World Health Organization also advocates the importance of understanding the wider mortality associated with Covid. In February 2021, an advisory group was formed in collaboration with the United Nations Department of Economic and Social Affairs to look into this topic.
“Gaps in quality, timely and disaggregated data are a major challenge for global health,” WHO Director-General Tedros Adhanom Ghebreyesus said at the first meeting of the group. “Covid-19 has created an unprecedented demand for this data. While we are all familiar with the daily death toll, the overall death toll is probably much higher.”
The information page for the advisory group promotes the importance of understanding this data as soon as possible, not later, in order to develop a fair response.
“Deaths directly related to COVID-19 provide only a narrow perspective on the wide spectrum of harm caused by the pandemic. The collateral damage from COVID-19 is much broader,” the group’s website said in a statement. “It’s important to quantify this now as it can inform the choices governments need to make regarding prioritization between conventional and emergency health care systems.”
Understanding excess mortality is also critical to future estimates of world population and pandemic preparedness. But a recent WHO health information systems assessment found that parts of Africa account for only 10% of all deaths.
Excess death rates over the past two years of the Covid-19 pandemic varied widely across countries and regions, according to a new study.
Bolivia, Bulgaria and Eswatini had the highest estimated excess death rates, each with over six excess deaths for every 1,000 people. Excess mortality rates were also particularly high in the respective regions: the Andes of Latin America, Eastern and Central Europe and southern sub-Saharan Africa.
But five countries reported fewer deaths in 2020 and 2021 than previous trends had predicted: Iceland, Australia, Singapore, New Zealand and Taiwan.
The cause of death needs further investigation, Wang said, but the hypothesis is that the strict lockdown policies in these countries have resulted in fewer deaths from external factors such as traffic accidents. Wearing masks and social distancing have also led to a decline in influenza deaths in many countries.
“It’s the impact of mediation policies or intervention strategies on all-cause mortality,” he said.
Excess deaths due to the Covid-19 pandemic vary greatly across the United States, according to the study. It was estimated that per capita in Mississippi it was almost twice as high as, for example, in the country as a whole, but only half as low in Washington State.
“Some of the excess deaths in Texas are the result of a power outage last year. And there are always deaths due to natural disasters,” said Bob Anderson, chief mortality statistician at the US Centers for Disease Control and Prevention, who was not involved in the study. new research.
“To some extent, the quality of the reports will depend on the resources available for things like post-mortem testing. Jurisdictions that have medical examiner’s offices that have the resources to investigate a death will tend to do better than your local elected coroner.”