SEATTLE, WASHINGTON: The first peer-reviewed global estimates of excess deaths indicate 18.2 million people may have died because of the Covid-19 pandemic by December 31, 2021.
While the official death toll due to the pandemic was 5.9 million between January 1, 2020, and December 31, 2021, the new study estimates 18.2 million excess deaths occurred over the same period, suggesting the full impact of the pandemic may have been far greater.
Excess deaths – the difference between the number of recorded deaths from all causes and the number expected based on past trends – are a key measure of the true death toll of the pandemic. While there have been several attempts to estimate excess mortality from Covid-19, most have been limited in geographical scope by the availability of data, said the study published in the Lancet.
The large differences between excess deaths and official records may be a result of under-diagnosis due to lack of testing and issues with reporting death data, the authors of the study said.
The new study provides the first peer-reviewed estimates of excess deaths due to the pandemic globally and for 191 countries and territories (and 252 subnational locations such as states and provinces).
With 5.3 million excess deaths, South Asia had the highest number of estimated excess deaths from Covid-19, followed by North Africa and the Middle East (1.7 million) and Eastern Europe (1.4 million).
At the country level, the highest number of estimated excess deaths occurred in India (4.1 million), the USA (1.1 million), Russia (1.1 million), Mexico (798,000), Brazil (792,000), Indonesia (736,000), and Pakistan (664,000).
These seven countries may have accounted for more than half of global excess deaths caused by the pandemic over the 24-month period. Among these countries, the excess deaths rates were highest in Russia (375 deaths per 100,000) and Mexico (325 deaths per 100,000), and were similar in Brazil (187 deaths per 100,000) and the USA (179 deaths per 100,000).
Because of its large population, India alone accounted for an estimated 22% of the global total deaths.
Lead author Dr Haidong Wang, of the Institute for Health Metrics and Evaluation, USA, said: “Understanding the true death toll from the pandemic is vital for effective public health decision-making. Studies from several countries including Sweden and the Netherlands, suggest Covid-19 was the direct cause of most excess deaths, but we currently don’t have enough evidence for most locations. Further research will help to reveal how many deaths were caused directly by Covid-19, and how many occurred as an indirect result of the pandemic.”