The true global death toll from covid-19 may be three times higher than official numbers show, according to a report out Friday. The peer-reviewed study estimates that over 18 million people have died due to the pandemic, based on excess death data.
Just this week, the world officially surpassed 6 million covid-19 deaths since the emergence of the SARS-CoV-2 coronavirus in late 2019. But it’s been clear from the very beginning that many more people have died from covid-19 than these numbers would suggest. To better understand the costs of the pandemic, researchers have turned to excess death data, which relies on comparing mortality records during a specific time period against the average baseline seen in recent past years. Many studies and organizations have estimated the excess mortality of individual countries, including the U.S., throughout the pandemic. But the authors of this latest report, published in the Lancet on Friday, say theirs is the first peer-reviewed study to try gauging it on a global scale.
As of December 31, 2021, they estimate that there have been 18.2 million excess deaths attributable to the pandemic—substantially more than the 5.9 million official deaths recorded at the time. But not every country was hit equally hard.
India alone saw more than 4 million deaths, the study found, with a large share coming from the horrific peak of the Delta variant last year. The U.S. saw over a million deaths as well, as did Russia. Mexico (798,000 deaths), Brazil (792,000 deaths), and Indonesia (736,000 deaths) were the next three highest. By contrast, only a few countries, such as Iceland, Australia, and Singapore, saw fewer deaths than expected during the pandemic.
While the U.S. deserves plenty of criticism for its handling of the pandemic, the excess death data suggests that covid-19 has been deadlier elsewhere. The highest death rates were seen in parts of Latin America, as well as Central Europe and Southern sub-Saharan Africa, though similar rates were seen in some Southern U.S. states as well. In many of these countries, there appears to have been a dramatic underestimate of covid-19 deaths. Much of this undercount is likely due to poor record-keeping, but some experts have speculated that at least some governments have deliberately tried to underplay the pandemic’s toll.
“Our estimates of COVID-19 excess mortality suggest the mortality impact from the COVID-19 pandemic has been more devastating than the situation documented by official statistics,” the study authors wrote. The international research team included collaborators from the Institute for Health Metrics and Evaluation researchers in Seattle, Washington, the University of Oxford in the UK, the University of Sao Paulo in Brazil, and many other institutions around the world.
Data from countries including Sweden has suggested that the large majority of these excess deaths can be directly attributed to infection from the coronavirus, according to the researchers. But at least some deaths may be due to trends indirectly set in motion by the pandemic, such as fatal heart attacks that wouldn’t have occurred if people had visited a doctor as regularly as they did before the pandemic. At the same time, survivors of severe covid-19 are thought to be at higher risk of dying from conditions like heart disease up to a year later than others, adding more complexity to the issue.
However, relatively few countries have so far released the kind of mortality data that would allow scientists to start untangling the direct and indirect toll of covid-19, the study authors say. So it’s likely to be a long time before we can get a full picture of the destruction caused by this still ongoing disaster.
“Further research and increased availability of cause of death data will be crucial for distinguishing the proportion of excess mortality that was directly caused by SARS-CoV-2 infection,” the researchers wrote.