Over the weekend, the world hit another depressing milestone: Over 5 million official deaths attributed to the covid-19 pandemic. As devastating as that number may seem, though, the actual death toll is almost certainly two to four times higher. Not to mention, the suffering caused by the pandemic runs far deeper than a simple count of the dead can convey.
As of the morning of Monday, November 1, according to the pandemic tracker established by Johns Hopkins University, there have been 5,001,991 covid-19 deaths recorded worldwide. Among all countries, the United States leads with over 745,000 deaths. Several other countries, including Brazil, Hungary, and Peru, have a higher death rate, though the U.S. is still near the top there.
Since the very beginning of the pandemic last year, however, experts have warned that any ongoing count of the death toll is going to fall short. Especially early on, doctors may have been unfamiliar with the characteristics of a fatal covid-19 case, leading to misattribution of a person’s cause of death. And even now, countries or areas with fewer resources are less able to devote the time needed (including testing) to properly determine potential pandemic deaths, particularly if victims died at home. Some countries, often with authoritarian governments, have been accused of outright manipulating their numbers in an effort to downplay the impact of the pandemic.
It will take years before a full accounting of the pandemic can be made. But we can already get a rough sense of the pandemic’s deadliness by turning to a country’s excess deaths—total deaths reported over a period of time that are above the average baseline of mortality seen in recent years. This isn’t a perfect system. Some excess deaths will be caused by the indirect effects of the pandemic, not by covid-19 directly, and it’s possible some causes of death may have declined during the pandemic due to social distancing, such as the seasonal flu last winter, skewing the math further. But it’s still a better barometer for the pandemic than any official count.
A running tally by the Economist, updated as of today, now estimates that somewhere between 10 million to 19 million people worldwide have died from covid-19, based on excess death data. Another estimate by the Institute for Health Metrics and Evaluation pegs the current toll at 12 million. The IHME also estimates that the U.S. has lost over 850,000 people to covid-19, though another estimate out today by researchers from the World Mortality project concludes that Russia has now become the country with the highest death toll, at over 872,000 excess deaths (India may have both countries beat, though, according to one estimate). These numbers would not only make covid-19 the single deadliest infectious disease over the past two years but at least the top third leading cause of death overall.
Deaths alone aren’t the only impact of the pandemic either. Millions of people have been hospitalized, and many leave with lingering, possibly lifelong complications as a result. Both hospitalized and non-hospitalized patients have reported chronic and often debilitating symptoms in the wake of their infection, which has become known as long covid. And while young people are less likely to be harmed directly by covid-19, over a million children worldwide have lost parents or caretakers, including over 100,000 in the United States. Public health campaigns against AIDS, malaria, tuberculosis, and other major threats have been set back, leading to more suffering and deaths there as well. All of this is horrifying, and at least some of it was preventable, even before the advent of vaccines this year that are highly effective against death and hospitalization from covid-19.
For many but not all countries, the pandemic has begun to recede, and for those with high vaccination rates, the worst may truly be over. But only half of the world’s population has gotten a single vaccine dose, including just 3.6% of people in the poorest countries—a deliberate choice by vaccine makers, aided by countries like the U.S., to hoard their supply and knowledge. So long as these areas remain vulnerable, the pandemic will have the opportunity to continue its devastation.