There have been more than 18 million global excess deaths due to the COVID-19 pandemic, according to the first peer-reviewed estimate, published today.
The figure, up to 31 December 2021, is more than three times bigger than official COVID-19 deaths, according to an analysis in The Lancet.
The official COVID-19 death toll was 5.9 million between January 1, 2020, and December 31, 2021, while this new study estimates 18.2 million excess deaths occurred over the same period, suggesting the full impact of the pandemic has been far greater.
This first peer-reviewed estimates of excess deaths due to the pandemic globally examined 191 countries and territories, and 252 subnational locations such as states and provinces, between January 1, 2020, and December 31, 2021.
Researchers obtained weekly or monthly data on deaths from all causes in 2021, 2020, and up to 11 prior years for 74 countries and 266 states and provinces through searches of government websites, the World Mortality Database, Human Mortality Database, and European Statistical Office.
The data were used in models to estimate excess mortality due to the pandemic, including for locations with no weekly or monthly reporting of death data.
The analysis the excess death rate is estimated to be 120 deaths per 100,000 population globally, while 21 countries were estimated to have rates of more than 300 excess deaths per 100,000 population.
The highest estimated excess death rates were in Andean Latin America, with 512 deaths per 100,000 population; Eastern Europe, with 345 deaths per 100,000; Central Europe, with 316 deaths per 100,000; Southern sub-Saharan Africa, where there were 309 deaths per 100,000; and Central Latin America, which recorded 274 deaths per 100,000.
Some countries were estimated to have had fewer deaths than expected based on mortality trends in prior years, including Iceland, at 48 fewer deaths per 100,000; Australia, which recorded 38 fewer deaths per 100,000; and Singapore, with 16 fewer deaths per 100,000.
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.”
The authors acknowledge some limitations to their study, including that a statistical model was used to predict excess deaths for countries that did not report weekly or monthly data on deaths from all causes.
Wang H, Paulson KR, Pease SA et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21. Lancet 11 March 2022
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