COVID’s Death Toll 3 Times Worse Than Official Counts

The global COVID-19 death toll may be three times higher than official tallies suggest, according to a systematic analysis of excess mortality during the pandemic.

From Jan. 1, 2020 to Dec. 31, 2021, global deaths directly attributed to COVID-19 reached 5.9 million, yet estimates put excess deaths during this period at a staggering 18.2 million (95% uncertainty interval [UI] 17.9-19.6), Haidong Wang, PhD, of the University of Washington in Seattle, and the COVID-19 Excess Mortality Collaborators reported in The Lancet.

India had the highest number of excess deaths (4.07 million, 95% UI 3.71-4.36), an estimated eight times higher than its 489,000 reported COVID-19 deaths, which was followed by the U.S. (1.13 million, 95% UI 1.08-1.18), where the official count reached 824,000 by the end of 2021.

The excess mortality rate in the U.S. (179.3 per 100,000) was about on par with Brazil (186.9 per 100,000), the study found.

“Understanding the true death toll from the pandemic is vital for effective public health decision-making,” Wang said in a statement. “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.”

The researchers undertook a massive effort, deriving models by using all-cause mortality reports for 74 countries and territories and 266 “subnational locations,” which included 31 locations in low and middle-income countries. These locations reported all-cause death from 2020-2021, and up to 11 years prior. They also obtained excess mortality reports for 12 states in India.