SEATTLE, Wash. — The number of deaths worldwide from the COVID-19 pandemic may be three times higher than official records suggest, a new study reveals. The official COVID-19 death toll stood at 5.9 million at the end of 2021, but researchers estimate the true number may be around 18.2 million deaths.
“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,” says Dr. Haidong Wang, a researcher at the University of Washington’s Institute for Health Metrics and Evaluation, in a media release.
The team calculated excess deaths, or the difference between the number of recorded deaths from all causes and the number expected based on past trends. While other scientists have attempted to calculate the excess mortality rate from COVID-19, they limited most of these studies to specific countries or regions.
The new study took weekly and monthly data on COVID-19 deaths from 74 countries and 266 states and provinces between Jan. 1, 2020, and Dec. 31, 2021 to arrive at this staggering new toll. Researchers used models to estimate excess mortality from the COVID-19 pandemic, including in locations where death data was not available.
The analysis calculated 18.2 million deaths, which is three times higher than the official death toll through 2021. For every 100,000 people, there were about 120 deaths from COVID-19 infection. However, the researchers estimate 21 countries had over 300 excess deaths per 100,000 residents.
Where is the hidden toll of COVID the highest?
The Andean region of Latin America — Bolivia, Colombia, Ecuador, Peru, and Venezuela — had the highest estimated excess death rates, with 512 deaths per 100,000 people. Eastern Europe followed as a close second, with 345 deaths per every 100,000 people. Other regions with high rates of excess deaths included Lebanon, Armenia, Tunisia, Libya, several regions in Italy, and several states in the southern United States.
Interestingly, some countries, such as Iceland, Australia, and Singapore, had fewer deaths than expected. For example, Singapore had 16 fewer deaths per every 100,000 people.
In total, South Asia had the highest number of estimated excess deaths from COVID-19, followed by North Africa and the Middle East. At the national level, the highest number of estimated excess deaths were in India, the United States, and Russia. These three, along with four other countries — Mexico, Brazil. Indonesia, and Pakistan — make up more than half the number of global excess deaths during the pandemic, study authors conclude.
The researchers suggest the differences between the estimated excess deaths and official records could come from difficulties with reporting COVID-19 data and lack of testing.
The study is published in the journal The Lancet.