If you think the reported worldwide death toll from the pandemic is already too high, new research suggests the number of excess deaths may be triple that of official estimates.
The official COVID-19 death toll between Jan. 1, 2020, and Dec. 31, 2021, was 5.9 million. However, the new analysis estimates that more than three times the number of excess deaths -- 18.2 million -- may have occurred over the same period.
Excess deaths are the difference between the number of recorded deaths from all causes and the number expected based on past trends, and they are a key measure of the true death toll of the pandemic.
By region, South Asia had the highest number of excess deaths (5.3 million), followed by North Africa and the Middle East (1.7 million), and Eastern Europe (1.4 million), according to the report.
By country, the highest number of excess deaths occurred in India (4.1 million), the United States (1.1 million), Russia (1.1 million), Mexico (798,000), Brazil (792,000), Indonesia (736,000) and Pakistan (664,000). These seven countries accounted for more than half of worldwide excess deaths during the 24-month study period.
The excess death rate was 120 deaths per 100,000 population globally, but 21 countries had rates of more than 300 excess deaths per 100,000 population, the findings showed.
The highest rates were in Andean Latin America (512 deaths per 100,000 population), Eastern Europe (345 deaths per 100,000), Central Europe (316 deaths per 100,000) and southern sub-Saharan Africa (309 deaths per 100,000).
Several locations outside these regions had similarly high rates, including Lebanon, Armenia, Tunisia, Libya, several regions in Italy, and several states in the southern United States.
The findings from the first peer-reviewed estimates of excess deaths during the pandemic were published March 10 in The Lancet.
The large spread between excess deaths and official records may be a result of underdiagnosis of COVID-19 due to lack of testing and issues with reporting death data, the researchers noted.
Further research is needed to understand the proportion of excess deaths directly caused by COVID-19 and those caused by indirect effects of the pandemic, including the impact on health care services, deaths from other diseases, and wider economic consequences.
"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," study author Haidong Wang, of the University of Washington's Institute for Health Metrics and Evaluation, in Seattle, said in a journal news release.
The World Health Organization has more on COVID-19.
SOURCE: The Lancet, news release, March 10, 2022