Estimate excess mortality from the COVID-19 pandemic, in 191 countries and territories, including 31 locations in low-income and middle-income countries, 12 states in India from Jan 1, 2020, to Dec 31, 2021
Estimate excess mortality from the COVID-19 pandemic, in 191 countries and territories, including 31 locations in low-income and middle-income countries, 12 states in India.
Methods
- Data collected for pandemic period and past 11 years
- All-cause mortality reports
- Excess mortality over time was calculated as observed mortality minus expected mortality
- Excess mortality = observed mortality -expected mortality
- Accounting for late registration,
Six models were used to estimate expected mortality (statistical model for low data areas)
Findings, as measured by excess mortality
Reported worldwide COVID-19 deaths = 5·94 million,
We estimate 18·2 million (17·1–19·6 million)
Global all-age rate of excess mortality due to the pandemic, 120·3 deaths per 100 000 of the population
Excess mortality rate exceeded 300 deaths per 100 000 of the population in 21 countries
Cumulative excess deaths due to COVID-19
- India, 4·07 million
- USA, 1·13 million
- Russia, 1·07 million
- Mexico, 798, 000
- Brazil, 792, 000
- Indonesia, 736, 000
- Pakistan, 664, 000
- Bangladesh, 413, 000
- Peru, 349, 000
- South Africa, 302, 000
- Iran, 274, 000
- Egypt, 265, 000
- Italy, 259, 000
- Australia , 18,100
- NZ, 827
- Canada, 43,700
- UK, 169,000
Excess mortality highest
- Russia, 374·6 deaths per 100 000
- Mexico, 433.6 per 100 000
- Brazil, 186·9 per 100 000
- USA, 179·3 per 100 000
- UK, 126.8 per 100 000
- Canada, 60.5 per 100 000
- Australia, 32.9 per 100 000
- NZ, 9.3 per 100 000
Ratio of excess mortality rate to reported COVID-19 mortality
A measurement of undercounting the true mortality impact of the pandemic
In high-income North America, the ratios were comparatively low
- Morocco, 10
- Egypt, 12·19
- Sudan, 25·12
- Afghanistan, 26·06
- Yemen, 33·04
- Canada, 1.44
- US, 1.37
- UK, 0.97
Interpretation
The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone.
Further research is warranted to distinguish excess mortality that was directly caused by SARS-CoV-2 infection,
and the changes in causes of death as an indirect consequence of the pandemic.